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Roddy MK, Spieker AJ, Greevy RA, Nelson LA, Berg C, Mayberry LS. Diabetes-specific family functioning typology associated with intervention engagement and effects: secondary analyses from a randomized controlled trial. Ann Behav Med 2025; 59:kaae070. [PMID: 39661957 PMCID: PMC11783318 DOI: 10.1093/abm/kaae070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2024] Open
Abstract
BACKGROUND Observationally, family and social support are important for optimal diabetes self-management; however, interventions targeting family/social support have not consistently been effective. A novel, diabetes-specific family functioning typology offers the opportunity to classify types of baseline family functioning to determine for whom family interventions may be effective. PURPOSE We examined the effects of an intervention by baseline type of family functioning post hoc, to inform differential benefit from interventions. METHODS Participants were randomized to enhanced treatment as usual or a 9-month, mobile phone-delivered, family-focused, self-care support intervention. Adults with type 2 diabetes (N = 318) who participated in the randomized clinical trial (RCT) and provided baseline data were included. We determined participants' diabetes-specific family functioning types at baseline using a validated, survey-administered, typology assessment tool. We investigated the associations between type and engagement (eg, attending coaching sessions and responding to text messages) and psychosocial (eg, well-being and diabetes distress) and glycemic outcomes at mid- and post-treatment. RESULTS Despite overall high engagement, there was variability across types in engagement and effects. WantMoreInvolvement benefited the most; Satisfied withLowInvolvement showed early improvements that waned; Collaborative &Helpful were highly engaged but derived minimal benefits from the intervention; and CriticallyInvolved benefitted the least and may have experienced some harm. CONCLUSIONS We demonstrated the utility of a novel diabetes-specific family functioning typology to explain variability in response to a family-focused intervention. Findings from this work answer the calls for systems-level consideration in precision behavioral medicine and drive hypothesis generation for future, tailored interventions. REGISTRATION The larger RCT is registered with ClinicalTrials.gov (NCT04347291).
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Affiliation(s)
- McKenzie K Roddy
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, United States
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN 37203,United States
| | - Andrew J Spieker
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203,United States
| | - Robert A Greevy
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203,United States
| | - Lyndsay A Nelson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, United States
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN 37203,United States
| | - Cynthia Berg
- Department of Psychology, University of Utah, Salt Lake City, UT 84112, United States
| | - Lindsay S Mayberry
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, United States
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN 37203,United States
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37203,United States
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Ehmann MM, Hagerman CJ, Milliron BJ, Butryn ML. The Role of Household Social Support and Undermining in Dietary Change. Int J Behav Med 2024:10.1007/s12529-024-10327-w. [PMID: 39436592 DOI: 10.1007/s12529-024-10327-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2024] [Indexed: 10/23/2024]
Abstract
BACKGROUND US adults find it challenging to meet disease prevention dietary recommendations and may participate in interventions to improve dietary quality. Social influences outside of the intervention, including level of social support and undermining of healthy eating in the home, may affect an individual's dietary intake. This secondary analysis examined (1) changes in household social support and undermining of healthy eating across a dietary intervention with household member participation and (2) the relationship between changes in social influences and dietary intake. METHOD Adults (N = 62) with low adherence to cancer prevention dietary recommendations recruited from the Philadelphia area participated in a 20-week dietary intervention focused on psychoeducation about NCI dietary recommendations and skills for behavior change. Half of the participants were also randomized to have an adult household member participate in some intervention contacts with them. Participants completed measures of social support and undermining of healthy eating and dietary intake at baseline and post-treatment (20 weeks). RESULTS Fifty-two participants had available data for baseline and post-treatment (i.e., completers). Household social support of healthy eating increased more among participants randomized to have household involvement in the intervention with a medium effect (η2 = .11). Fruit and vegetable intake significantly increased among participants with meaningful increases in household social support with a large effect (η2 = .37). There were no significant interaction effects of change in household undermining and time on change in dietary intake. CONCLUSION Dietary interventions with a household support component show promise for improving household social support and may impact magnitude of dietary change.
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Affiliation(s)
- Marny M Ehmann
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, 19104, USA.
| | - Charlotte J Hagerman
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, 19104, USA
| | - Brandy-Joe Milliron
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, 19104, USA
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, 19104, USA
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Ye X, Liu R, Che S, Zhang Y, Wu J, Jiang Y, Luo X, Xie C. Role perceptions and experiences of adult children in remote glucose management for older parents with type 2 diabetes mellitus: a qualitative study. BMC Geriatr 2024; 24:653. [PMID: 39097684 PMCID: PMC11297597 DOI: 10.1186/s12877-024-05224-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 07/15/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND With the advent of the smart phone era, managing blood glucose at home through apps will become more common for older individuals with diabetes. Adult children play important roles in glucose management of older parents. Few studies have explored how adult children really feel about engaging in the glucose management of their older parents with type 2 diabetes mellitus (T2DM) through mobile apps. This study provides insights into the role perceptions and experiences of adult children of older parents with T2DM participating in glucose management through mobile apps. METHODS In this qualitative study, 16 adult children of older parents with T2DM, who had used mobile apps to manage blood glucose for 6 months, were recruited through purposive sampling. Semi-structured, in-depth, face-to-face interviews to explore their role perceptions and experiences in remotely managing their older parents' blood glucose were conducted. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were followed to ensure rigor in the study. The data collected were analyzed by applying Colaizzi's seven-step qualitative analysis method. RESULTS Six themes and eight sub-themes were identified in this study. Adult children's perceived roles in glucose management of older parents with T2DM through mobile apps could be categorized into four themes: health decision-maker, remote supervisor, health educator and emotional supporter. The experiences of participation could be categorized into two themes: facilitators to participation and barriers to participation. CONCLUSION Some barriers existed for adult children of older parents with T2DM participating in glucose management through mobile apps; however, the findings of this study were generally positive. It was beneficial and feasible for adult children to co-manage the blood glucose of older parents. Co-managing blood glucose levels in older parents with T2DM can enhance both adherence rates and confidence in managing blood glucose effectively.
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Affiliation(s)
- Xiang Ye
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Rongzhen Liu
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China
| | - Shangjie Che
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yanqun Zhang
- Department of Emergency, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China
| | - Jiaqi Wu
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Ya Jiang
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China
| | - Xiangrong Luo
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China
| | - Cuihua Xie
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No.1838, Guangzhou Avenue North, Baiyun District, Guangzhou, China.
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Gouin JP, Dymarski M. Couples-based health behavior change interventions: A relationship science perspective on the unique opportunities and challenges to improve dyadic health. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 19:100250. [PMID: 39155951 PMCID: PMC11326928 DOI: 10.1016/j.cpnec.2024.100250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 07/05/2024] [Accepted: 07/12/2024] [Indexed: 08/20/2024] Open
Abstract
Epidemiological studies indicate that better marital quality is associated with less morbidity and premature mortality. A number of interpersonal processes related to marital quality are also associated with health-relevant surrogate biomarkers across different physiological systems. Despite these replicated correlational findings, few interventions have harnessed interpersonal processes as potential interventions to enhance health. Building on Dr. Janice Kiecolt-Glaser's model of relationships and health, we propose that couples-based health behavior change interventions may represent an effective way to decrease dysregulation across autonomic, endocrine and immune systems and, ultimately, improve dyadic health. Given that the cohabiting partner is an essential part of the social context in which the behavior change is being pursued, it is important to consider the relational issues triggered by dyadic interventions. Using a relationship science perspective, this article reviews the literature on couples' concordance in health behaviors and health outcomes, the potential pathways underlying this concordance, theories of the couple as a self-sustaining social system, dyadic adaptation of individual self-regulation strategies, effective and ineffective social support and social control in couple relationships, the integration of relationship-building and health behavior change strategies, and the consideration of key moderators related to the nature of the relationship and the context surrounding the relationship. These findings highlight the importance of adopting a relationship science perspective when designing and testing dyadic interventions to improve health outcomes. The data reviewed provide insights on how to optimize couples-based health behavior change interventions to reduce physiological dysregulation and improve dyadic health.
