A randomized, controlled trial of a stress management intervention for Latinos with type 2 diabetes delivered by community health workers: Outcomes for psychological wellbeing, glycemic control, and cortisol

Wagner, Julie; Bermúdez‐Millán, Angela; Damio, Grace; Segura‐Pérez, Sofía; Chhabra, Jyoti; Vergara, Cunegundo; Feinn, Richard; Pérez‐Escamilla, Rafael

doi:10.1016/j.diabres.2016.07.022

Cited by 49 publications

(75 citation statements)

References 35 publications

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“…Yet, our findings suggest that affect, self-management and glucose are linked in clinically important ways. These findings, together with CALMS-D findings previously reported (18,19), call for adding mental health care to behavioral diabetes treatment models that have traditionally focused mainly on SMBG, nutrition, and medication adherence (38). …”

Section: Discussionmentioning

confidence: 59%

“…The study reported here was a sub-study of the Community Health Workers Assisting Latinos Manage Stress and Diabetes (CALMS-D) trial (18,19) which tested a group stress management intervention delivered by community health workers for Latinos with type 2 diabetes. Data for the substudy were collected between 2012 and 2014 and participants were enrolled in the substudy upon their completion of the trial.…”

Section: Methodsmentioning

confidence: 99%

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Mean Levels and Variability in Affect, Diabetes Self-Care Behaviors, and Continuously Monitored Glucose: A Daily Study of Latinos With Type 2 Diabetes

Wagner¹,

Armeli

Tennen

et al. 2017

Psychosom Med

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Objective This study investigated between-person and within-person associations among mean levels and variability in affect, diabetes self-care behaviors, and continuously monitored glucose in Latinos with type 2 diabetes. Methods Fifty participants (mean age=57.8 [SD=11.7] years, 74% women, mean A1c=8.3% [SD=1.5%]) wore a “blinded” continuous glucose monitor for 7 days, and they responded to twice-daily automated phone surveys regarding positive affect (PA), negative affect (NA) and self-care behaviors. Results Higher mean levels of NA were associated with higher mean glucose (r=.30), greater % hyperglycemia (r = .34) and greater % out of range glucose (r = .34). Higher NA variability was also related to higher mean glucose (r = .34), greater % hyperglycemia (r = .44) and greater % out-of-range glucose (r = .43). Higher PA variability was related to lower % hypoglycemia (r = −.33). Higher mean levels of self-care behaviors were related to lower glucose variability (r = −.35). Finally, higher self-care behavior variability was related to greater % hyperglycemia (r =.31) and greater % out-of-range glucose (r =−.28). In multilevel regression models, within-person increases from mean levels of self-care were associated with lower mean levels of glucose (b = −7.4, 95% CI: −12.8 to -1.9), lower % hyperglycemia (b = −.04, 95% CI: −.07 to −.01), and higher % hypoglycemia (b = .02, 95% CI: .01 to .03) in the subsequent 10-hour period. Conclusions Near-to-real time sampling documented associations of glucose with affect and diabetes self-care that are not detectable with traditional measures.

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Section: Discussionmentioning

confidence: 59%

Section: Methodsmentioning

confidence: 99%

Mean Levels and Variability in Affect, Diabetes Self-Care Behaviors, and Continuously Monitored Glucose: A Daily Study of Latinos With Type 2 Diabetes

Wagner¹,

Armeli

Tennen

et al. 2017

Psychosom Med

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“…Wagner et al [36] studied a low-income Type 2 diabetes Hispanic population in the USA, comparing diabetes education (DE, control) with diabetes education + stress management (DE+SM, intervention). All sessions were conducted in Spanish and delivered by the same community health worker.…”

Section: Study Resultsmentioning

confidence: 99%

Systematic review and meta‐analysis of psychological interventions in people with diabetes and elevated diabetes‐distress

Schmidt

Loon

Vergouwen³

et al. 2018

Diabet. Med.

121

105

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“…Of the five studies that examined stress as an outcome, four found a significant reduction following the intervention [45, 53, 58, 62], although only three [53, 58, 62] of these were controlled studies. Similarly, of the 12 studies measuring changes in depression, 11 found significant symptom reductions [48–51, 53, 54, 56–58, 60, 62], 10 of which were controlled studies. With respect to anxiety and diabetes-related distress, three out of six studies that measured these outcomes found a significant reduction following the intervention [50, 51, 56, 58, 60] compared to the control group.…”

Section: Resultsmentioning

confidence: 99%

Well-being interventions for individuals with diabetes: A systematic review

Massey

Feig

Duque-Serrano

et al. 2019

Diabetes Research and Clinical Practice

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In patients with diabetes, psychological well-being constructs (e.g., optimism, positive affect) have been associated with superior medical outcomes, including better glucose control and lower mortality rates. Well-being interventions may be well-suited to individuals with diabetes, as they are simple to deliver, broadly applicable across a range of psychological distress, and may help increase self-efficacy and motivation for diabetes self-care. This systematic review, completed using PRISMA guidelines, examined peer-reviewed studies indexed in PubMed, PsycINFO, and/or Scopus between database inception and October 2017 that investigated the effects of well-being interventions (e.g., positive psychology interventions, mindfulness-based interventions, resilience-based interventions) on psychological and physical health outcomes in individuals with Type 1 or Type 2 diabetes. The search yielded 34 articles (N=1635 participants), with substantial variability in intervention type, measures used, and outcomes studied; the majority found the intervention to provide benefit. Overall, results indicate that a range of well-being interventions appear to have promise in improving health outcomes in this population, but the literature does not yet provide definitive data about which specific interventions are most effective. The variability in interventions and outcomes points to a need for further rigorous, controlled, and well-powered studies of specific interventions, with well-accepted, clinically relevant outcome measures.

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A randomized, controlled trial of a stress management intervention for Latinos with type 2 diabetes delivered by community health workers: Outcomes for psychological wellbeing, glycemic control, and cortisol

Cited by 49 publications

References 35 publications

Mean Levels and Variability in Affect, Diabetes Self-Care Behaviors, and Continuously Monitored Glucose: A Daily Study of Latinos With Type 2 Diabetes

Mean Levels and Variability in Affect, Diabetes Self-Care Behaviors, and Continuously Monitored Glucose: A Daily Study of Latinos With Type 2 Diabetes

Systematic review and meta‐analysis of psychological interventions in people with diabetes and elevated diabetes‐distress

Well-being interventions for individuals with diabetes: A systematic review

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