Stress Management Among Latinos with Type 2 Diabetes

描述(由申请人提供)：本研究的目的是评估哈特福德医院对患有2型糖尿病(T2D)的拉丁裔患者进行的减压干预对以下方面的影响：a)糖化血红蛋白水平，以及b)通过血糖传感器和自动交互式语音反应系统(IVR)测量的应激反应性。为了获得200名研究完成者，将从‘Amigos en Salud’诊所招募250名患有T2D的拉美人。他们将被随机分配到：a)接受3次社区卫生工作者(CHW)领导的营养教育小组会议的对照组，或b)干预组，除接受由受过培训的CHW提供的8次压力管理干预外，还将接受8次会议的压力管理干预。干预措施将在西班牙裔健康理事会以小组形式进行(每个小组12名成员)。干预的主要结果将是在基线、干预后(登记后9周)和6个月时测量HbA1c。次要结果将是通过IVR系统测量压力反应，该系统涉及插入新陈代谢传感器，参与者将携带3天，以及通过自动语音系统每天报告同一时间段和S注册后6个月期间的压力相关事件和应对方式。一次抽样(n=75)将参与在干预前/后进行的IVR和代谢传感器测量。所有研究参与者都将在家里接受基于电子平板的调查，以评估心理健康、营养以及基本的社会经济和人口统计参数。一名社区抽血员将在同一时间在参与者家中采集血样。从这项随机试验中获得的知识可能会导致CHW领导的一种高度创新的方法来改善生活在非常紧张的社会经济环境中的T2D患者的生活质量。 公共卫生相关性：目前还没有已发表的关于压力管理对患有2型糖尿病(T2D)的拉美裔人代谢控制影响的研究。从这项随机试验中获得的知识可能会导致一种高度创新的社区卫生工作者领导的方法来改善生活在非常紧张的社会经济环境中的T2D患者的生活质量。

DESCRIPTION (provided by applicant): The objectives of this study are to assess the impact of a stress reduction intervention among Latinos with Type 2 Diabetes (T2D) served by Hartford Hospital on: a) HbA1c levels, and b) stress reactivity measured through a blood glucose sensor and an automated Interactive Voice Response System (IVR). To obtain 200 study completers, 250 Latinos with T2D will be recruited from the 'Amigos en Salud' clinic. They will be randomly assigned to either: a) the control group that will receive 3 community health worker (CHW) led nutrition educational group sessions, or b) the intervention group that in addition will receive an 8-session stress management intervention delivered by a trained CHW. Intervention will be delivered at the Hispanic Health Council in a group format (12 members per group). The primary outcome of the intervention will be HbA1c measured at baseline, post-intervention (9 weeks post-enrollment) and 6 months. The secondary outcome will be stress reactivity measured through an IVR system that involves inserting a metabolic sensor that participants will carry for 3 days as well as daily reporting, via an automated voice system, of stress related events and coping during the same period of time and 6 month s post-enrollment. A subsample (n=75) will participate in the IVR and metabolic sensor measurements conducted pre/post intervention. All study participants will be applied an e-tablet based survey in their homes to assess mental health, nutrition and basic socio-economic and demographic parameters. Blood samples will be collected by a community phlebotomist in the participants' homes at the same time points. Knowledge gained from this randomized trial could lead to a highly innovative CHW led approach to improving the quality of life among individuals with T2D living in very stressful socio-economic environments. PUBLIC HEALTH RELEVANCE: There are no published studies examining the impact of stress management on metabolic control among Latinos with type 2 diabetes (T2D). Knowledge gained from this randomized trial could lead to a highly innovative community health worker led approach to improving the quality of life among individuals with T2D living under very stressful socio-economic environments.