Please select the eligibility criteria that correspond to the clinical trial below.
Title: Biobehavioral Bases & Management of Type 2 Diabetes
Brief Summary: The major objective of this project is to determine if compared to Standard Care (SC), a Community Approach to Lifestyle Modification for Diabetes (CALM-D) program including diet, exercise and coping skills training, can decrease depression, weight and HbA1c and improve medication adherence in low income, primarily Black and Latino/Hispanic, depressed, overweight, Type 2 diabetic patients seen in a large, comprehensive, community health center. Type 2 diabetes is a major risk factor for coronary heart disease (CHD). Obesity, poor glycemic control, depression, low socioeconomic status (SES) and being a member of a racial/ethnic minority group all increase this risk.

The project will compare 100 CALM-D and 100 SC participants. Following 3 run-in sessions assessment sessions to determine eligibility, given to both SC and CALM-D participants, SC patients will be treated in accordance with ADA Clinical Practice Guidelines (2005) and also assessed by project staff at baseline, 6 months and 1 year. The CALM-D participants will receive 2 individual stress management and lifestyle sessions followed by 2 weekly group sessions. Then 4 bi-weekly sessions will be followed by 9 monthly sessions for a total of 17 sessions. Secondary objectives of the project are to determine if compared to SC, CALM-D can improve glucose tolerance to challenge, insulin resistance, oxidative stress, inflammation, procoagulation, lipid profile, endothelial function resting blood pressure, cardiac and vascular function, cardiac morphology, psychosocial functioning and health quality of life. As many of the participants will already have been prescribed aspirin, statins, oral hypoglycemics and other medications, an important objective of the project will be to assess the extent to which improved adherence to medications - a goal of the CALM-D program - can account for improved intervention effects.


Options:
A: Inclusion Criteria:

1. Lifetime ACS per medical record and/or patient confirmation
2. Current elevated depression symptoms (PHQ-9 greater than or equal to 5)
3. Age 35-85 years
4. Access to high-speed internet

Exclusion Criteria:

1. Active suicidal ideation or past-year psychiatric hospitalization (per patient report and/or medical record review)
2. Non-English-speaking
3. Cognitive impairments preventing informed consent per medical record review and/or cognitive Screen less than or equal to 4
4. Patient deemed unable to complete the study protocol or has a condition that would likely interfere with the study
B: Inclusion Criteria:

* at least moderate depressive symptoms (PHQ-9 ≥ 10)
* rural dwelling
* has had physician-documented acute coronary syndrome (ACS) event

Exclusion Criteria:

* cognitive impairment
* major psychiatric comorbidities, which might require additional treatment
* presence of non-CHD conditions likely to be fatal within next year.
C: Inclusion Criteria:

* Type 2 diabetes
* Major depression
* Overweight (BMI≥27 kg/m2)
* 18-70 years

Exclusion Criteria:

* Non-diabetics or Type 1 diabetes
* Not depressed
* Other psychosis
* Normal weight
* Age \<18 or \>70
D: Inclusion Criteria:

* a current diagnosis of at least one of the following: major or minor depression, dysthymia according to DSM-IV criteria, and demoralization according to DCPR criteria
* Mini-Mental State Examination score higher than 24
* written informed consent provided by the patient to participate

Exclusion Criteria:

* history of bipolar disorder (DSM-IV criteria)
* major depression with psychotic features
* history of substance abuse or dependency during the previous 12 months
* serious suicide risk
* current use of antidepressants
* current treatment with any form of psychotherapy

Answer: C