Behavioral Activation Enhanced Exercise Intervention for Diabetes and Depression

行为激活增强运动干预对糖尿病和抑郁症的影响

• 批准号: 7708198
• 负责人: Kristin L Schneider
• 金额: $ 24.6万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-12 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7708198
• 关键词: Address; Adherence; Adult; Affect; Antidepressive Agents; Anxiety; Awareness; Behavior; Behavioral; Blood; Blood Pressure; Body Weight; Cognition; Cognitive; Comorbidity; Data; Development; Diabetes Mellitus; Educational Intervention; Emotional; Exercise; Fatigue; Feedback; Frustration; Generic Drugs; Glycosylated Hemoglobin; Glycosylated hemoglobin A; Goals; Health; Individual; Instruction; Intervention; Interview; Lead; Life Style; Major Depressive Disorder; Manuals; Measures; Modality; Moods; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Outcome Measure; Overweight; Participant; Patients; Pharmaceutical Preparations; Phase; Physical activity; Placebo Control; Population; Protocols documentation; Public Health; Quality of life; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Recommendation; Recruitment Activity; Reporting; Resistance; Risk; Sampling; Self Efficacy; Self Management; Structure; Testing; Time; Weight; Woman; Work; base; cardiovascular disorder risk; depression; depressive symptoms; diabetes management; diet and exercise; effective therapy; experience; fitness; glycemic control; improved; interest; meetings; negative mood; novel; pleasure; positive mood; primary outcome; public health relevance; research study; secondary outcome; sedentary; skills; theories; treatment adherence; treatment as usual; waist circumference

DESCRIPTION (provided by applicant): Type 2 diabetes mellitus (T2DM) affects 7.8% of US adults. Women with T2DM are three times more likely to have depression than their counterparts without T2DM. The comorbidity between depression and T2DM is a concern because it is associated with worse glycemic control and poor diabetes self-management. Studies have shown that exercise improves glycemic control among individuals with T2DM and improves depressive symptoms among individuals with major depressive disorder. Exercise might then be a parsimonious treatment approach for women with comorbid T2DM and depression by improving both conditions. One limitation of exercise as an effective treatment modality for T2DM and depression is that patients with this comorbidity report difficulty initiating and maintaining exercise, making them especially resistant to exercise recommendations. Exercise interventions should be theoretically-based and include strategies to address the motivational challenges of this population. We aim to develop and pilot test a novel exercise intervention that is based on principles of behavioral theory and incorporates strategies of behavioral activation treatment for depression (BA). In the developmental phase, BA strategies will be integrated into an exercise class intervention to be led by an exercise instruction professional. A pre-pilot exercise class (n=10) will then be conducted to examine treatment acceptability and feasibility. Once intervention materials are refined, sedentary, overweight women with inadequately controlled T2DM and depression (n=60) will be randomized to either the 24-week BA-enhanced exercise condition or the usual care condition. The primary outcomes will be feasibility (adherence, treatment acceptability, exercise enjoyment) and initial efficacy (depression score and glycosylated hemoglobin) at 3-, 6- and 12-months following randomization. Secondary outcomes measured at baseline, 3-, 6- and 12-months, include physical activity, diet, exercise self-efficacy, fitness, blood pressure, body weight, waist circumference and quality of life. Products of this study include a treatment manual and preliminary data for a larger randomized controlled trial. PUBLIC HEALTH RELEVANCE: Women with type 2 diabetes mellitus (T2DM) are at heightened risk for depression, and the combination of T2DM and depression is associated with worse health outcomes. Exercise has been shown to improve diabetes management as well as depression, but has not been evaluated as a treatment for women with both T2DM and depression. This population is often more sedentary and reports greater barriers to exercise. The proposed work aims to develop a unique exercise intervention that addresses exercise barriers and improves diabetes management and depression in women with T2DM and depression.

描述（由申请人提供）：2型糖尿病（T2DM）影响美国成年人的7.8％。具有T2DM的女性患有抑郁症的可能性是没有T2DM的女性的三倍。抑郁症和T2DM之间的合并症是一个令人关注的问题，因为它与较差的血糖控制和糖尿病自我管理差有关。研究表明，运动可以改善T2DM个体的血糖控制，并改善重度抑郁症患者的抑郁症状。然后，通过改善这两种疾病，运动​​可能是合并症T2DM和抑郁症的女性的一种简约的治疗方法。锻炼作为T2DM和抑郁症的有效治疗方式的一种局限性是，这种合并症的患者报告了难以发起和维持运动的困难，从而使他们特别抵抗运动建议。运动干预措施应基于理论上，并包括应对该人群的动机挑战的策略。我们旨在开发和试点测试一种基于行为理论原则的新型运动干预措施，并结合了抑郁症行为激活治疗策略（BA）。在发展阶段，BA策略将被整合到运动类干预措施中，以由运动指导专业人士领导。然后，将进行小便前运动类（n = 10），以检查治疗可接受性和可行性。一旦干预材料精制，久坐的，超重的T2DM和抑郁症（n = 60）的久坐，超重的女性将被随机分为24周的BA增强运动状况或通常的护理状况。在随机分组后的3 、、6和12个月，主要结果将是可行性（依从性，治疗可接受性，运动享受）和初始功效（抑郁评分和糖基化血红蛋白）。在基线，3，6和12个月时测量的次要结果包括体育锻炼，饮食，运动自我效能，健身，血压，体重，腰围和生活质量。这项研究的产品包括用于更大的随机对照试验的治疗手册和初步数据。 公共卫生相关性：2型糖尿病妇女（T2DM）患有抑郁症的风险增加，T2DM和抑郁症的结合与健康状况较差有关。运动已被证明可以改善糖尿病管理和抑郁症，但尚未被评估为T2DM和抑郁症的女性的治疗方法。这个人群通常更久坐，并报告了更大的运动障碍。拟议的工作旨在开发独特的运动干预措施，以解决运动障碍并改善T2DM和抑郁症女性的糖尿病管理和抑郁症。