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.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Research Project (R01)
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Special Emphasis Panel (ZMD1-PA (05))
Program Officer
Alvidrez, Jennifer L
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Yale University
Public Health & Prev Medicine
Schools of Medicine
New Haven
United States
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Wagner, Julie; Armeli, Stephen; Tennen, Howard et al. (2018) Effects of stress management and relaxation training on the relationship between diabetes symptoms and affect among Latinos. Psychol Health 33:1172-1190
Bermúdez-Millán, Angela; Pérez-Escamilla, Rafael; Lampert, Rachel et al. (2017) Diabetes-Specific Food Insecurity Is Associated with Impaired Heart Rate Variability Independent of Glycemic Control: Exploratory Findings among Latinos with Type 2 Diabetes. Curr Dev Nutr 1:e000521
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