Review of type 2 diabetes management interventions for addressing emotional well-being in Latinos.
The purpose of this article is (1) to investigate if type 2 diabetes management programs with Latino participants address emotional well-being in addition to the standard diabetes self-care behaviors and (2) to describe the approaches taken to improve psychological and diabetes management outcomes.



Online article and research databases, Internet searches, and review of article citations were used to identify relevant articles published 1995-2008. Type 2 diabetes management interventions with a psychological (emotion or cognitive) component or outcome measure and Latino sample were selected. Articles were limited to randomized clinical/controlled trials and pre-post comparative studies.



Thirteen interventions met the inclusion criteria for this review. Eight studies included emotion outcome measures, and 13 included at least one cognitive outcome measure. One study was specifically designed to improve emotional well-being. This study was not targeted for Latinos but did include Latino participants. A specialized depression case manager and collaborative care model showed significant improvements in depression and mental functioning. Psychological improvements were also found in those studies that assessed cognitive outcomes and were based on cognitive theories. The most frequent cognitive outcomes assessed were diabetes knowledge, problem solving, and self-efficacy.



Few type 2 diabetes interventions address emotional well-being in Latinos. More attention has been directed toward designing culturally sensitive community-based programs for improving behavior and physical outcomes. Because some Latino groups believe that negative emotions cause diabetes and because depression and anxiety are associated with poor self-management, programs should address emotional well-being as an important aspect of diabetes management.
Concha
Jeannie Belinda
JB
University of Washington, Department of Health Services, Seattle, Washington (Dr Concha)
Kravitz
Howard M
HM
Rush University Medical Center, Departments of Psychiatry and Preventive Medicine, Chicago, Illinois (Dr Kravitz)
Chin
Marshall H
MH
University of Chicago, Department of Medicine, Illinois (Dr Chin)
Kelley
Michele A
MA
University of Illinois at Chicago, School of Public Health, Chicago, Illinois (Dr Kelley, Dr Chavez)
Chavez
Noel
N
University of Illinois at Chicago, School of Public Health, Chicago, Illinois (Dr Kelley, Dr Chavez)
Johnson
Timothy P
TP
University of Illinois at Chicago, Survey Research Laboratory, Chicago, Illinois (Dr Johnson)
D003071:Cognition; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy*; D004644:Emotions; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care