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.

Public Health Relevance

There are no published studies examining the impact of stress management on metabolic control among Latinos with type 2 diabetes (T2D). Knowledge gained from this randomized trial could lead to a highly innovative community health worker led approach to improving the quality of life among individuals with T2D living under very stressful socio-economic environments.

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Research Project (R01)
Project #
5R01MD005879-03
Application #
8277835
Study Section
Special Emphasis Panel (ZMD1-PA (05))
Program Officer
Alvidrez, Jennifer L
Project Start
2010-09-30
Project End
2015-06-30
Budget Start
2012-07-01
Budget End
2013-06-30
Support Year
3
Fiscal Year
2012
Total Cost
$378,425
Indirect Cost
$27,608
Name
Yale University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520
Petry, N M; Cengiz, E; Wagner, J A et al. (2013) Incentivizing behaviour change to improve diabetes care. Diabetes Obes Metab 15:1071-6
Osborn, Chandra Y; de Groot, Mary; Wagner, Julie A (2013) Racial and ethnic disparities in diabetes complications in the northeastern United States: the role of socioeconomic status. J Natl Med Assoc 105:51-8