1051-OR: Differences in Glycemic and Psychosocial Gains: Effects of the HAPPY-T1D Intervention

Introduction and Objective: Adolescents and young adults (AYA) with T1D have challenges achieving target glycemic control and frequently experience diabetes distress. The Healthy And Positive Pathways for Young People with Type 1 Diabetes (HAPPY-T1D) intervention demonstrated positive effects for AYAs. The intervention included virtually delivered monthly sessions that targeted glycemic improvement and distress reduction. This analysis explored moderating effects to assess differential intervention gains. Methods: AYAs ages 14-25 years at two centers enrolled in an RCT comparing HAPPY-T1D to usual care over 12 months. Regressions tested interaction effects between condition and baseline percent time-above-range (250, TAR) on 12-month outcomes, adjusting for age, gender, and baseline levels of the assessed outcomes. Significant interactions were probed at high baseline TAR (one SD above mean) and low baseline TAR (one SD below mean). Results: The sample of 191 AYAs (50% female, 78% NHW) had a mean age of 19.8 years (SD=3.41), HbA1c of 8.0% (SD=1.22), and T1D duration of 11.4 years (SD=5.40). Mean TAR at baseline was 25%. Significant moderation showed that the intervention lowered TAR (β=-0.27, p=.004) among AYAs with high baseline TAR. Further, improvements were observed for low baseline TAR on diabetes distress (β=-0.16, p=.043), physical health (β=0.20, p=.014), and mental health (β=0.19, p=.015). Conclusion: The HAPPY-T1D intervention improved both glycemic and psychosocial outcomes. There were stronger glycemic benefits for AYAs with more time in hyperglycemia at baseline, suggesting sessions targeting self-care for glycemic management were critical, especially for those in greatest need of glycemic improvement. Likewise, greater psychosocial benefits were seen in those with less time in hyperglycemia at study entry, suggesting greater receptivity to the psychosocial sessions targeting diabetes distress when AYAs were less challenged by glycemia. Overall, AYAs with T1D will likely benefit from tailored multi-factorial supportive interventions. Disclosure J. Wong: None. A. Adam: None. S. Hanes: None. L.J. Tinsley: None. P. Commissariat: None. L. Volkening: None. L.M. Laffel: Other - Travel support for scientific presentations; Ended; Boehringer Ingelheim International GmbH. Other - DSMB Chair; Ended; Janssen Pharmaceuticals, Inc. Consultant; Current; Dexcom, Inc. Advisory Panel; Current; Medtronic, Sequel, Tandem Diabetes Care, Inc. Consultant; Current; Roche Diabetes Care, Sinocare. Advisory Panel; Ended; Sanofi. Advisory Panel; Current; MannKind Corporation. K. Hood: Consultant; Current; Sanofi, MannKind Corporation, Insulet Corporation. Funding NIH R01DK129479