An 11-week culturally relevant group diabetes self-management training (DSMT), coping skills training (CST), and diabetes care intervention was compared to a 10-week usual diabetes education and diabetes care intervention on physiological and psychosocial outcomes in 109 Black women (aged 48 +/- 10 years) with type 2 diabetes in primary care (PC). Strong time effects for hemoglobin A1c improvement were seen in both groups from baseline to 3 months and remained similar at 12 and 24 months (p < .0001). Systolic blood pressure (p =.01) and low-density lipoprotein cholesterol levels (p = .05) improved in both groups from baseline to 24 months. Baseline quality of life ([QOL]; Medical Outcome Study Short Form-36) was low. Social function, role-emotional, and mental health domains increased initially in both groups then declined slightly, with less decline for the experimental group at 12 months. At 24 months, experimental group scores increased. General health (p = .002), vitality (p = .01), role-physical, and bodily pain (p = .02) domains increased in both groups over time. Perceived provider support for diet (p = .0001) and exercise (p = .0001) increased in both groups over time. Diabetes-related emotional distress decreased in the experimental compared to the control group (group x time, p = .01). Findings suggest that both methods of diabetes education combined with care can improve metabolic control, QOL, and perceptions of provider care. CST may further assist in long-term improvements in health outcomes. Behavioral interventions are needed in addition to routine diabetes care, particularly in PC.

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Objective-To evaluate the impact of a multifaceted, school-based intervention on inner city youth at high risk for type 2 diabetes mellitus (T2DM) and to determine whether the addition of coping skills training (CST) and health coaching improves outcomes.Method-198 students in New Haven, CT at risk for T2DM (BMI > 85 th percentile and family history of diabetes) were randomized by school to an educational intervention with or without the addition of CST and health coaching. Students were enrolled from 2004-2007 and followed for 12 months.Results-Students in both groups showed some improvement in anthropometric measures, lipids, and depressive symptoms over 12 months. BMI was not improved by the intervention. Students who received CST showed greater improvement on some indicators of metabolic risk than students who received education only.Conclusion-A multifaceted, school-based intervention may hold promise for reducing metabolic risk in urban, minority youth.

Because depressive symptoms may affect ability to engage in healthy behavior changes, evaluation and treatment of depressive symptoms should be considered in preventive interventions for youth at risk for T2DM.

A systematic approach of planning and actively incorporating health-promoting activities into one's lifestyle as a young adult may protect or delay the onset of diabetes and prevent complications.

Purpose-The purpose of the study was to examine the differences in clinical, psychosocial, and demographic factors by sex and weight status.Methods-Baseline data were analyzed from 318 adolescents (mean age = 12.3 ± 1.1 years, 55.0% female, 62.7% white) with type 1 diabetes (T1D) from a multisite clinical trial. Differences were examined between normal weight (body mass index ≥5th and <85th percentile) and overweight/obese (body mass index ≥85th percentile) boys and girls with T1D in clinical, psychosocial, and demographic factors. Descriptive and multiple logistic regression analyses were used.Results-Overweight/obesity was prevalent (39.0%) and common in girls (42.6%) and boys (33.1%). In bivariate analyses, overweight/obese girls had parents with lower educational attainment, longer diabetes duration, and significantly worse self-management and psychosocial health as compared with normal weight girls. There were no differences between overweight/ obese and normal weight girls in A1C, therapy type, race/ethnicity, or household income. No significant differences were found between normal weight and overweight/obese boys. In For reprints and permission queries, please visit SAGE's Web site at http://www.sagepub.com/journalsPermissions.nav. Correspondence to Karl E. Minges, Yale University School of Nursing, 400 West Campus Drive, Orange, CT 06477, USA (karl.minges@yale.edu). HHS Public Access Author ManuscriptAuthor Manuscript Author ManuscriptAuthor Manuscript multivariate analysis, parental educational attainment (master or higher vs high school diploma or less) and perceived stress were significantly associated with overweight/ obesity in girls. Longer duration of T1D bordered statistical significance.Conclusions-Overweight/obesity is prevalent among adolescents with T1D. Clinical, psychosocial, and demographic factors are associated with overweight/obesity in girls but not boys. Greater attention to weight status and aspects of health that are germane to adolescents with T1D is warranted.Overweight and obesity (body mass index [BMI] ≥85th percentile) in adolescents with type 1 diabetes (T1D) has become an important clinical and public health concern. 1 The prevalence of overweight and obesity in adolescents with T1D now mirror that of the general population of adolescents, approximately 39%, and the rate of overweight and obesity among adolescents with T1D has more than tripled over the past few decades. [1][2][3] Youth with T1D have a higher prevalence of overweight (22% vs 16%) but not obesity (13% vs 17%) than do their peers without diabetes, 4 and girls with T1D have a higher prevalence of overweight than do boys with T1D. 5,6 Reasons for these rates of overweight and obesity in adolescents with T1D are unclear but may be related to the concomitant increase in the use of intensive insulin regimens, gene-environment interactions, and/or lifestyle factors. [7][8][9] Overweight/obesity and the associated cardiometabolic risk factors in adolescents with T1D account for significant cardiovascular co...

Introduction-The purpose of this paper is to describe components of a health coaching intervention based on coping skills training delivered via telephone. This intervention was provided to urban adolescents at risk for type 2 diabetes mellitus (T2DM), reinforcing a schoolbased curriculum designed to promote a healthy lifestyle and prevent T2DM.

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