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MIP: Program ACTIVE: (Adults Coming Together to Increase Vital Exercise: cognitive behavioral therapy (CBT) and community-based exercise (EXER) intervention for Black Men with Type 2 Diabetes

April 2020 - September 2020

Black men have a 1.5 higher incidence of type 2 diabetes (T2D) compared to non-Hispanic White men and are twice as likely to die from diabetes-related complications.1 Because Black men have poorer glycemic control compared to non-Hispanic White men, their risk for these diabetes complications is higher.3,4 In addition to physical complications, patients with T2D are twice as likely to experience depressive symptoms than their non-diabetes non-Hispanic White men5. Depressive symptoms are associated with suboptimal blood glucose levels6 and diabetes complications7. Gender plays a critical role in the management of T2D and depression, and male gender norms may conflict with help-seeking and healthy behaviors. Program ACTIVE (Adults Coming Together to Increase Vital Exercise) is an evidence-based, cognitive behavioral therapy (CBT) and community-based exercise (EXER) intervention that aims to improve diabetes and depression outcomes. Of all the health concerns faced by black men, mental health challenges may be among the most stigmatized. Research suggests that black men have more adverse life experiences than men of other racial/ethnic groups, and consequently, experience poorer mental health. Tailoring these existing interventions to meet the needs of Black men with T2D is critical, especially given that high rates of T2D and depression exist in low income Black communities. The proposed implementation project, guided by the Theoretical Domains Framework (TDF), seeks to:1) Adapt an evidence-based intervention to work with Black men with T2D and depression in a community-based clinic and 2) conduct a pilot randomized controlled trial to evaluate participant recruitment and retention rates, treatment and intervention satisfaction and estimate intervention effect sizes on our primary outcomes of glycemic control (HbA1c) and depression. Data from the pilot trial will help refine recruitment strategies, training materials, and the implementation protocol to be used in a larger pilot trial.

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