The primary aims of this study are to:
1. Tailor a diabetes stress management intervention for delivery by community health
workers (CHWs) serving an urban Latino population.
2. Investigate the efficacy of the stress management intervention on glycemic control.
Secondary aims of this study are to:
3. Investigate the efficacy of the stress management intervention on stress hormones,
psychosocial functioning, and stress-glucose reactivity.
A CHW-led group-based diabetes education model enhanced with stress management education
will improve glycemic control more than CHW-led group-based diabetes education alone.
- Latinos age 18 or older that are ambulatory
- Spanish speaking
- Diagnosed with type 2 diabetes for at least 1 year
- Hemoglobin A1c levels greater than 7.0
- Medical instability or medical treatment requiring inpatient care
- Diagnoses of bipolar disorder or thought disorder (or taking medications prescribed
for either); current substance abuse or dependence disorder
- Current suicidality or history of suicide attempt
- History of psychiatric hospitalization
- Taking antidepressant medications prescribed for the treatment of depression
accompanied by either a) changes to the antidepressant regimen within previous 6
weeks, or b) anticipated changes to the regimen during period of study. Such patients
will be deferred and re-evaluated for eligibility after 6 months