Community-Engaged Approach to Supporting South Asians w/ Type 2 Diabetes at Risk for Depression - Community-Engaged Approach to Supporting Patients with Type 2 Diabetes at Risk for Depression Background: Patients with Type 2 diabetes (T2D) are at increased risk for depression (60%), and patients with depression have a 32% increased risk for T2D. The resulting comorbidity has significant implications for disease burden, healthcare costs, and management of these disorders. In NYC, prevalence of diabetes ranges from 7.1%-14.4%, and T2D patients are twice as likely to have symptoms of depression. This comorbidity is more prevalent by sociodemographic characteristics such as sex, education level, income, and English proficiency. Given significant barriers to accessing medical and mental healthcare services (e.g., affordability, accessibility) there is an urgent need for interventions to comprehensively address this comorbidity. Building on an innovative and successful community health worker (CHW)-led T2D intervention at NYU Grossman School of Medicine (DREAM Initiative - R01DK11048), this K01 proposal will adapt this CHW-led T2D intervention to include mental health and digital health components, and test the feasibility and acceptability of this intervention to support participants with T2D who are at risk for depression. In this proposed pilot intervention, CHWs will provide tailored health education to participants on management of T2D and depressive symptoms using the DREAM intervention and adapted content from the WHO’s Group Problem Management+ psychological intervention program, and facilitate referrals to mental healthcare services. A CHW facilitated text message discussion group will reinforce health messages between health education sessions, and a wearable fitness tracker will be given to participants to monitor daily fitness and sleep patterns. Specific Aims: 1) Examine factors associated with distress, poor mental health, and comorbid T2D and depression among participants to inform pilot study structure and content; 2) Adapt CHW-led T2D intervention to include mental health and digital health components using a trauma informed care approach and the ecological validity model; and 3) Evaluate the feasibility and acceptability of a pilot CHW-led intervention to support participants with T2D who are at risk for depression. Training: The mentored training plan will include didactic and experiential learning opportunities. Primary training topics will include clinical management of diabetes, clinical T2D research, trauma informed care, mental health, digital health, and grant writing. The training will include formal coursework, workshops, seminars, directed readings with mentors, and participation in mentor study meetings.
