Exploring the REACHOUT Mental Health Support App for Type 1 Diabetes From the Perspectives of Recipients and Providers of Peer Support: Qualitative Study

Background: Existing qualitative research in peer support interventions has largely focused on the recipients of support rather than those delivering support. Exploring the perspectives of both roles may provide a holistic understanding of the peer support experience. Objective: This study elicits the experiences of recipients and providers of support who participated in REACHOUT, a 6-month peer-led mental health support intervention delivered via mobile app for adults with type 1 diabetes. REACHOUT offered multiple support delivery modalities (one-on-one, group-based texting, and virtual face-to-face small group sessions) that could be customized by recipients. Methods: A total of 32 study participants (recipients and peer supporters) attended focus group discussions following the completion of REACHOUT. Thematic analysis was performed in an inductive approach. Results: Four major themes were identified by thematic analysis: (1) need for a sense of community and belonging, (2) factors to enhance the recipient-peer supporter experience, (3) key aspects of the peer supporter experience, and (4) importance of personalizing the user experience while using the REACHOUT mobile app. REACHOUT successfully fostered connectedness by bringing together adults with type 1 diabetes who previously felt isolated. Recipients felt greater agency when given the opportunity to self-select a peer supporter. The main factors considered during the matching process included insulin delivery and glucose monitoring systems, duration of diabetes, shared hobbies, life stage, and age. While support was designed to be unidirectional from peer supporter to recipient, the former also derived benefits. Peer supporters expressed the need for greater guidance around navigating boundaries and responding to emotionally charged conversations. Finally, the REACHOUT app was able to accommodate a heterogeneity of support needs by offering one-on-one and group support across multiple communication platforms including text, audio, and video. Conclusions: The success of peer-led mental health support interventions such as REACHOUT is likely associated with the recipient-peer supporter dynamic. By offering a range of support delivery and communication modalities, participants can better personalize solutions to meet their unique support needs. Understanding the perspectives of both recipients and peer supporters is essential to refining interventions and optimizing digitally delivered mental health support models.