Please select the eligibility criteria that correspond to the clinical trial below.
Title: Multifaceted Depression Diabetes Program for Hispanics
Brief Summary: This study will evaluate the effectiveness of culturally adapted depression treatment for reducing depressive symptoms and improving adherence to diabetes self-care regimens in Hispanics with depression and diabetes.


Options:
A: Inclusion Criteria:

* ▪ Age 18 and older

  ▪ Body mass index at least 25 kg/m2 OR one of the following CVD risk factors:
* Hypertension (SBP\>= 140mmHg or DBP\>= 90mmHg or on antihypertensive medications;
* Diabetes mellitus (fasting blood sugar\> 125mg/dl or hemoglobin A1c\>6.5 or on a hypoglycemic medication);
* Dyslipidemia (LDL \>130 mg/dl , HDL\<40 or total cholesterol \>=200 or on a lipid lowering agent);
* Current tobacco smoker

  * Able and willing to give informed consent
  * Completion of baseline data collection
  * Willing to accept randomization
  * Willing to participate in the intervention

Exclusion Criteria:

* ▪ Cardiovascular event (unstable angina, myocardial infarction) within the past 6 months

  * Serious medical condition which either limits life expectancy or requires active management (e.g., certain cancers)
  * Condition which interferes with outcome measurement (e.g., dialysis)
  * Pregnant or planning a pregnancy during study period. Nursing mothers would need approval from physician.
  * Alcohol or substance use disorder if not sober/abstinent for 30 days
  * Planning to leave rehabilitation center or clinic within 6 months or move out of geographic area within 18 months
  * Investigator judgment (e.g., for concerns about participant or staff safety)
B: Inclusion Criteria:

* Meets criteria for major depression based on a score of greater than 2 for five or more symptoms, including one of the two cardinal depression symptoms and a nine-item depression scale of the Patient Health Questionnaire (PHQ-9) score of greater than 10
* Patient with diabetes
* Has attended two community safety net clinics

Exclusion Criteria:

* Current suicidal ideation
* Score of 8 or greater on the Alcohol Use Disorders Identification Test (AUDIT)
* Recent use of lithium or antipsychotic medication
C: Inclusion Criteria:

Patients with bipolar disorder. Index episode of manic, major depression or both requiring hospitalization on acute unit. At lease two hospitalizations, three or more months apart within the past 5 years.

Exclusion Criteria:
D: Mental Health Provider Organizations Inclusion Criteria:

* Provide outpatient behavioral health services to people with SMI as defined by primary DSM-V Axis I diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder or any other state-certified serious mental illness diagnosis (e.g., post-traumatic stress disorder)
* Agree to study procedures including a commitment by CEO or designee to: (a) participate over the full program, including randomization to VLC or TA; (b) engage (if randomized to VLC) in monthly web-based meetings with other VLC members, including sharing implementation outcome data and performance evaluations; (c) collect and submit aggregate participant-level data, including demographics, weight/BMI, physical fitness as measured by a 6-minute walk test, waist circumference, frequency of physical activity, and self-reported changes in nutrition; and (d) participate in phone-based organizational change and implementation assessments, including organization leadership, middle management, and InSHAPE staff.

InSHAPE Participant Inclusion Criteria:

* Age 18 or older
* SMI as defined by primary DSM-V Axis I diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder or any other state-certified SMI diagnosis (e.g., post-traumatic stress disorder)
* Verbal permission from participant to share de-identified data with the research team
* Overweight or obesity as indicated by BMI of 25 kg/m2 or greater
* Medical clearance for participation in an exercise and dietary medication program by a physician, physician assistant, or nurse practitioner.

Exclusion Criteria:

• None

Answer: B