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Affiliation(s)
| | - Maegan Dymarski
- Department of Psychology, Concordia University, Montreal, Canada
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Ogugu EG, Bidwell JT, Ruark A, Butterfield RM, Weiser SD, Neilands TB, Mulauzi N, Rambiki E, Mkandawire J, Conroy AA. Barriers to accessing care for cardiometabolic disorders in Malawi: partners as a source of resilience for people living with HIV. Int J Equity Health 2024; 23:83. [PMID: 38678232 PMCID: PMC11055364 DOI: 10.1186/s12939-024-02181-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/18/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND People living with HIV (PLWH) are at increased risk of cardiometabolic disorders (CMD). Adequate access to care for both HIV and CMD is crucial to improving health outcomes; however, there is limited research that have examined couples' experiences accessing such care in resource-constrained settings. We aimed to identify barriers to accessing CMD care among PLWH in Malawi and the role of partners in mitigating these barriers. METHODS We conducted a qualitative investigation of barriers to CMD care among 25 couples in Malawi. Couples were eligible if at least one partner was living with HIV and had hypertension or diabetes (i.e., the index patient). Index patients were recruited from HIV care clinics in the Zomba district, and their partners were enrolled thereafter. Interviews were conducted separately with both partners to determine barriers to CMD care access and how partners were involved in care. RESULTS Participants framed their experiences with CMD care by making comparisons to HIV treatment, which was free and consistently available. The main barriers to accessing CMD care included shortage of medications, cost of tests and treatments, high cost of transportation to health facilities, lengthy wait times at health facilities, faulty or unavailable medical equipment and supplies, inadequate monitoring of patients' health conditions, some cultural beliefs about causes of illness, use of herbal therapies as an alternative to prescribed medicine, and inadequate knowledge about CMD treatments. Partners provided support through decision-making on accessing medical care, assisting partners in navigating the healthcare system, and providing financial assistance with transportation and treatment expenses. Partners also helped manage care for CMD, including communicating health information to their partners, providing appointment reminders, supporting medication adherence, and supporting recommended lifestyle behaviors. CONCLUSIONS Couples identified many barriers to CMD care access, which were perceived as greater challenges than HIV care. Partners provided critical forms of support in navigating these barriers. With the rise of CMD among PLWH, improving access to CMD care should be prioritized, using lessons learned from HIV and integrated care approaches. Partner involvement in CMD care may help mitigate most barriers to CMD care.
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Affiliation(s)
- Everlyne G Ogugu
- Betty Irene Moore School of Nursing, University of California Davis, Davis, CA, USA.
- Betty Irene Moore School of Nursing, University of California Davis, 2570 48th Street, Sacramento, CA, 95817, USA.
| | - Julie T Bidwell
- Betty Irene Moore School of Nursing, University of California Davis, Davis, CA, USA
| | - Allison Ruark
- Wheaton College, Biological and Health Sciences, Wheaton, IL, USA
| | - Rita M Butterfield
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Sheri D Weiser
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Torsten B Neilands
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | | | | | - Amy A Conroy
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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Smalls BL, Kruse-Diehr A, Ortz CL, Douthitt K, McLouth C, Shelton R, Taylor Z, Williams E. Older adults using social support to improve self-care (OASIS): Adaptation, implementation and feasibility of peer support for older adults with T2D in appalachia: A feasibility study protocol. PLoS One 2024; 19:e0300196. [PMID: 38498512 PMCID: PMC10947915 DOI: 10.1371/journal.pone.0300196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION The prevalence of type 2 diabetes (T2D) is 17% higher in rural dwellers compared to their urban counterparts, and it increases with age, with an estimated 25% of older adults (≥ 65 years) diagnosed. Appropriate self-care is necessary for optimal clinical outcomes. Overall, T2D self-care is consistently poor among the general population but is even worse in rural-dwellers and older adults. In rural Kentucky, up to 23% of adults in Appalachian communities have been diagnosed with T2D and, of those, 26.8% are older adults. To attain optimal clinical outcomes, social environmental factors, including social support, are vital when promoting T2D self-care. Specifically, peer support has shown to be efficacious in improving T2D self-care behaviors and clinical and psychosocial outcomes related to T2D; however, literature also suggests self-selected social support can be obstructive when engaging in healthful activities. Currently available evidence-based interventions (EBIs) using peer support have not been used to prioritize older adults, especially those living in rural communities. METHOD To address this gap, we conducted formative research with stakeholders, and collaboratively identified an acceptable and feasible peer support EBI-peer health coaching (PHC)-that has resulted in improved clinical and psychosocial T2D-related outcomes among participants who did not reside in rural communities nor were ≥65 years. The goal of the proposed study is to use a 2x2 factorial design to test the adapted PHC components and determine their preliminary effectiveness to promote self-care behaviors and improve glycemic control among older adults living in Appalachian Kentucky. Testing the PHC components of the peer support intervention will be instrumental in promoting care for older adults in Appalachia, as it will allow for a larger scale intervention, which if effective, could be disseminated to community partners in Appalachia. TRIAL REGISTRATION This study was registered at www.clinicaltrials.gov (NCT06003634) in August 2023.
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Affiliation(s)
- Brittany L. Smalls
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Aaron Kruse-Diehr
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Courtney L. Ortz
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Key Douthitt
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Christopher McLouth
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, United States of America
| | - Rachel Shelton
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Zoe Taylor
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Edith Williams
- Center for Community Health and Prevention, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America
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August KJ, Novak JR, Markey CH, Mason MB, Peak T, Gast J. A dyadic analysis of anti-fat attitudes and partners' diet-related influence among gay married men. Psychol Health 2024:1-20. [PMID: 38419401 DOI: 10.1080/08870446.2024.2322069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES The focus on physical appearance among gay men has potential implications for anti-fat attitudes, including those directed toward romantic partners. Partners often influence each other's behaviors including those linked to weight, but most research has examined the consequences of these influence strategies versus their antecedents. To address this research gap, we examined how men's own and their partners' anti-fat attitudes were related to both health-promoting (control) and health-compromising (undermining) types of diet-related influence and whether these associations differed by weight status. METHODS AND RESULTS Analyzing data from a cross-sectional online survey of 450 U.S. adult gay married men (225 couples), Actor-Partner Interdependence Models revealed that individuals' own anti-fat attitudes (all types) were positively associated with more frequent receipt of spousal control and undermining. Additionally, partner's fears about gaining weight were positively associated with more frequent receipt of spousal control and dislike of higher weight people and fear of gaining weight (among those of higher weight status) were positively associated with more frequent receipt of spousal undermining. CONCLUSION Our findings add to the literature on diet-related interactions among gay married men, highlight the value of examining these processes dyadically, and suggest the importance of including both members of couples in health promotion and intervention efforts.
