Stress Management Among Latinos with Type 2 Diabetes

摘要 本研究的目的是评估减压干预的影响。 在哈特福德医院提供的拉丁裔2型糖尿病(T2D)患者中：A)HbA1c 水平，以及b)通过血糖传感器和 自动交互语音应答系统(IVR)。为了获得200名研究完成者， 250名患有T2D的拉丁裔将从‘Amigos en Salud’诊所招募。他们将会是 随机分配到以下任一组：a)接受3个社区卫生服务的对照组 工人(CHW)领导营养教育小组会议，或b)干预组 此外，将接受为期8个疗程的压力管理干预 训练过的CHW。干预措施将在西班牙裔健康理事会以小组形式进行 格式(每组12名成员)。干预的主要结果将是HbA1c 在基线、干预后(注册后9周)和6个月进行测量。这个 次要结果将是通过IVR系统测量的压力反应性 包括插入一个代谢传感器，参与者将携带3天以及 通过自动语音系统每日报告与压力有关的事件和应对 在同一时间段和6个月后，S入学。子样本(n=75)将 参与IVR和代谢感应器的测量 干预。所有研究参与者都将在家里接受基于电子平板电脑的调查 评估精神健康、营养以及基本的社会经济和人口 参数。血液样本将由一名社区抽血员采集 参与者的家在相同的时间点。从这种随机化中获得的知识 试验可能导致CHW领导的高度创新的方法来提高生活质量 在生活在非常紧张的社会经济环境中的T2D患者中。

Abstract 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.