East Carolina University (ECU) in partnership with stakeholders from rural, eastern North Carolina, implemented an individually-tailored, stepped-care intervention for patients experiencing uncontrolled type 2 diabetes and distress or depression. This approach featured combining primary care, cognitive behavioral treatment, and community support. The goals of this project were to implement and evaluate the effectiveness of the approach in a pragmatic trial, its impact on psychological mediators, and establish a cost-effective care model.
It can also produce greater improvements in those on oral medication regimens compared to insulin-treated patients, and that it can result in greater improvement in medication adherence if distress is reduced
Participants especially found especially helpful:
- Accountability to interventionists
- Information/knowledge gained, especially about food/nutrition
- Having a “safe” person to talk to in a confidential manner