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Affiliation(s)
- Kristin J August
- Departments of Psychology and Health Sciences and Graduate Program in Prevention Science, Rutgers University, Camden, New Jersey, USA
| | - Josh R Novak
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - Charlotte H Markey
- Departments of Psychology and Health Sciences and Graduate Program in Prevention Science, Rutgers University, Camden, New Jersey, USA
| | - Megan B Mason
- Departments of Psychology and Health Sciences and Graduate Program in Prevention Science, Rutgers University, Camden, New Jersey, USA
| | - Terry Peak
- Departments of Social Work and Kinesiology and Health Science, Utah State University, Logan, Utah, USA
| | - Julie Gast
- Departments of Social Work and Kinesiology and Health Science, Utah State University, Logan, Utah, USA
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Jere J, Ruark A, Bidwell JT, Butterfield RM, Neilands TB, Weiser SD, Mulauzi N, Mkandawire J, Conroy AA. "High blood pressure comes from thinking too much": Understandings of illness among couples living with cardiometabolic disorders and HIV in Malawi. PLoS One 2023; 18:e0296473. [PMID: 38153924 PMCID: PMC10754453 DOI: 10.1371/journal.pone.0296473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/13/2023] [Indexed: 12/30/2023] Open
Abstract
Cardiometabolic disorders (CMD) such as hypertension and diabetes are increasingly prevalent in sub-Saharan Africa, placing people living with HIV at risk for cardiovascular disease and threatening the success of HIV care. Spouses are often the primary caregivers for people living with CMD, and understanding patients' and partners' conceptions of CMD could inform care. We conducted semi-structured interviews with 25 couples having a partner living with HIV and either hypertension or diabetes. Couples were recruited from HIV clinics in Malawi and were interviewed on beliefs around symptoms, causation, prevention, and treatment for CMD. Data were analyzed at the individual and dyadic levels using framework analysis and Kleinman's theory of explanatory models as a lens. On average, participants were 51 years old and married for 21 years. Approximately 57%, 14%, and 80% had hypertension, diabetes, and HIV. Couples endorsed a combination of biomedical explanatory models (beliefs around physical and mental health) and traditional explanatory models (beliefs around religion and natural remedies), although tended to emphasize the biomedical model. Half of couples believed stress was the main cause of hypertension. For diabetes, diet was believed to be a common cause. In terms of prevention, dietary changes and physical activity were most frequently mentioned. For disease management, medication adherence and diet modifications were emphasized, with some couples also supporting herbal remedies, stress reduction, and faith in God as strategies. Participants were generally more concerned about CMD than HIV due to poor access to CMD medications and beliefs that CMD could lead to sudden death. Within couples, partners often held many of the same beliefs but diverged around which etiological or preventive factors were most important (e.g., stress versus diet) and the best diet for CMD. Health education programs should involve primary partners to build knowledge of CMD and address overlap with HIV, and reinforce accurate information on lifestyle factors for the prevention and treatment of CMD.
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Affiliation(s)
- Jane Jere
- School of Public Health, University of California Berkeley, Berkeley, California, United States of America
| | - Allison Ruark
- Wheaton College, Biological and Health Sciences, Wheaton, IL, United States of America
| | - Julie T. Bidwell
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California, United States of America
| | - Rita M. Butterfield
- Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, United States of America
| | - Torsten B. Neilands
- Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, United States of America
| | - Sheri D. Weiser
- Division of HIV, Infectious Disease and Global Medicine, University of California San Francisco, San Francisco, CA, United States of America
| | | | | | - Amy A. Conroy
- Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, United States of America
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LaBuda JE, Kochendorfer LB, Gere J. Daily perceptions of romantic partner autonomy support and undermining of health behavior. Psychol Health 2023:1-20. [PMID: 38153205 DOI: 10.1080/08870446.2023.2296584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 12/11/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE This study examined accuracy and bias in daily perceptions of a romantic partner's autonomy support and undermining of health behaviors and the associations between misperceptions and both partners' daily experiences. DESIGN A sample of 106 cohabiting couples from the community completed daily reports (N = 2377) of their own and their partner's autonomy support and undermining, and their daily experiences. RESULTS We found tracking accuracy and projection in perceptions of provider's autonomy support and undermining, and evidence of misperceptions: people over-perceived the provider's undermining and under-perceived the provider's autonomy support. Misperceptions were linked with more negative experiences, indicating support and undermining may have the most benefit and least harm when more accurately perceived. CONCLUSION Although there is some accuracy in daily perceptions of provider support and undermining of health behaviors, there are also biases at play in perceptions and misperceptions are linked with more negative experiences, indicating that support and undermining have the most benefit and least harm to both perceiving and providing partners when such behaviors are accurately perceived.
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Affiliation(s)
- Jessica E LaBuda
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | | | - Judith Gere
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
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Jafari A, Tehrani H, Mansourian M, Nejatian M, Gholian-Aval M. Translation and localization the Persian version of diabetes distress scale among type 2 diabetes. Diabetol Metab Syndr 2023; 15:201. [PMID: 37838688 PMCID: PMC10576313 DOI: 10.1186/s13098-023-01173-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/27/2023] [Indexed: 10/16/2023] Open
Abstract
INTRODUCTION The aimed of this psychometric cross-sectional research was translation and localization the Persian version of diabetes distress scale in type 2 diabetes. METHODS This psychometric cross-sectional research was translation and localization the Persian version of diabetes distress scale among 1028 type 2 diabetes in Mashhad city, Iran, 2022. Cluster sampling method was used for selection the participants. The validity and reliability of diabetes distress scale designed and evaluated by Polonsky was assessed in this study. The validity of diabetes distress scale was evaluated by face validity, content validity, and structural validity. Twenty-six type 2 diabetes were selected for evaluation the reliability of scale. RESULTS The factor loading of all questions of diabetes distress scale were more than 0.4 and the results of goodness-of-fit indexes showed acceptable values (for example: RMSEA = 0.076, IFI = 0.909, AGFI = 0.819, PNFI = 0.758). Cronbach's alpha coefficient, McDonald omega coefficient and Intraclass Correlation Coefficient (ICC) showed a value of 0.950, 0.955, and 0.903, respectively for all items of diabetes distress scale. Cronbach's alpha coefficient, McDonald omega coefficient and ICC showed a value of 0.914, 0.917, and 0.893, respectively for Core Level of Distress (8 items). Also, Cronbach's alpha coefficient, McDonald omega coefficient, and ICC showed a value of 0.920, 0.928, and 0.884, respectively for all factors of Sources of Distress (21 items). CONCLUSION The Persian form of diabetes distress scale with 29 items and two parts of Core Level of Distress with 8 items and Sources of Distress with 21 items and 7 factors (Hypoglycemia with 3 items, Long-term Health with 3 items, Healthcare Provider with 3 items, Interpersonal Issues with 3 items, Shame/Stigma with 3 items, Healthcare Access with 3 items, and Management Demands with 3 items) is a good scale to evaluation the status of diabetes distress in Iranian type 2 diabetes.
