MON-533 Efficacy Of Home-based Diabetes-modified Behavioral Activation Treatment For Low-income Seniors With Type 2 Diabetes

Abstract Disclosure: L.E. Egede: None. R.J. Walker: None. J.A. Campbell: None. Introduction and Objective: Prevalence of diabetes is higher and outcomes of diabetes worse for minority groups compared to non-Hispanic white adults, with higher risk of complications, higher mortality, and worse glycemic control in both African American and Hispanic adults. In elderly populations, disparities are compounded by additional differences in risk factors, including multimorbidity and cognitive decline, complex treatment regimens, impaired functional status, and limited social and financial resources. The primary aim of this randomized controlled trial was to test the efficacy of a home-based diabetes-modified behavioral activation treatment (Home DM-BAT) on HbA1c at 12-months post-randomization. Methods: 200 participants were randomized to receive: 1) Home DM-BAT intervention or 2) Control - general health education with supportive therapy. The Home DM-BAT intervention consisted of 8-weekly sessions of nurse delivered behavioral activation education and skills training over the telephone. Behavioral targets included medication taking, physical activity, health eating, and self-monitoring of glucose and blood pressure. Environmental context was accounted for in this intervention to incorporate and set goals around activating patients to engage in activities to support emotional well-being based on patient preferences including spending time with friends, spirituality, or volunteer work. Longitudinal mixed models with treatment, time, and treatment x time interactions for change in HbA1c from baseline were run for the intervention arm using 0.5% as a clinically meaningful drop in HbA1c and p<0.05 as statistically significant. This preliminary analysis focused on the treatment arm alone. Results: The sample had a mean age 70.7, 61.5% female, 35% making <$25,000 per year and the mean baseline HbA1c was 9.5 (sd=1.58). Longitudinal mixed effects trajectories over time showed statistically significant change in HbA1c at 3-months (-0.65, p<0.001), 6-months (-0.86, p<0.001), 9-months (-0.79, p<0.001), and 12-months (-0.77, p<0.001). Notably, at 12-months HbA1c for Home DM-BAT maintained at from 6-months (8.63 at 6-months to 8.73 at 12-months). Conclusion: Use of a behavioral activation-based intervention for older minority adults with poorly controlled diabetes improved glycemic control over time and maintained the drop in glycemic control at 12-months indicating sustainability of intervention effect over time. Presentation: Monday, July 14, 2025