A Model of Community-Based Behavioral Intervention for Depression in Diabetes: Program ACTIVE

Groot, Mary de; Kushnick, Michael R.; Doyle, Todd; Merrill, Jennifer C.; McGlynn, Mark L.; Shubrook, Jay H.; Schwartz, Frank

doi:10.2337/diaspect.23.1.18

Cited by 10 publications

(16 citation statements)

References 38 publications

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“…The current study represents a secondary data analysis of Program ACTIVE (Adults Coming Together to Increase Vital Exercise) (31,32). From 2006 to 2009, a single-arm pilot and feasibility study was conducted to test a combination behavioral approach (10 sessions of cognitive behavioral therapy combined with 12 weeks of community-based exercise) to treating depression in adults with T2D.…”

Section: Methodsmentioning

confidence: 99%

“…From 2006 to 2009, a single-arm pilot and feasibility study was conducted to test a combination behavioral approach (10 sessions of cognitive behavioral therapy combined with 12 weeks of community-based exercise) to treating depression in adults with T2D. Participants were recruited from physician practices, community advertisement, and local media from rural Appalachian counties in southeastern Ohio and western West Virginia (31). The study was approved by the Ohio University Institutional Review Board, and informed consent was given by all participants.…”

Section: Methodsmentioning

confidence: 99%

“…Participants with current suicidal ideation, substance abuse or dependence, a lifetime history of bipolar depression, or psychotic symptoms were excluded. The methods of the parent study are described in detail elsewhere (31). …”

Section: Methodsmentioning

confidence: 99%

“…A total of 50 participants were enrolled, and 40 participants completed the intervention, the postintervention follow-up assessment, and the 3-month follow-up assessment. At each time point, data were collected on depression, glycemic control, and cardiovascular risk outcomes (31). The current study captured lifetime history and course of depression before, during, and following the 12-week behavioral intervention.…”

Section: Methodsmentioning

confidence: 99%

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Lifetime Duration of Depressive Disorders in Patients With Type 2 Diabetes

et al. 2016

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OBJECTIVEDepression in patients with type 2 diabetes (T2D) is associated with long-term complications, disability, and early mortality. No studies have systematically examined the length of episodes and remission in adults with major depressive disorder (MDD) and T2D. This study examined the course of depressive disorders in patients with T2D and MDD.RESEARCH DESIGN AND METHODSParticipants (N = 50) enrolled in a behavioral intervention for adults with T2D and MDD were interviewed using the Structured Clinical Interview for DSM-IV-TR to assess history of depressive disorders at baseline (lifetime history), postintervention, and 3-month follow-up. Onset and remission dates were recorded for all Axis I depressive disorders from birth to final interview.RESULTSAverage number of MDD episodes was 1.8 with a mean duration of 23.4 months (SD 31.9; range 0.5–231.3). Over the life course, mean exposure to MDD was 43.1 months (SD 46.5; range 0.5–231.3). Kaplan-Meier survival curve analysis indicated median episode duration decreased with subsequent episodes (14 months, first episode; 9 months, second episode; P < 0.002). In patients with multiple depressive episodes, recovery time was shorter with each subsequent episode (P = 0.002). No differences in length of episode or remission were observed based on chronology of T2D diagnosis.CONCLUSIONSThe overall exposure to depression in this sample of adults with T2D represents a substantial period of time that can contribute to negative medical and psychiatric outcomes. Recurrent episodes decrease in duration as do recovery periods, resulting in a waxing and waning pattern. Findings from this study underscore the need to effectively diagnose and treat depression in patients with T2D to minimize risk of future depressive episodes.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Lifetime Duration of Depressive Disorders in Patients With Type 2 Diabetes

et al. 2016

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“…Participants were not paid for their participation in the study’s assessment or intervention activities. A detailed description of study inclusion/exclusion criteria and assessment procedures is provided elsewhere (de Groot et al, 2010). …”

Section: Methodsmentioning

confidence: 99%

Program ACTIVE: Cognitive Behavioral Therapy to Treat Depression in Adults With Type 2 Diabetes in Rural Appalachia

2017

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High rates of type 2 diabetes (T2DM) and depression exist in rural Appalachia with limited access to psychotherapeutic treatment. No manualized cognitive behavioral therapy (CBT) treatment materials exist that are culturally tailored for individuals in this region with T2DM. We describe the development of the Program ACTIVE CBT intervention for use with adults with T2DM and depression by mental health providers in rural Appalachia. Qualitative and quantitative methods were used to test the feasibility and acceptability of Program ACTIVE. Intervention materials were rated at the 6th–7th grade reading level. Key informant interviews evaluated materials as culturally sensitive and accessible. Participants indicated high levels of satisfaction with therapy (94%), support from their therapist (86%), and usefulness of therapy and depression improvement (80.3%). Program ACTIVE was found to be a feasible and acceptable culturally tailored manualized CBT treatment for adults with T2DM and depression living in rural Appalachia. Implementation of these materials on a regional scale needs to be assessed.

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Can Lifestyle Interventions Do More Than Reduce Diabetes Risk? Treating Depression in Adults With Type 2 Diabetes With Exercise and Cognitive Behavioral Therapy

et al. 2012

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The epidemic of metabolic syndrome, prediabetes, and type 2 diabetes is global in scope and comprehensive in its impact on individuals, health care systems, and societies. One in four patients with diabetes will experience depression in their lifetime. Comorbid depression is associated with poorer outcomes, greater functional disability, and early mortality. Prior studies have demonstrated beneficial effects of exercise as an efficacious form of treatment for depression in the general population. Few studies have evaluated this strategy in patients with prediabetes or type 2 diabetes. Program ACTIVE (Appalachians Coming Together to Increase Vital Exercise) was designed to treat depression among adults with type 2 diabetes by pairing aerobic activity with individual cognitive behavioral therapy. This combination treatment approach has been shown to be feasible to implement in a rural environment and promising in terms of depression, diabetes, and cardiovascular outcomes. Data from this study suggest that exercise can be used to achieve multiple benefits for adults with type 2 diabetes. Future work to compare this approach to singular treatment strategies for adults at risk for type 2 diabetes is needed.

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A Model of Community-Based Behavioral Intervention for Depression in Diabetes: Program ACTIVE

Cited by 10 publications

References 38 publications

Lifetime Duration of Depressive Disorders in Patients With Type 2 Diabetes

Lifetime Duration of Depressive Disorders in Patients With Type 2 Diabetes

Program ACTIVE: Cognitive Behavioral Therapy to Treat Depression in Adults With Type 2 Diabetes in Rural Appalachia

Can Lifestyle Interventions Do More Than Reduce Diabetes Risk? Treating Depression in Adults With Type 2 Diabetes With Exercise and Cognitive Behavioral Therapy

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