Kaltman, Stacey I., PhD
Integrated self-management: A novel intervention for diabetes and depression
General Research Subject: Type 2 Diabetes
Focus: Psychosocial Behavioral Medicine
Type of Grant: Innovation
Project Start Date: January 1, 2013
Project End Date: December 31, 2014
Diabetes Type: Type 2 diabetes
Diabetes and depression often co-occur and are associated with poor health outcomes. Latino patients experience diabetes at a higher rate than the general population and are more likely to have uncontrolled diabetes, diabetes-related complications, and more severe depression. Given the strong link between diabetes and depression, there is a need for treatments that target both conditions. Despite this identified need, there are no fully integrated treatments that simultaneously target diabetes and depression.
This project will apply qualitative and quantitative research methods to develop and preliminarily test a treatment that simultaneously targets diabetes and depression. The treatment will use behavioral intervention strategies and will be culturally appropriate for depressed Latinos with uncontrolled diabetes that receive care in clinics that serve low-income patients. This will be achieved by adapting and integrating existing interventions that have been shown to be effective in prior research into a single, seamless intervention that targets both conditions. This project will include interviews and focus groups with patients, family members, and primary care providers to inform the development of the intervention and a preliminary test of the intervention to ensure that it is safe and acceptable to the target population.
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and curing diabetes?
Diabetes and depression often co-occur. When they do, patient health outcomes are much worse. Typically, treatments for the two conditions proceed independently. This project seeks to develop an integrated, behavioral intervention that targets both diabetes and depression self-management. This project will include interviews and focus groups with patients, family members, and primary care providers to inform the development of the intervention and a preliminary test of the intervention to ensure that it is safe and acceptable to the target population. It is our ultimate hypothesis that this patient-centered approach will lead to improved self-management, thus yielding better diabetes-related health outcomes
If a person with diabetes were to ask you how your project will help them in the future, how would you respond?
This project is the first step in helping us to determine if we can have a lasting impact on diabetes and depression self-management among patients who have conditions. This intervention is intended to be brief and delivered in primary care settings by personnel typically found in medical settings (e.g., nurses, diabetes educators). If the intervention is determined to be safe and acceptable, the next step will be a formal evaluation of its efficacy. If the intervention is ultimately shown to be efficacious, the next area of focus will be how best to disseminate it to primary care clinics around the country.
Why is it important for you, personally, to become involved in diabetes research? What role will this award play in your efforts?
In multiple clinical and research settings, I have witnessed the pernicious impact of the co-occurrence of diabetes and depression. This has driven my interest in the integration of care for mental and physical health problems. In reviewing the research literature, I could find no evidence-based single, behavioral intervention that targets both diabetes and depression self-management. It makes sense to simultaneously treat these frequently comorbid conditions both from a patient-centeredness perspective and from a cost efficiency perspective This award will allow me and my research team to devote time to developing and evaluating a novel intervention that simultaneously treats both conditions.
In what direction do you see the future of diabetes research going?
Because so much of diabetes-related health outcomes are determined by a patient's ability to manage his/her own illness, I hope there is an increased focus on the development of evidence-based strategies to facilitate successful patient self-management. These approaches should be patient-centered and whenever possible integrate treatment for other comorbid conditions, such as depression.
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