Abstract P145: Randomized Trial of an Integrated Care Intervention Among Latino Adults: Sustained Effects on Diabetes Management

Abstract

Purpose: Adequate diabetes management is challenging to sustain. In healthcare practices serving under-resourced communities, the development of cost-efficient interventions with a sustainable impact are crucial. We examined the 12-month maintenance effects of a previously successful integrated model of diabetes care at improving glycemic management and psychological well-being among Latino adults with type 2 diabetes (T2D). Methods: A randomized controlled trial (2015-2019) compared an Integrated Care Intervention (ICI) with Usual Care (UC) among 456 adults with T2D. The ICI included integrated medical and behavioral care and health education over 6 months. Assessments were completed at baseline, 3-, 6-, 9-, and 12-months. Results: Most participants were female (63.7%), with a mean age of 55.7 years. In multi-level models, significant group x time (quadratic) interaction effects were found for HbA1c ( ß = .10, 95% CI .02,.17, p < .01) and anxiety ( ß = .20, 95% CI .05,.35, p < .009), but not depression symptoms ( ß = .15, 95% CI -.01,.31, p < .07). Analyses of instantaneous rate of change in the ICI group showed significant decreases at 3- and 6-months for HbAc1 ( ß = -.31 at 3-months; ß = -.12 at 6-months) and anxiety symptoms ( ß = -.92 at 3-months; ß = -.46 at 6-months), and no significant changes at 9- or 12-months, suggesting that initial improvements were largely maintained. The UC group showed a small decrease in anxiety symptoms at 6 months ( ß = -.17), but no other significant changes (all ps > .05). (See Figure 1). Conclusions: This culturally tailored integrated care model that included both medical and behavioral care and health education programs, shows potential in producing and sustaining positive effects on clinical and psychological outcomes above standard care. Findings have implications for practice and policies that facilitate implementing these models in healthcare organizations.