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 在哈特福德医院服务的2型糖尿病（T2 D）拉丁美洲人中：a）HbA 1c 水平，和B）通过血糖传感器测量的应激反应性， 自动交互式语音应答系统（IVR）。为了获得200名研究完成者， 将从“健康之友”诊所招募250名患有T2 D的拉丁美洲人。他们将 随机分配到：a）对照组，将接受3个社区健康 工作人员（CHW）领导的营养教育小组会议，或B）干预组， 此外，还将接受由一名 训练CHW干预措施将在西班牙裔卫生理事会以小组形式进行 格式（每组12名成员）。干预的主要结局将是HbA 1c 在基线、干预后（入组后9周）和6个月时测量。的 次要结果是通过IVR系统测量的应激反应， 包括插入一个代谢传感器，参与者将携带3天， 通过自动语音系统每日报告与压力相关的事件和应对措施 在同一时间段和入组后6个月内。子样本（n=75）将 参与治疗前/治疗后进行的IVR和代谢探头测量 干预所有研究参与者将在家中接受基于电子平板电脑的调查 评估心理健康、营养和基本的社会经济和人口 参数血液样本将由社区采血师在 在同一时间点的参与者家中。从随机化的 试验可能会导致一个高度创新的CHW领导的方法，以改善生活质量 生活在非常紧张的社会经济环境中的T2 D患者。

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.