Adapting a peer mentorship program to improve CGM use among latino youth with type 1 diabetes from families with limited english proficiency

The National Institute for Minority Health and Health Disparities awarded The Nemours Foundation $188,890 on August 16, 2026, under the Minority Health and Health Disparities Research program (CFDA 93.307) to adapt and pilot-test a peer mentorship intervention promoting continuous glucose monitoring use among Latino youth with Type 1 Diabetes from families with limited English proficiency.

The award funds development and testing of "Type 1 Together," an intervention co-developed with English-proficient Black and Latino youth with Type 1 Diabetes and their caregivers. During the first year, the recipient will conduct focus groups with Latino adolescents and caregivers to gather perspectives on the intervention, then work with family research partners to adapt it for families with limited English proficiency. Following adaptation, the recipient will conduct a pilot randomized controlled trial recruiting 20 families during or after endocrinologist clinic visits and randomizing them 1:1 to the adapted Type 1 Together intervention or a three-month waitlist control. The intervention involves monthly meetings with peer mentor families and a community health worker.

The Nemours Foundation, Nemours Biomedical Research — Delaware Division (doing business as Nemours Children's Hospital, Delaware), is the recipient. Work is performed in Wilmington, Delaware. The period of performance runs through January 31, 2028.

Abstract

Limited english proficiency contributes to adverse health outcomes. Latino youth with type 1 diabetes (T1D) tend to have higher glycemic levels than non-latino WHITE (WHITE) youth and are less likely to use continuous glucose monitoring systems (CGM), an advanced diabetes technology that can lower glycemic levels and improve health. Barriers to CGM use exist at family (e.g., skepticism about CGM), provider (e.g., not tailoring education to families), and healthcare system levels (e.g., complex insurance approval process, cost of devices). Due to limitations of our healthcare system (e.g., few bilingual providers), latino families with limited english proficiency may have even more difficulty overcoming these barriers. In our ongoing research, we partnered with english-proficient black and latino youth with T1D and their caregivers to CO-develop type 1 together, an intervention to promote use of CGM. In type 1 together, families meet monthly with peer mentor families and a community health worker. Families of youth with T1D and limited english proficiency report unique challenges to managing T1D, indicating a need for interventions tailored to family beliefs and values and delivered in their preferred language. The objective of this proposal is to adapt and pilot-test type 1 together for latino youth from families with limited english proficiency. During the first year of this proposal, we will conduct focus groups to gather latino adolescent and caregiver perspectives on the intervention and then work with family research partners to adapt the intervention accordingly. Then, we will conduct a pilot randomized controlled trial. Families (N=20) will be recruited during or after endocrinologist clinic visits and randomized (1:1) to the adapted type 1 together or a 3-month waitlist control. Primary outcomes will be intervention acceptability and feasibility, use of CGM, and glycemic levels (i.e., HBA1C, time in range). Findings from the current study will inform future research aimed at testing the efficacy of the intervention in a larger, multisite randomized controlled trial.