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Affiliation(s)
- Alireza Jafari
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Hadi Tehrani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mahbobeh Nejatian
- Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mahdi Gholian-Aval
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
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Roddy MK, Nelson LA, Spieker AJ, Greevy RA, Mayberry LS. Family involvement and diabetes distress across dyads for adults with type 2 diabetes. PATIENT EDUCATION AND COUNSELING 2023; 112:107719. [PMID: 37018880 PMCID: PMC10332408 DOI: 10.1016/j.pec.2023.107719] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/08/2023] [Accepted: 03/28/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Family/friend involvement and diabetes distress are associated with outcomes for persons with type 2 diabetes (PWDs), but little is known about how they relate to each other. We aim to (1) describe associations between PWD and support person (SP) distress; (2) describe associations between involvement and diabetes distress for PWDs, for SPs, and across the dyad; and (3) explore whether associations differ by PWD-SP cohabitation. METHODS PWDs and SPs co-enrolled in a study evaluating the effects of a self-care support intervention and completed self-report measures at baseline. RESULTS PWDs and SPs (N = 297 dyads) were, on average, in their mid-50s and around one-third identified as racial or ethnic minorities. The association between PWD and SP diabetes distress was small (Spearman's ρ = 0.25, p < 0.01). For PWDs, experienced harmful involvement from family/friends was associated with more diabetes distress (standardized β = 0.23, p < 0.001) independent of helpful involvement in adjusted models. Separately, SPs' self-reported harmful involvement was associated with their own diabetes distress (standardized β = 0.35, p < 0.001) and with PWDs' diabetes distress (standardized β = 0.25, p = 0.002), independent of SPs' self-reported helpful involvement. CONCLUSION AND PRACTICE IMPLICATIONS Findings suggest dyadic interventions may need to address both SP harmful involvement and SP diabetes distress, in addition to PWD distress.
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Affiliation(s)
- McKenzie K Roddy
- Quality Scholars Program, VA Tennessee Valley Healthcare System, Nashville, TN, USA; Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lyndsay A Nelson
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Andrew J Spieker
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Robert A Greevy
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lindsay S Mayberry
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
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12
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Gray KE, Silvestrini M, Ma EW, Nelson KM, Bastian LA, Voils CI. Gender differences in social support for diabetes self-management: A qualitative study among veterans. PATIENT EDUCATION AND COUNSELING 2023; 107:107578. [PMID: 36463824 DOI: 10.1016/j.pec.2022.107578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/04/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Describe the role of social support in veterans' diabetes self-management and examine gender differences. METHODS We conducted semi-structured interviews among veterans with diabetes from one Veterans Health Administration Health Care System. Participants described how support persons influenced their diabetes self-management and perspectives on a proposed self-management program incorporating a support person. We used thematic analysis to identify salient themes and examine gender differences. RESULTS Among 18 women and 18 men, we identified four themes: 1) women felt responsible for their health and the care of others; 2) men shared responsibility for managing their diabetes, with support persons often attempting to correct behaviors (social control); 3) whereas both men and women described receiving instrumental and informational social support, primarily women described emotional support; and 4) some women's self-management efforts were hindered by support persons. Regarding programs incorporating a support person, some participants endorsed including family/friends and some preferred programs including other individuals with diabetes. CONCLUSIONS Notable gender differences in social support for self-management were observed, with women assuming responsibility for their diabetes and their family's needs and experiencing interpersonal barriers. PRACTICE IMPLICATIONS Gender differences in the role of support persons in diabetes self-management should inform support-based self-management programs.
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Affiliation(s)
- Kristen E Gray
- Health Services Research & Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA.
| | - Molly Silvestrini
- Health Services Research & Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Erica W Ma
- Health Services Research & Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Karin M Nelson
- Health Services Research & Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; General Medicine Service, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Division of General Internal Medicine, University of Washington, Seattle, WA, USA
| | - Lori A Bastian
- Pain Research, Informatics, Multimorbidities, Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, USA; Yale University School of Medicine, New Haven, CT, USA
| | - Corrine I Voils
- William S. Middleton Memorial Veterans Administration Hospital, Madison, WI, USA; Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA
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13
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Dailey RM, Zhang Z, Kurlak R, Lloyd R, Burdick S. Romantic Partner Perspectives of the Relational Context of Weight Loss Support. HEALTH COMMUNICATION 2022; 37:1788-1797. [PMID: 33941002 DOI: 10.1080/10410236.2021.1920712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Much of the research on romantic partner support of weight loss takes the perspective of targets pursuing weight loss. This study, however, assesses the perspectives of the partners providing support, and specifically their perceptions of the relational context and their support strategy use. An MTurk sample of 283 partners of individuals trying to lose weight reported on relational context characteristics (i.e., having a team effort, opposing approaches, and imposition regarding the weight loss pursuits) and their use of encouragement, direct influence, and coercion. Analyses largely supported the hypotheses regarding the associations between the relational characteristics and strategy use. For example, higher team effort and lower opposing approaches about weight management were linked with more encouragement, and greater opposing approaches and imposition were associated with more coercion. Four relational weight loss climates based on the collective of these characteristics were also linked with strategy use. All associations were found after accounting for general relationship satisfaction as well as other control variables. Overall, the findings suggest that perceptions of the weight loss in the context of the relationship were connected to the strategies partners employed in helping targets achieve weight loss. Because strategies vary in effectiveness, understanding which relational characteristics, as well as which broader relational climates, facilitate partner strategy choice can ultimately help augment individuals' weight loss success.
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Affiliation(s)
- René M Dailey
- Department of Communication Studies, University of Texas at Austin
| | - Zhengyu Zhang
- Department of Communication Studies, Western Washington University
| | - Rebecca Kurlak
- Department of Communication Studies, University of Texas at Austin
| | - Rachel Lloyd
- Department of Communication Studies, University of Texas at Austin
| | - Suzanne Burdick
- Department of Communication Studies, University of Texas at Austin
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14
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Mayberry LS, Felix HC, Hudson J, Curran GM, Long CR, Selig JP, Carleton A, Baig A, Warshaw H, Peyrot M, McElfish PA. Effectiveness-implementation trial comparing a family model of diabetes self-management education and support with a standard model. Contemp Clin Trials 2022; 121:106921. [PMID: 36096282 DOI: 10.1016/j.cct.2022.106921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/09/2022] [Accepted: 09/06/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Diabetes self-management education and support (DSMES) is an effective approach for improving diabetes self-care behaviors to achieve improved glycemic management and other health outcomes. Engaging family members may improve outcomes, both for the person with diabetes (PWD) and for the family members. However, family models of DSMES have been inconsistently defined and delivered. We operationalize Family-DSMES to be generalizable and replicable, detail our protocol for a comparative effectiveness trial comparing Standard-DSMES with Family-DSMES on outcomes for PWDs and family members, and detail our mixed-methods implementation evaluation plan. METHODS We will examine Family-DSMES relative to Standard-DSMES using a Hybrid Type 1 effectiveness-implementation design. Participants are ≥18 years old with type 2 diabetes mellitus and hemoglobin A1c ≥7.0%, recruited from rural and urban primary care clinics that are part of an academic medical center. Each participant invites a family member. Dyads are randomly assigned to Family- or Standard-DSMES, delivered in a small-group format via telehealth. Data are collected at baseline, immediately post-intervention, and 6-, 12-, and 18-months post-intervention. Outcomes include PWDs' hemoglobin A1c (primary), other biometric, behavioral, and psychosocial outcomes (secondary), and family members' diabetes-related distress, involvement in the PWD's diabetes management, self-efficacy for providing support, and biometric outcomes (exploratory). Our mixed-methods implementation evaluation will include process data collected during the trial and stakeholder interviews guided by the Consolidated Framework for Implementation Research. CONCLUSION Results will fill knowledge gaps about which type of DSMES may be most effective and guide Family-DSMES implementation efforts. REGISTRATION The trial is pre-registered at clinicaltrials.gov (#NCT04334109).
