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Community Based Intervention

Community Based Intervention

Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
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A randomized trial to decrease risk for diabetes among Cambodian Americans with depression: Intervention development,

Julie Wagner¹, Angela Bermudez-Millan², Thomas Buckley³

¹UConn Schools of Medicine and Dental Medicine, USA.

Contemporary Clinical Trials

|May 6, 2021

Summary

This summary is machine-generated.

This study developed and tested the DREAM intervention to prevent type 2 diabetes in Cambodian Americans with depression. The intervention showed high fidelity, satisfaction, and retention, suggesting successful implementation for this high-risk group.

Keywords:

Cambodian Community based participatory research Community health worker Depression Diabetes prevention Implementation

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Area of Science:

Public Health
Behavioral Science
Clinical Intervention Research

Background:

Depression and antidepressant use increase type 2 diabetes risk.
Cambodian Americans exhibit high rates of both depression and type 2 diabetes.
The potential for diabetes prevention in individuals with depression remains understudied.

Purpose of the Study:

To report the development and design of the "Diabetes Risk Reduction through Eat, Walk, Sleep and Medication Therapy Management" (DREAM) intervention.
To assess the feasibility and process outcomes of implementing DREAM for Cambodian Americans with depression.
To evaluate baseline characteristics and intervention adherence in a high-risk population.

Main Methods:

Recruited 188 participants aged 35-75, Khmer-speaking, at high risk for diabetes and meeting depression criteria.
Randomized participants into three arms: lifestyle intervention (Eat, Walk, Sleep - EWS), EWS plus medication therapy management (EWS + MTM), or social services (control).
Collected data on treatment fidelity, satisfaction, attendance, and retention over 15 months.

Main Results:

High treatment fidelity (98% adherence) and participant satisfaction with interventions (M=2.9).
Successful participant engagement with high session attendance rates (EWS: 86% completed ≥24 sessions; EWS+MTM: 77% completed ≥4 sessions).
Excellent retention rates at 12-month (95%) and 15-month (96%) assessments.

Conclusions:

The DREAM intervention, encompassing lifestyle and medication management, was successfully implemented in Cambodian Americans with depression.
High fidelity, satisfaction, and retention indicate the feasibility of this intervention for diabetes prevention in this population.
Lessons learned offer valuable insights for future trials targeting similar demographic and health profiles.