Exploring CBT-DM's Absoulte and Relative Efficacy for Depressed T1DM Latino Youth

探索 CBT-DM 对抑郁 T1DM 拉丁裔青年的绝对和相对功效

• 批准号: 8546344
• 负责人: Eduardo Cumba
• 金额: $ 17.87万
• 依托单位: UNIVERSITY OF PUERTO RICO RIO PIEDRAS
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-15 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8546344
• 关键词: Address; Adherence; Administrator; Adolescent; Affect; Affective; Aftercare; Age; Behavior; Behavioral; Blindness; Blood; Blood Glucose; Cessation of life; Child; Childhood; Chronic Disease; Clinical; Cognitive; Cognitive Therapy; Coma; Competence; Complications of Diabetes Mellitus; Data; Depressed mood; Diabetes Mellitus; Diagnosis; Diagnostic; Diet; Early Intervention; Early identification; Early treatment; Employee Strikes; Evidence based intervention; Evidence based treatment; Exercise; Expenditure; Family; Focus Groups; Glycosylated Hemoglobin; Glycosylated hemoglobin A; Goals; Health; Health Personnel; Health Status; Heart Diseases; Hispanics; Hormones; Hyperglycemia; Hypertension; Immune system; Incidence; Injection of therapeutic agent; Insulin; Insulin-Dependent Diabetes Mellitus; Intake; Intervention; Interview; Investigation; Kidney Failure; Knowledge; Laboratories; Latino; Lead; Life; Light; Long-Term Effects; Manuals; Medical; Mental Depression; Mental Health; Metabolic Control; Minority Groups; Monitor; Mood Disorders; Morbidity - disease rate; National Institute of Diabetes and Digestive and Kidney Diseases; Nature; Nerve; Not Hispanic or Latino; Onset of illness; Outcome; Parents; Participant; Patient Self-Report; Pilot Projects; Population; Prevalence; Prevention; Primary Health Care; Procedures; Process; Puerto Rican; Puerto Rico; Quality of life; Randomized; Randomized Clinical Trials; Regimen; Registries; Relative (related person); Research; Risk; Self Care; Self Efficacy; Staging; Structure; Structure of beta Cell of islet; Testing; Time; Training; Treatment Efficacy; Youth; depressive symptoms; design; diabetes education; diabetes management; diabetic; follow-up; glucose monitor; health disparity; improved; innovation; novel; pilot trial; prevent; programs; psychosocial; self esteem; therapy development; tool; treatment adherence; treatment as usual; young adult

DESCRIPTION (provided by applicant): This is an R03 (PAR-09-223) application submitted to NIDDK. This study entails the revision of the 12-session Group Cognitive Behavioral Therapy (CBT-DM) manual for depressed Type 1 Diabetes Mellitus (T1DM) Latino youth, and explores both the absolute efficacy of CBT-DM against a treatment as usual (TAU) condition, and the added impact of CBT-DM over the original culturally-adapted CBT for depression. After initial manual revision by our expert team, in-depth interviews with diabetes treatment providers, and a small pre-pilot study with 8 depressed T1DM Latino youth and their parents will be conducted to inform the revision of and further refine CBT-DM treatment manual. Focus groups with youth and parents in the small pre-pilot study will serve to complete the refinement process. Finally, 60 depressed T1DM youth will be randomized to one of three conditions: CBT-DM, CBT for depression, and TAU. Treatment efficacy will be assessed by comparing changes on depression, self-esteem and functionality scores, diabetes self-efficacy and quality of life, and treatment adherence and self-care management of T1DM. We propose that both CBT-DM and CBT will be superior to TAU in reducing depression, and improving self-esteem and functionality. We also hypothesize that CBT-DM will be superior to the other conditions in domains related to T1DM (diabetes self-efficacy, quality of life, treatment adherence and self-care behaviors). Intake data will be obtained with structured diagnostic interviews, self-report scales and laboratory tests of glycosylated hemoglobin (HbA1c). We will assess youth T1DM health and treatment adherence information, mental health (including depression) diagnostic status, youth cognitive and affective variables, parent and family functioning, and family knowledge about youth depression and T1DM. We will also evaluate the feasibility and acceptability of treatment, the adequacy of randomization, attrition rates, therapist competence and treatment integrity. The assessment will be conducted at baseline, at weeks 5, 9 and 12 (post-treatment), and at the three- and six-month follow-ups. This investigation is the second step in a research program aimed to bring the benefits of evidence-based treatment (EBT) development to Latino youth with comorbid T1DM and depression, and set the stage for a larger-scale and definite study of treatment efficacy (R01). This study is innovative because it is the first that could potentially contribute to provide initial evidence in support of the probably-efficacious status of a psychosocial intervention aimed at both improving diabetes health status and reducing depressive symptoms in youth. The revised CBT-DM manual for T1DM Latino youth would also be an innovative clinical tool that could enhance the prevention of mood disorders and the reduction of health disparities in this minority group.