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Affiliation(s)
- Lindsay S Mayberry
- Department of Medicine, Vanderbilt University Medical Center, 2525 West End Ave., Nashville, TN 37203, USA
| | - Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA
| | - Jonell Hudson
- College of Pharmacy, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA
| | - Geoffrey M Curran
- College of Pharmacy, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA; Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 37 Circle Dr., North Little Rock, AR 72114, USA
| | - Christopher R Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA
| | - Ayoola Carleton
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA
| | - Arshiya Baig
- Department of Medicine, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA
| | - Hope Warshaw
- Hope Warshaw Associates, LLC, Asheville, NC, USA
| | - Mark Peyrot
- Department of Sociology, Loyola University Maryland (Retired), 4501 N. Charles St., Baltimore, MD 21210, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA.
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15
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Dailey RM, Lloyd R, Burdick S, Zhang Z, Kurlak R. Romantic partner undermining of weight loss: Links between overweight individuals' weight management efforts and perceptions of their partner's undermining motivations and behaviors. J Health Psychol 2022; 28:583-596. [PMID: 36124728 DOI: 10.1177/13591053221123842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study investigated romantic partners' undermining of weight management (i.e. hindrance of weight loss efforts) and how perceived motivations behind undermining were associated with weight loss progress. Data from 241 overweight individuals currently cohabiting with a romantic partner and trying to lose weight revealed two overarching undermining factors (i.e. verbal criticism/complaint, behavioral interference) and six perceived motivations (e.g. partner believed weight loss was unnecessary, partner relational fears, weight loss was an imposition on partner). Path modeling showed both undermining behaviors were negatively associated with weight management. Yet, only certain motivations (e.g. imposition on partner, weight loss was unnecessary) were linked to weight management, either directly or indirectly, through undermining. Specifically, whereas criticism/complaint mediated the associations between these motivations and weight management, interference only mediated the association between imposition and weight management. Findings are discussed in terms of the theoretical and practical value of distinguishing undermining behaviors and their underlying motivations.
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16
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Li TJ, Zhou J, Ma JJ, Luo HY, Ye XM. What are the self-management experiences of the elderly with diabetes? A systematic review of qualitative research. World J Clin Cases 2022; 10:1226-1241. [PMID: 35211556 PMCID: PMC8855189 DOI: 10.12998/wjcc.v10.i4.1226] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/21/2021] [Accepted: 12/28/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The number of elderly individuals with diabetes is dramatically increasing. Diabetes is a long-term condition and a noncommunicable disease and requires intensive daily self-management. Understanding of self-management from the patients’ perspectives is important to nurses, healthcare providers, and researchers and benefits people by improving their self-management skills.
AIM To examine and synthesize qualitative studies that explore the experiences of elderly people in self-managing diabetes.
METHODS Electronic databases were searched, including MEDLINE, CINAH, PsycINFO, PubMed, CNKI, and WANFADATA. Relevant research was identified by manually searching reference lists and gray literature. Only English and Chinese publications were included. The Critical Appraisal Skills Program was used to assess the quality of the research. The Confidence in the Evidence from Reviews of Qualitative research approach was used to assess the confidence of the findings.
RESULTS A total of 10 qualitative studies were included, and content analysis was performed. Five themes were identified: The need for knowledge about diabetes care, support systems, functional decline, attitudes toward diabetes, and healthy lifestyle challenges.
CONCLUSION This present review provides a deep and broad understanding of the experiences in the self-management of diabetes and can be valuable to nursing practice and provide recommendations for future research.
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Affiliation(s)
- Ting-Jun Li
- Department of Nursing, The Second People's Hospital of Futian District Shenzhen, Shenzhen 518049, Guangdong Province, China
| | - Jie Zhou
- Department of Nursing, Shenzhen Shekou People’s Hospital, Shenzhen 518067, Guangdong Province, China
| | - Juan-Juan Ma
- Department of Nursing, Shenzhen Shekou People’s Hospital, Shenzhen 518067, Guangdong Province, China
| | - Hui-Yan Luo
- Department of Traditional Chinese Medicine, Shenzhen People's Hospital, Shenzhen 518000, Guangdong Province, China
| | - Xiao-Mei Ye
- Intensive Care Unit, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510220, Guangdong Province, China
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17
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Changes in family involvement occasioned by FAMS mobile health intervention mediate changes in glycemic control over 12 months. J Behav Med 2022; 45:28-37. [PMID: 34386838 PMCID: PMC8821125 DOI: 10.1007/s10865-021-00250-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/30/2021] [Indexed: 02/03/2023]
Abstract
Mobile phone-delivered interventions have proven effective in improving glycemic control (HbA1c) in the short term among adults with type 2 diabetes (T2D). Family systems theory suggests engaging family/friend in adults' diabetes self-care may enhance or sustain improvements. In secondary analysis from a randomized controlled trial (N = 506), we examined intervention effects on HbA1c via change in diabetes-specific helpful and harmful family/friend involvement. We compared a text messaging intervention that did not target family/friend involvement (REACH), REACH plus family-focused intervention components targeting helpful and harmful family/friend involvement (REACH + FAMS), and a control condition. Over 6 months, both intervention groups experienced improvement in HbA1c relative to control, but at 12 months neither did. However, REACH + FAMS showed an indirect effect on HbA1c via change in helpful family/friend involvement at both 6 and 12 months while REACH effects were not mediated by family/friend involvement. Consistent with family systems theory, improvements in HbA1c mediated by improved family/friend involvement were sustained.
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18
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Kandel S, Assanangkornchai S, Wichaidit W. Association between family behaviors and self-care activities among type-II diabetes mellitus patients at a teaching hospital in Kathmandu, Nepal. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:25. [PMID: 35281405 PMCID: PMC8893064 DOI: 10.4103/jehp.jehp_25_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/24/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Self-care activities are associated with prognosis of type-II diabetes mellitus patients and include medication adherence, dietary adherence, physical activity, self-monitoring of blood glucose (SMBG), and appropriate foot care. The behaviors of a patient's family members can influence the patient's self-care activities, but little data exist on this association. The objective of this study was to assess the extent of the association between behaviors of family members of Type-II diabetes patients and the patients' self-care activities. MATERIALS AND METHODS We conducted a cross-sectional study at a teaching hospital in Kathmandu, Nepal, and interviewed 411 outpatients with Type-2 diabetes mellitus. We used exploratory factor analysis to group family members' behaviors into 3 domains ("authoritarian," "supportive," and "planning" behaviors) and graded the level of the behavior into 3 categories ("high" vs. "medium" vs. "low") according to its ranking distribution in each domain. We assessed the association between domains of family behavior and self-care activities using multivariate logistic regression with Bonferroni correction. RESULTS High (vs. low) level of supportive behavior was associated with compliance to SMBG (58% vs. 11%; adjusted odds ratio [OR] =7.44; 95% confidence interval [CI] =2.41, 23.01). High (vs. low) level of planning behavior was associated with high level of foot care adherence (64% vs. 21%; adjusted OR = 6.03; 95% CI = 3.01, 12.11). CONCLUSIONS We found associations between behaviors of diabetes patients' family members and the patients' own self-care behaviors. However, the incongruence between the family behavior measurement questions and the self-care of interest limited the implications of the findings.
