MOOD/DIABETES SELF-CARE INTERVENTION RESEARCH PROJECT

该项目将是一项针对同时患有抑郁症状和糖尿病的拉丁裔人的干预性研究 将建立在我们出口中心教职员工现有专业知识的基础上。最近，曼乔内博士(联合校长 该项目的调查者)证明了自我护理干预可以改善老年糖尿病患者的预后 拉丁裔。然而，这些年长的拉美裔人中有30%患有抑郁症，干预没有导致 改善这一亚组抑郁症糖尿病患者的糖尿病结局。米兰达博士(联合首席调查员 该项目)已经证明认知行为疗法在治疗抑郁症方面是高效的 最近修改了这种抑郁症干预措施，使其可以由非精神疾病患者给予 健康专业人士。因此，我们的中心处于独特的地位，可以检查这种联合干预， 这将使用随机设计在东北旧金山招募的340名拉丁裔受试者中进行研究 费尔南多山谷和休伯特·汉弗莱综合健康中心。我们假设 将接受这两种干预的干预组将显示出两种糖尿病的显著改善 与对照组相比，抑郁的结果将接受自我管理干预 独自一人。该项目还将为几名出口初级调查人员提供培训机会， 对糖尿病和抑郁症的兴趣和专业知识，使他们能够在最初的工作基础上再接再厉 在曼乔内博士、米兰达博士和其他参与的资深人士的指导下，在这些领域进行表演 教职员工。 该项目的具体目标是： 具体目标1：评估为期12周的情绪治疗对增强自我护理糖尿病的影响 对老年抑郁症拉丁裔糖尿病患者的干预与单独进行自我护理糖尿病干预的比较： 1.a.确定情绪/自我护理联合干预是否导致血红蛋白A1c降低。 与单独的自我护理干预相比，在3个月和6个月时。 1.B.确定情绪/自我护理联合干预是否能降低抑郁 在3个月和6个月时，与单独进行自我护理干预的症状进行比较。 1.C.确定情绪/自理联合干预是否能改善自理能力 在3个月和6个月时，与单独进行自我护理干预的糖尿病患者进行比较。 具体目标2.支持向社会传播我们干预措施的积极结果 通过我们与健康和建筑桥梁见证人的社区核心的持续参与 为了优化健康-糖尿病在整个生命周期中的社区传播项目。

This project will be an intervention study among Latinos with both depressive symptoms and diabetes and will build upon existing expertise among our EXPORT Center faculty. Recently, Dr. Mangione (Co Principal Investigator of this project) demonstrated that a self-care intervention improves diabetes outcomes for older Latinos. However, 30% of these older Latinos were depressed, and the intervention did not result in improved diabetes outcomes for this subset of depressed diabetics. Dr. Miranda (Co-Principal Investigator of this project) has demonstrated that Cognitive Behavioral Therapy is highly effective for treating depression in low-income Latinos and has recently modified this depression intervention so that it can be given by nonmental health professionals. Thus, our Center is uniquely positioned to examine this combined intervention, which will be studied using a randomized design in 340 Latino subjects recruited at the Northeast San Fernando Valley and Hubert Humphrey Comprehensive Health Centers. We hypothesize that the intervention group, which will receive both interventions, will display significant improvement in both diabetes and depression outcomes compared to the control group will receive the self-management intervention alone. This project will also serve as a training opportunity for several EXPORT junior investigators with interest and expertise in diabetes and depression, allowing them to build upon initial work they have performed in these fields under the mentorship or Drs. Mangione, Miranda and other participating senior faculty. The Specific Aims of this project are: Specific Aim 1: To evaluate the impact of a 12-week mood treatment enhanced self-care diabetes intervention as compared with a self-care diabetes intervention alone for older depressed Latino diabetics: 1.a. To determine if the combined mood/self-care intervention results in lowered hemoglobin A1c as compared with a self-care intervention alone, at 3 and 6 months. 1.b. To determine if the combined mood/self-care intervention results in lowered depressive symptoms as compared with a self-care intervention alone, at 3 and 6 months. 1 .c. To determine if the combined mood/self-care intervention results in improved self-care for diabetes as compared with a self-care intervention alone, at 3 and 6 months. Specific Aim 2. To support dissemination of positive findings from our intervention to the community through our ongoing participation in the Community Core with the Witness for Wellness and Building Bridges to Optimum Health-Diabetes Throughout the Lifespan community dissemination projects.