Intervention
diabetes
DIABETES
Assigned to cohorts of 6-12 participants based on study arm, participants convened in clinical or virtual settings for 8 weekly DMGVs. Each session lasted approximately 120 minutes and started with the completion of an intake form to document acute or chronic symptoms, health system usage, and self-management activities, followed by the measurement of vital signs and the delivery of DSME. Sessions included a one-on-one clinical consult. Study clinicians were 4 board-certified physicians and 2 nurse practitioners. Nonclinical group facilitators received training on core DSME topics and facilitation skills from lead faculty (SEM, PG). All participants received a paper curriculum booklet.Prior to the first virtual DMGV, staff provided laptops and wireless internet to VW participants and conducted IP computer training. All participants then met weekly for 8 weeks, according to a session schedule. During DMGVs, all participants received the same WIC2 curriculum, which was adapted from During each session, a clinician met individually with participants (in a separate physical space or via secure telehealth platform or telephone depending on study group) to review blood glucose readings and hyper or hypo glycemic data, conduct diabetes medication reconciliation, and address concerns. Recommendations for medication adjustments were based on an algorithm [To ensure fidelity of DMGV protocols and standard operating procedures, we used checklists, audits of session recordings, and participant observation field notes.Following the 8-week DMGV sessions, participants entered a 16-week maintenance period. They were encouraged to self-monitor (tracking blood glucose, blood pressure, diet, and exercise) using a paper booklet or mobile app. No formal DMGVs occurred.Illustration of avatars in the virtual world.