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Affiliation(s)
- Shashi Kandel
- National Health Education, Information and Communication Centre (NHEICC), Ministry of Health and Population, Kathmandu, Nepal
| | - Sawitri Assanangkornchai
- Department of Epidemiology, Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Wit Wichaidit
- Department of Epidemiology, Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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19
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Mayberry LS, Greevy RA, Huang LC, Zhao S, Berg CA. Development of a Typology of Diabetes-Specific Family Functioning Among Adults With Type 2. Ann Behav Med 2021; 55:956-969. [PMID: 33761527 DOI: 10.1093/abm/kaab009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Family members' responses to adults' diabetes and efforts to manage it vary widely. Multiple aspects of diabetes-specific family functioning have been identified as important for self-management and psychosocial well-being in theoretical (i.e., theories of social support and collaborative coping) and observational literature. PURPOSE Develop a typological framework of diabetes-specific family functioning and examine cross-sectional associations between type and diabetes outcomes. METHODS We used electronic health record (EHR) data to identify a cohort of 5,545 adults receiving outpatient care for type 2 diabetes and invited them to complete a survey assessing 10 dimensions of diabetes-specific family functioning. We used k-means cluster analysis to identify types. After type assignment, we used EHR data for the full cohort to generate sampling weights to correct for imbalance between participants and non-participants. We used weighted data to examine unadjusted associations between participant characteristics and type, and in regression models to examine associations between type and diabetes outcomes. Regression models were adjusted for sociodemographics, diabetes duration, and insulin status. RESULTS We identified and named four types: Collaborative and Helpful (33.8%), Satisfied with Low Involvement (22.2%), Want More Involvement (29.6%), and Critically Involved (14.5%; reflecting the highest levels of criticism and harmful involvement). Across these types, hemoglobin A1c, diabetes distress, depressive symptoms, diabetes medication adherence, and diabetes self-efficacy worsened. After covariate adjustment, type remained independently associated with each diabetes outcome (all p's < .05). CONCLUSIONS The typology extends theories of family support in diabetes and applications of the typology may lead to breakthroughs in intervention design, tailoring, and evaluation.
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Affiliation(s)
- Lindsay S Mayberry
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt Center for Diabetes Translation Research, Nashville, TN, USA
| | - Robert A Greevy
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Li-Ching Huang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.,Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shilin Zhao
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.,Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cynthia A Berg
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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20
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A valid self-help tool to measure the role of spousal support in the care of persons with diabetes mellitus. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-01001-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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21
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Berzins TL, LaBuda JE, Gere J. Consideration of Future Consequences Influences Involvement in Romantic Partners' Health. HEALTH COMMUNICATION 2021; 36:639-649. [PMID: 32122172 DOI: 10.1080/10410236.2020.1733229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study examined the influence of people's short-term (e.g., convenience) and long-term (e.g., maintain weight) motives toward their romantic partner's health on their provision of health-related social control and autonomy support for their partner's health behaviors, as well as their indifference toward their romantic partner's health. Data from a sample of cohabiting couples (N = 212) were analyzed using multilevel path models. Results showed having more long-term motives for a partner's health lead to increased provisions of autonomy support and social control, and less indifference toward the partner's health, especially when the partner had lower long-term health motives themselves. In contrast, having more short-term motives for a partner's health was associated with providing less social control and autonomy support and showing more indifference toward the partner's health. Thus, people motivated to improve their partner's long-term health engage in more behaviors meant to improve their romantic partner's health choices, particularly when the partner has low motivation to regulate their own health behaviors.
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Affiliation(s)
| | | | - Judith Gere
- Department of Psychological Sciences, Kent State University
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22
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Novak JR, Wilson SJ, Gast J, Miyairi M, Peak T. Associations between partner's diet undermining and poor diet in mixed-weight, older gay married couples: a dyadic mediation model. Psychol Health 2020; 36:1147-1164. [PMID: 33090040 DOI: 10.1080/08870446.2020.1836179] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Prior studies have examined how individuals may undermine their partner's efforts to maintain a healthy diet, but gay couples have not been represented in this work. Additionally, research has not accounted for mixed-weight status [lighter partner (LP) and heavier partner] nor investigated the mechanisms through which undermining is associated with dietary outcomes. OBJECTIVE/DESIGN/MEASURES Utilising dyadic data from 224 gay married couples across the United States, we tested associations between perceptions of partner's diet undermining strategies and diet quality with couple food disagreements and depressive symptoms as putative, serial mediators in an actor-partner interdependence mediation model. RESULTS Results revealed that more severe diet undermining was associated with both partners' poorer diet quality, which was explained by more frequent couple food disagreements and higher depressive symptoms for both heavier and LPs. CONCLUSION These findings suggest that undermining strategies are detrimental to both partners' relational health (increased conflict), emotional health (depressive symptoms) and physical health (diet)-regardless of weight status-and provide valuable targets for prevention and intervention. Our study underscores the interdependence of couple relations in lifestyle changes and specifically highlight the need for health professionals to discuss the partner's indirect or unintended disruptions to the patient's plan.
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Affiliation(s)
- Joshua R Novak
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA
| | - Stephanie J Wilson
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | - Julie Gast
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, USA
| | - Maya Miyairi
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, USA
| | - Terry Peak
- Department of Sociology, Social Work, and Anthropology, Utah State University, Logan, UT, USA
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23
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Rauer A, Sabey AK, Proulx CM, Volling BL. What are the Marital Problems of Happy Couples? A Multimethod, Two-Sample Investigation. FAMILY PROCESS 2020; 59:1275-1292. [PMID: 31433860 DOI: 10.1111/famp.12483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
How couples handle marital conflict may depend on what issues they are facing, as some issues may be more difficult to resolve than others. What is unclear, however, is what issues happy couples face and how these issues may be different for couples depending on their developmental stage. To explore this possibility, the current study used both self-reports and observations drawn from two separate samples of happily married couples-one early in middle adulthood (N = 57 couples; average marital duration = 9 years) and one in older adulthood (N = 64 couples; average marital duration = 42 years). Results indicated that all issues were relatively minor, but early middle-aged couples reported more significant problems than did older couples. As to determining the most salient topic for happy couples, it depended on the spouses' gender, developmental stage, and how salience was assessed (i.e., highest rated issue vs. most discussed issue). Only moderate links were found between what happy couples said was their most serious concern and what they actually tried to resolve during observations of marital problem-solving, but there were differences in how spouses behaved based on the proportion of their time discussing certain topics. Findings suggest that more attention should be devoted to understanding what marital issues happy couples discuss and why, as doing so may reveal how couples maintain their marital happiness.
