Trial reportJournal of general internal medicine2025
The Influence of Depression, Positive Health Behaviors, and Weight Status on Glycated Hemoglobin: A Sequential Mediation Analysis of the INDEPENDENT Trial.
Trial report in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Healthcare utilization and expenditures among adults with type 2 diabetes mellitus and comorbid psychological distress.Frontiers in endocrinology · 2026Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundCollaborative care models (CoCM) improve both depression and cardiometabolic outcomes, but the mechanisms driving these effects remain unclear.
objectiveTo determine whether changes in depressive symptoms, positive health behaviors (PHBs), body mass index (BMI), and waist circumference mediate the effect of an adapted CoCM on glycemic control among adults with cardiometabolic risk in India.
designLongitudinal structural equation modeling of data from the INtegrating DEPrEssioN and Diabetes TreatmENT (INDEPENDENT) Randomized Control Trial.
participantsAdults in India with type 2 diabetes or elevated cardiometabolic risk factors and clinically significant depressive symptoms.
interventionsAn adapted CoCM integrating behavioral activation (BA) within diabetes care, delivered by a multidisciplinary team to enhance engagement in self-care activities. MAIN MEASURES: Intervention exposure was the independent variable; mediators were depressive symptoms (Symptom Checklist-20), PHBs (Summary of Diabetes Self-Care Activities), BMI, and waist circumference; the primary outcome was hemoglobin A1c (HbA1c). Confirmatory factor analyses ensured measurement validity, with second-order factors capturing depressive symptom domains (anhedonia, somatization, internalizing symptoms, restlessness). KEY
resultsThe intervention significantly reduced depressive symptoms from 0-6 months (β = -0.22, p < 0.01) and 6-12 months (β = -0.34, p < 0.01) and increased PHBs from 0-6 months (β = 0.15, p < 0.05) and 6-12 months (β = 0.11, p < 0.05). Higher depressive symptoms predicted lower PHBs at 6 months (β = -0.26, p < 0.01) and 12 months (β = -0.25, p < 0.01). PHBs mediated reductions in BMI (β = -0.08 to -0.09, p < 0.01) and waist circumference, which in turn mediated improvements in HbA1c.
conclusionsAn adapted CoCM improved glycemic control and cardiometabolic risk by alleviating depressive symptoms, enhancing PHBs, and reducing BMI and waist circumference. Integrating BA within CoCM may be a key mechanism for optimizing outcomes in integrated cardiometabolic care.
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