描述（由申请人提供）：这是提交给 NIDDK 的 R03 (PAR-09-223) 申请。这项研究需要修订针对抑郁症 1 型糖尿病 (T1DM) 拉丁裔青少年的 12 疗程团体认知行为治疗 (CBT-DM) 手册，并探讨 CBT-DM 对照常治疗 (TAU) 状况的绝对疗效，以及 CBT-DM 相对于最初的文化适应 CBT 对抑郁症的额外影响。在我们的专家团队对手册进行初步修订后，将与糖尿病治疗提供者进行深入访谈，并对 8 名抑郁的 T1DM 拉丁裔青少年及其父母进行小型预试点研究，为 CBT-DM 治疗手册的修订和进一步完善提供信息。小型预试点研究中由青少年和家长组成的焦点小组将有助于完成细化过程。最后，60 名抑郁的 T1DM 青少年将被随机分配到以下三种情况之一：CBT-DM、针对抑郁症的 CBT 和 TAU。将通过比较抑郁症、自尊和功能评分、糖尿病自我效能和生活质量以及 T1DM 的治疗依从性和自我护理管理的变化来评估治疗效果。我们认为，CBT-DM 和 CBT 在减少抑郁、提高自尊和功能方面均优于 TAU。我们还假设 CBT-DM 在 T1DM 相关领域（糖尿病自我效能、生活质量、治疗依从性和自我护理行为）优于其他条件。摄入数据将通过结构化诊断访谈、自我报告量表和糖化血红蛋白 (HbA1c) 实验室测试获得。我们将评估青少年 T1DM 健康和治疗依从性信息、心理健康（包括抑郁症）诊断状态、青少年认知和情感变量、父母和家庭功能以及有关青少年抑郁和 T1DM 的家庭知识。我们还将评估治疗的可行性和可接受性、随机化的充分性、流失率、治疗师的能力和治疗的完整性。评估将在基线、第 5、9 和 12 周（治疗后）以及三个月和六个月的随访时进行。这项调查是一项研究计划的第二步，旨在为患有 T1DM 和抑郁症共病的拉丁裔青年带来循证治疗 (EBT) 发展的益处，并为更大规模、明确的治疗效果研究 (R01) 奠定基础。这项研究具有创新性，因为它是第一项可能有助于提供初步证据，以支持旨在改善糖尿病健康状况和减少青少年抑郁症状的心理社会干预措施的可能有效状态的研究。修订后的针对 T1DM 拉丁裔青少年的 CBT-DM 手册也将成为一种创新的临床工具，可以加强对这一少数群体情绪障碍的预防并减少健康差距。

项目成果

Correlates and Predictors of Chronicity among Adolescents Living in Puerto Rico With a History of Depressive Symptoms.

居住在波多黎各有抑郁症状史的青少年慢性病的相关性和预测因素。

• 发表时间: 2021
• 期刊: Revista Puertorriquena de psicologia
• 作者: Cumba-Avilés,Eduardo;Meléndez,MarieliPiñero;Luiggi-Hernández,JoséG;Feliciano-López,Vidalina
• 通讯作者: Feliciano-López,Vidalina

Pilot Validation Study for the Spanish-language CDI-2 among Adolescents from Puerto Rico.

波多黎各青少年西班牙语 CDI-2 试点验证研究。

• 发表时间: 2020
• 期刊: Revista Puertorriquena de psicologia
• 作者: Cumba-Avilés,Eduardo;López-Robledo,YaritzaM;Caro-González,Wildaliz;Rosario-Nieves,Ilia
• 通讯作者: Rosario-Nieves,Ilia

Comorbid Chronic Physical Illnesses in Type 1 Diabetes Adolescents: Personal, Caregiver, and Family Functioning.

1 型糖尿病青少年的共病慢性身体疾病：个人、照顾者和家庭功能。

• 发表时间: 2021
• 期刊: Salud y conducta humana
• 作者: Gómez-Rivera,Demivette;Cumba-Avilés,Eduardo
• 通讯作者: Cumba-Avilés,Eduardo

Systematic Review on the Use of the Children's Depression Inventory-2 among Hispanics.

• DOI: 10.1177/0739986320915170
• 发表时间: 2020-05
• 期刊: Hispanic journal of behavioral sciences
• 影响因子: 1.4
• 作者: Cumba-Avilés E