PMID- 35776001 OWN - NLM STAT- MEDLINE DCOM- 20220819 LR - 20230703 IS - 1613-9860 (Electronic) IS - 1869-6716 (Print) IS - 1613-9860 (Linking) VI - 12 IP - 8 DP - 2022 Aug 17 TI - Effectiveness of an integrated primary care intervention in improving psychosocial outcomes among Latino adults with diabetes: the LUNA-D study. PG - 825-833 LID - 10.1093/tbm/ibac042 [doi] AB - OBJECTIVE: To compare the effectiveness of usual care (UC) versus a culturally tailored integrated care model in improving mental health symptoms for Latino patients with Type 2 diabetes mellitus (T2DM). METHODS: We conducted a two-arm randomized controlled trial from 2015 to 2019 at a federally qualified health center. Participants were 456 adults ages 23-80 years who had a previous diagnosis of T2DM and were not currently using insulin. Participants were randomly assigned to Integrated Care Intervention (ICI; including behavioral/mental healthcare, medical visits, health education and care coordination) or UC; standard of care including referrals for health education and behavioral/mental health care where appropriate. Intention-to-treat, multilevel models were used to compare group x time changes in depression and anxiety symptoms (PHQ-8; GAD-7) and perceived stress (PSS-10) across 6 months. RESULTS: Participant mean age was 55.7 years, 36.3% were male, and 63.7% were primarily Spanish speaking. Baseline sociodemographic factors and mental health symptoms across study arms were balanced. Significant group x time interaction effects were observed for anxiety and depression symptoms (p < .05). Within the ICI and UC groups, mean depression symptom changes were -0.93 and -0.39 (p < .01); anxiety symptom changes were -0.97 (p < .01) and -0.11 (p = .35); and perceived stress changes were -1.56 and -1.27 (p < .01), respectively. CONCLUSIONS: Although both ICI and UC showed decreases over time, the ICI group evidenced larger, statistically significant changes in both depression and anxiety. Adapted integrated models of behavioral and chronic disease management appear to be effective and could be considered for usual care practices. CLINICALTRIALS.GOV IDENTIFIER: NCT03983499. CI - (c) Society of Behavioral Medicine 2022. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. FAU - Castaneda, Sheila F AU - Castaneda SF AUID- ORCID: 0000-0002-1975-0544 AD - South Bay Latino Research Center, Chula Vista, CA, USA. AD - Department of Psychology, San Diego State University, San Diego, CA, USA. FAU - Gallo, Linda C AU - Gallo LC AD - South Bay Latino Research Center, Chula Vista, CA, USA. AD - Department of Psychology, San Diego State University, San Diego, CA, USA. FAU - Garcia, Melawhy L AU - Garcia ML AD - Center for Latino Community Health, Evaluation, and Leadership Training, Department of Health Science, California State University Long Beach, Long Beach, CA, USA. FAU - Mendoza, Paulina M AU - Mendoza PM AD - South Bay Latino Research Center, Chula Vista, CA, USA. AD - Department of Psychology, San Diego State University, San Diego, CA, USA. FAU - Gutierrez, Angela P AU - Gutierrez AP AD - South Bay Latino Research Center, Chula Vista, CA, USA. FAU - Lopez-Gurolla, Maria AU - Lopez-Gurolla M AD - South Bay Latino Research Center, Chula Vista, CA, USA. AD - Department of Psychology, San Diego State University, San Diego, CA, USA. FAU - Roesch, Scott AU - Roesch S AD - South Bay Latino Research Center, Chula Vista, CA, USA. AD - Department of Psychology, San Diego State University, San Diego, CA, USA. FAU - Pichardo, Margaret S AU - Pichardo MS AD - College of Medicine, Howard University, Washington, D. C., USA. AD - Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA. FAU - Munoz, Fatima AU - Munoz F AD - Department of Research, San Ysidro Health, San Diego, CA, USA. FAU - Talavera, Gregory A AU - Talavera GA AD - South Bay Latino Research Center, Chula Vista, CA, USA. AD - Department of Psychology, San Diego State University, San Diego, CA, USA. LA - eng SI - ClinicalTrials.gov/NCT03983499 GR - 5 P30 DK111022/DK/NIDDK NIH HHS/United States GR - 5 U54 TR002550/TR/NCATS NIH HHS/United States GR - R01 NR014866/NR/NINR NIH HHS/United States GR - P30 DK111022/DK/NIDDK NIH HHS/United States GR - UL1 TR002550/TR/NCATS NIH HHS/United States GR - R01NR014866/NH/NIH HHS/United States PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PL - England TA - Transl Behav Med JT - Translational behavioral medicine JID - 101554668 SB - IM EIN - Transl Behav Med. 2023 Feb 28;13(2):120. PMID: 36170040 MH - Adult MH - Aged MH - Aged, 80 and over MH - Anxiety Disorders MH - *Diabetes Mellitus, Type 2/psychology/therapy MH - Female MH - Hispanic or Latino MH - Humans MH - Male MH - Mental Health MH - Middle Aged MH - Primary Health Care MH - Young Adult PMC - PMC9385125 OAB - We developed and tested a culturally adapted, enhanced service ("Integrated Care Intervention") for Latino patients with Type 2 diabetes (T2D) to support their physical and mental health. The Integrated Care Intervention included receiving mental healthcare (i.e., "behavioral healthcare") services and health education during a routine appointment. Patients receiving the Integrated Care Intervention were compared to patients receiving standard primary care services (i.e., "Usual Care"), which may include a referral for health education and behavioral health services if their provider feels it is warranted. The study was conducted from 2015 to 2019 at a community health center. Study participants were 456 adults ages 23-80 years who had a previous diagnosis of T2D and were not currently using insulin. Participants were randomly assigned to an Integrated Care Intervention group or Usual Care group. We compared changes in depression and anxiety symptoms and perceived stress over a 6-month period for the two study participant groups. Patients assigned to the Integrated Care Intervention group showed larger improvements in both depression and anxiety symptoms over 6 months than the patients assigned to the Usual Care group. These findings indicate that Latino patients may benefit from receiving both behavioral and chronic disease management services during routine visits with their primary care provider. OABL- eng OTO - NOTNLM OT - Hispanic/Latino OT - Integrated care OT - Mental health symptoms OT - Primary care EDAT- 2022/07/02 06:00 MHDA- 2022/08/20 06:00 PMCR- 2023/07/01 CRDT- 2022/07/01 10:06 PHST- 2022/07/02 06:00 [pubmed] PHST- 2022/08/20 06:00 [medline] PHST- 2022/07/01 10:06 [entrez] PHST- 2023/07/01 00:00 [pmc-release] AID - 6625756 [pii] AID - ibac042 [pii] AID - 10.1093/tbm/ibac042 [doi] PST - ppublish SO - Transl Behav Med. 2022 Aug 17;12(8):825-833. doi: 10.1093/tbm/ibac042.