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Affiliation(s)
- Amy Rauer
- Department of Child and Family Studies, University of Tennessee, Knoxville, TN
| | - Allen K Sabey
- The Family Institute, Northwestern University, Evanston, IL
| | - Christine M Proulx
- Department of Human Development and Family Science, University of Missouri, Columbia, MO
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24
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Chu K, Wang Y, He Y, Tang Y, Gu J, Wu S, Zhang H, Sun N, Li Z, Zhang Q, Li W. The psychosocial impact of premature ovarian insufficiency on male partners and their perceptions of the disease. PSYCHOL HEALTH MED 2020; 26:1248-1257. [PMID: 32844666 DOI: 10.1080/13548506.2020.1810717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Premature ovarian insufficiency (POI) is affecting about 1% women of reproductive age. However, current studies have primarily focused on women with the views of male partners greatly absent from the literature. We conduct this research to investigate the psychosocial effect of POI on male partners and their perceptions of the disease.52 male partners of POI patient (experiment group) and 52 controls (control group) were available for analysis. Anxiety, depression, and marital relationship were assessed for male partners in both groups. A questionnaire about perceptions of POI was completed by the experiment group. Male partners of POI patient experienced greater levels of anxiety (10.96 versus 4.88; P < 0.01) and depression (12.23 versus 5.19; P < 0.01) compared with controls. In addition, they experienced worse marital relationship in several aspects than their counterparts. The findings also demonstrate that most POI patient male partners had inadequate and inaccurate knowledge about their partners' disease, which may be the results of insufficient professional counseling from health-care practitioners. Moreover, their understanding level of the disease was correlated to anxiety (r = -0.64; P < 0.01), depression (r = -0.38; P < 0.01), and communication (r = 0.28; P < 0.05).The study highlights the need for health-care services, as well as support and professional information resources aimed at POI patients' male partners.
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Affiliation(s)
- Kun Chu
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Yining Wang
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Yi He
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Yunxiang Tang
- Department of Medical Psychology, Second Military Medical University, Shanghai, China
| | - Jiayi Gu
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Shuang Wu
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Honghong Zhang
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Ningxia Sun
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Ziyuan Li
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Qing Zhang
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
| | - Wen Li
- Center for Reproductive Medicine, Changzheng Hosptial, Second Military Medical University, Shanghai, China
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Mayberry LS, Berg CA, Greevy RA, Nelson LA, Bergner EM, Wallston KA, Harper KJ, Elasy TA. Mixed-Methods Randomized Evaluation of FAMS: A Mobile Phone-Delivered Intervention to Improve Family/Friend Involvement in Adults' Type 2 Diabetes Self-Care. Ann Behav Med 2020; 55:165-178. [PMID: 32706852 DOI: 10.1093/abm/kaaa041] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Family and friends have both helpful and harmful effects on adults' diabetes self-management. Family-focused Add-on to Motivate Self-care (FAMS) is a mobile phone-delivered intervention designed to improve family/friend involvement, self-efficacy, and self-care via monthly phone coaching, texts tailored to goals, and the option to invite a support person to receive texts. PURPOSE We sought to evaluate how FAMS was received by a diverse group of adults with Type 2 diabetes and if FAMS improved diabetes-specific family/friend involvement (increased helpful and reduced harmful), diabetes self-efficacy, and self-care (diet and physical activity). We also assessed if improvements in family/friend involvement mediated improvements in self-efficacy and self-care. METHODS Participants were prospectively assigned to enhanced treatment as usual (control), an individualized text messaging intervention alone, or the individualized text messaging intervention plus FAMS for 6 months. Participants completed surveys at baseline, 3 and 6 months, and postintervention interviews. Between-group and multiple mediator analyses followed intention-to-treat principles. RESULTS Retention, engagement, and fidelity were high. FAMS was well received and helped participants realize the value of involving family/friends in their care. Relative to control, FAMS participants had improved family/friend involvement, self-efficacy, and diet (but not physical activity) at 3 and 6 months (all ps < .05). Improvements in family/friend involvement mediated effects on self-efficacy and diet for FAMS participants but not for the individualized intervention group. CONCLUSIONS The promise of effectively engaging patients' family and friends lies in sustained long-term behavior change. This work represents a first step toward this goal by demonstrating how content targeting helpful and harmful family/friend involvement can drive short-term effects. TRIAL REGISTRATION NUMBER NCT02481596.
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Affiliation(s)
- Lindsay S Mayberry
- Department of Medicine, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN 37203, USA.,Vanderbilt Center for Diabetes Translation Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cynthia A Berg
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Robert A Greevy
- Vanderbilt Center for Diabetes Translation Research, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Biostatistics, Vanderbilt University, Nashville, TN, USA
| | - Lyndsay A Nelson
- Department of Medicine, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN 37203, USA.,Vanderbilt Center for Diabetes Translation Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Erin M Bergner
- Department of Medicine, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - Kenneth A Wallston
- Vanderbilt Center for Diabetes Translation Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kryseana J Harper
- Department of Medicine, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - Tom A Elasy
- Department of Medicine, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN 37203, USA.,Vanderbilt Center for Diabetes Translation Research, Vanderbilt University Medical Center, Nashville, TN, USA
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Dailey RM. Strategies in Context: How Perceptions of Romantic Partner Support for Weight Loss Vary by the Relational Context. HEALTH COMMUNICATION 2019; 34:1095-1106. [PMID: 29723479 DOI: 10.1080/10410236.2018.1461584] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Because romantic partners can be a strong influence on individuals' weight loss efforts and progress, the current study assessed the relational context of weight loss-dynamics within the relationship that pertain to weight loss. Three relational characteristics were examined: whether the weight loss was a team effort, how much partners had opposing approaches to weight loss, and individuals' difficulty in balancing their weight loss goals within their relationship goals. Findings showed that the relational characteristics were associated with both the perceived frequency and effectiveness of partner strategies (i.e., instrumental influence, encouragement, and coercion). Team effort was associated with perceiving all three strategies as more frequent and effective; opposing approaches were negatively associated with encouragement but positively associated with coercion for both frequency and effectiveness; and balance struggle was positively associated with coercion frequency and effectiveness. Additionally, a cluster analysis of the three relational characteristics yielded four relational climates: synchronized (high team effort, low relational strains), contentious cooperatives (moderate in all three relational characteristics), autonomous (low in all relational characteristics), and lone battlers (low team effort, high relational strains). The groups varied in the strategies they perceived as effective. All of these findings emerged beyond the variance explained by general relationship satisfaction. Overall, these results better explicate relationship characteristics that can be incorporated into a larger, ecological model on health behavior change.
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Affiliation(s)
- René M Dailey
- a Department of Communication Studies, University of Texas at Austin
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27
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If He Is in Shape, So Is the Marriage: Perceptions of Physical Fitness and Exercise and Older Couples' Marital Functioning. J Aging Phys Act 2019; 27:503-509. [PMID: 30507265 DOI: 10.1123/japa.2018-0203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The current study explored concordance in spouses' perceptions about exercise and how these perceptions predicted observed and self-reported marital functioning using a sample of 64 older married couples. Although couples were similarly motivated to exercise, their views on their physical fitness and potential barriers to exercise were uncorrelated. Dyadic analyses suggested that spouses' exercise perceptions, particularly husbands', were associated with how spouses treated each other during a marital problem-solving task and with their concurrent and future marital satisfaction. Exploring how spouses' views of exercise are related to their marital functioning and for whom these links are most salient may highlight potential opportunities and challenges for those wishing to strengthen couples' individual and relational well-being through exercise.
