Introduction and Objective: Engagement is a critical determinant of intervention effectiveness. Our study compares engagement factors between two intervention modalities: in-person and telehealth for a group-based intervention aimed at reducing diabetes distress in teens with T1D: Supporting Teen Problem-Solving (STePS). Methods: Youth (n=125; ages 14-18; T1D for ≥1 year) from six academic health centers were randomized: 44 to STePS In-Person, 44 to Telehealth, and 37 to control. Analyses included youth who attended ≥1 STePS session (n=54). Group-level session engagement (1=no engagement, 4=excellent), was rated by interventionists, and the proportion of sessions rated “excellent” were compared by modality. Attendance was assessed as total sessions attended (1-9). Engagement levels and attendance outcomes were examined via t-tests and chi-square analyses. Results: Mean engagement did not differ between in-person and telemedicine delivery (M = 3.53 vs. 3.48; p = 0.101), indicating high engagement in both formats. A greater proportion of in-person sessions were rated “excellent” compared with telemedicine sessions (72.3% vs 54.5%; x2(1) = 6.17, p = 0.013). Mean attendance was similar across modalities (M = 5.76 vs 6.30; p = 0.241), as was the proportion of participants attending ≥7 sessions (52.4% vs 60.6%; x2 (1) = 0.355, p = 0.551). Conclusion: Telemedicine delivery of STePS demonstrated both engagement and attendance levels comparable to in-person delivery, supporting both intervention modalities. In-person delivery was more likely to achieve the highest level of engagement, suggesting unique benefits of face-to-face delivery. Future studies should further examine mechanisms that drive peak engagement in an in-person setting while addressing practical barriers such as transportation and time demands. Strategies to improve engagement in telehealth sessions should also be explored, as telehealth is generally a more scalable modality. Disclosure S. Powers: None. J. Ellis: None. S.A. Helseth: None. G.V. Memba: None. R. Urena: None. A. Grimmett: None. M. Bennett: None. C. Sayegh: None. M.L. Boeh: None. T. Drossos: None. J. Pierce: None. M. Feldman: None. E. O'Donnell: Consultant; Current; Eddii Inc. J. Raymond: None. M.A. Harris: None. C. Dunne: None. J. Weissberg-Benchell: Consultant; Ended; Sanofi. Funding American Diabetes Association (9-23-ICTSBMH-11), Breakthrough T1D (5-SRA-2024-1579-M-B)
POWERS et al. (Fri,) studied this question.