The New York City Research and Improvement Networking Group (NYC RING)

Examining Distress and Treatment Adherence in Type 2 Diabetes

Type 2 Diabetes patients will be assessed at baseline for a cross-sectional and longitudinal study of distress, neurocognitive impairment, family and individual factors, treatment adherence, and glycemic control.

Participating Practices
Williamsbridge Family Practice
Family Health Center
Grand Concourse

Principal Investigator
Jeffery S. Gonzalez, PhD
Assistant Professor of Psychology, Medicine and Epidemiology & Population Health
Ferkauf Graduate School of Psychology

Study Overview
This project will conduct a cross-sectional study examining the independent relationships among diabetes distress, symptoms of depression, family and individual factors, adherence to treatment, and glycemic control in type 2 diabetes patients. A longitudinal study will also be conducted examining the relationships between psychological factors and treatment adherence and glycemic control in type 2 diabetes patients. We hypothesize that increased levels of depression, neurocognitive impairment, and diabetes specific distress treatment will be related to treatment nonadherence among individuals currently receiving prescribed medications for the treatment for type 2 diabetes. We also hypothesize that maladaptive eating behavior will be associated with insulin misuse and poor diabetes control among individuals in treatment for type 2 diabetes. In addition, we hypothesize that a family history of diabetes will impact the diabetes specific distress, illness perceptions, and treatment nonadherence of individuals currently in treatment for type 2 diabetes.

Patient recruitment and participation
Inclusion/exclusion criteria: We are looking to recruit adults (18+) with type 2 diabetes who are on some form of oral medication for diabetes or a diabetes-related condition. We welcome participants who are also on an insulin regimen. As the study involves a brief neurocognitive assessment, the completion of multiple self-report questionnaires and structured clinical interviews the participants must be able to read, write, and understand English. The must also be primarily in charge of their medication (as opposed to having a health attendant of family member responsible for when they take their medication and how much).

Recruitment: Physician/provider referrals, in-clinic recruitment, and opt-out mailings will be used to recruit participants. Regarding the opt-out mailing, a list of potentially eligible patients will be generated from participating sites. These patients will receive a letter, addressed by the sites’ medical director, with information on the study and be given the opportunity to opt out of further contact by study staff.

Participation: Patients who consent to participate will meet with study team members at the Montefiore Diabetes Center at an initial and 3-month follow-up visit. At the baseline visit, participants will be provided with an electronic cap, used to assess the pill-form medication adhered. At each visit, participants will complete a series of psychosocial self-report assessment measures and brief clinical interview(s); the second visit includes a brief neurocognitive assessment and fewer self-reports and a short interview). Each session is estimated to take around 3 hours. Participants will be compensated $50 for completing the baseline and follow-up assessments each, and travel can be compensated, if needed.

Contact information:
NYC RING: Claudia Lechuga,, (718) 430-2023
Study:         Jeffrey Gonzalez,
                   Sabrina Esbitt,

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