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Mayberry LS, Berg CA, Greevy RA, Wallston KA. Assessing helpful and harmful family and friend involvement in adults' type 2 diabetes self-management. PATIENT EDUCATION AND COUNSELING 2019; 102:1380-1388. [PMID: 30922622 PMCID: PMC6546510 DOI: 10.1016/j.pec.2019.02.027] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/21/2019] [Accepted: 02/28/2019] [Indexed: 05/24/2023]
Abstract
OBJECTIVE Develop and evaluate a measure assessing helpful and harmful family/friends' involvement in adults' type 2 diabetes (T2D) self-management. METHODS Prior mixed-methods research, cognitive interviews, and expert input informed measure development. We administered the measure in two studies (N = 392 and N = 512) to evaluate its factor structure, internal consistency reliability, test-retest reliability, and construct, criterion and predictive validity. RESULTS Analyses supported a two-factor solution: helpful and harmful involvement with internal consistency reliability α = .86 and .72, respectively. Three-month test-retest reliability was rho = 0.64 for helpful and rho = 0.61 for harmful (both p < 0.001). Over 90% reported at least one instance of family/friend involvement in the past month. Associations with other measures of diabetes involvement were as anticipated (all p < .01). Helpful and harmful involvement were independently associated with diabetes self-efficacy, diet, blood glucose testing and medication adherence cross-sectionally [βs 0.13-0.39 helpful, -0.12--0.33 harmful; all p < .05]. Harmful involvement independently predicted worse HbA1c (β = 0.08), and worsening HbA1c over three months (β = 0.12, both p < 0.05). CONCLUSION The Family and Friend Involvement in Adults' Diabetes (FIAD) is a reliable and valid measure assessing family/friend involvement in adults' T2D. PRACTICE IMPLICATIONS FIAD use can inform interventions to improve social contexts in which adults manage diabetes.
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Affiliation(s)
- Lindsay S Mayberry
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA; Center for Diabetes Translation Research, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Cynthia A Berg
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Robert A Greevy
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kenneth A Wallston
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA; School of Nursing, Vanderbilt University, Nashville, TN, USA
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Deprouw C, Guignot M, Bougeois-Sarran C, Bougeois-Sarran C, Coblentz-Baumann L, Ea HK. Partners and nurses' knowledge and representations of gout: A qualitative study. Joint Bone Spine 2019; 86:769-776. [PMID: 31067503 DOI: 10.1016/j.jbspin.2019.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 04/24/2019] [Indexed: 10/26/2022]
Abstract
Adherence to gout treatment is poor. Partners of patients and nurses are two major communicators with gouty patients, and their perceptions of illness may affect patient behavior. OBJECTIVE To explore partners' and nurses' knowledge and representations of gout. METHODS We used a qualitative grounded approach with semi-structured face-to-face individual interviews with a purposive sample of hospital nurses working in rheumatology and internal medicine departments and patient partners. Interviews were audio-recorded and transcribed. All authors met regularly to discuss coding and data interpretation. RESULTS Overall, 20 nurses and 12 partners participated in the interviews. Four major themes were evidenced: knowledge gaps (gout cause was unknown, unawareness of urate-lowering therapy and the possibility to cure gout, focus in gout flare and diet); lack of information and education on gout (knowledge acquired by personal experiences, nurses complained to be insufficiently educated, partners highlighted the lack of information and that general practitioners did not have time to educate patients); gout consequences and social impacts (handicapping disease, avoid social activities like dinner with friends); attitudes towards gout flare and patient management (feeling powerless during flare, negative feelings such as being ashamed leading to postpone medical seek or unconcerned about their partner disease). Nurses regretted that they had not enough time to discuss issues with patients. CONCLUSION Partners and nurses' knowledge of gout is based on daily experiences. Participants were eager to learn more about gout. Nurses' education and education programs including partners may improve gout management and patient adherence to treatment.
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Affiliation(s)
- Camille Deprouw
- Hôpital Lariboisière, service de rhumatologie, pôle locomoteur, AP-HP, 2, rue Ambroise Paré 75010 Paris, France
| | - Maxime Guignot
- Hôpital Lariboisière, service de rhumatologie, pôle locomoteur, AP-HP, 2, rue Ambroise Paré 75010 Paris, France
| | - Céline Bougeois-Sarran
- Hôpital Lariboisière, service de rhumatologie, pôle locomoteur, AP-HP, 2, rue Ambroise Paré 75010 Paris, France
| | - Constance Bougeois-Sarran
- Hôpital Lariboisière, service de rhumatologie, pôle locomoteur, AP-HP, 2, rue Ambroise Paré 75010 Paris, France
| | | | - Hang-Korng Ea
- Hôpital Lariboisière, service de rhumatologie, pôle locomoteur, AP-HP, 2, rue Ambroise Paré 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, 75018 Paris, France; Inserm U1132 Bioscar, Paris 75010, France.
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Gupta L, Khandelwal D, Lal PR, Gupta Y, Kalra S, Dutta D. Factors Determining the Success of Therapeutic Lifestyle Interventions in Diabetes - Role of Partner and Family Support. EUROPEAN ENDOCRINOLOGY 2019; 15:18-24. [PMID: 31244906 PMCID: PMC6587903 DOI: 10.17925/ee.2019.15.1.18] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 10/31/2018] [Indexed: 12/29/2022]
Abstract
Background and aims: Knowledge of therapeutic lifestyle interventions is one of the most important pillars of diabetes care; however, its incorporation in real-world settings is poor. This review evaluates the role of partner and family support in diabetes management. Methods: Literature searches were performed in PubMed, Medline and Embase for articles published before July 2018, using the terms “therapeutic lifestyle intervention” [MeSH Terms], OR “diet changes” [All Fields], OR “spousal participation” [All Fields], OR “lifestyle interventions” [All Fields], “lifestyle changes” [All Fields] AND “diabetes” [All Fields]. The search was not restricted to English-language literature; literature in Spanish, French and German were also evaluated. Results: A total of 66 of articles were reviewed, which included 33 original work, 21 review articles, and 12 systematic reviews and meta-analyses. Studies and meta-analyses have showed that if one partner has type-2 diabetes this increases the risk in other by 5–26%. Partner and family have similar diet, lifestyle, and micro- and macro-environments which could explain the similar increased risk of diabetes and non-communicable diseases. Studies have consistently shown that spousal and family support plays a key role in overcoming negative behaviours and optimising behaviours in diabetes control. Partner support has major role in prevention and control of diabetes distress, associated depression, and medication non-compliance which have an adverse impact in glycaemic outcomes. These data are predominantly available from observational studies. There is paucity of data from interventional trials evaluating effects of family and spousal participation on health, glycaemic control and quality of life. Conclusion: The support of family and spouse/partner is beneficial to improve adherence to the lifestyle interventions and pharmacotherapy required to achieve optimum glycaemic control and avoid associated complications.
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Affiliation(s)
- Lovely Gupta
- Department of Food and Nutrition, Lady Irwin College, University of Delhi, New Delhi, India
| | | | - Priti Rishi Lal
- Department of Food and Nutrition, Lady Irwin College, University of Delhi, New Delhi, India
| | - Yasheep Gupta
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospitals, Karnal, Haryana, India
| | - Deep Dutta
- Department of Endocrinology, Diabetes & Metabolic Disorders, Venkateshwar Hospitals, New Delhi, India
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Albanese AM, Huffman JC, Celano CM, Malloy LM, Wexler DJ, Freedman ME, Millstein RA. The role of spousal support for dietary adherence among type 2 diabetes patients: a narrative review. SOCIAL WORK IN HEALTH CARE 2019; 58:304-323. [PMID: 30596355 PMCID: PMC6353694 DOI: 10.1080/00981389.2018.1563846] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 11/16/2018] [Accepted: 12/19/2018] [Indexed: 06/09/2023]
Abstract
Healthy eating is key to successful management of type 2 diabetes (T2D). As discussed in this narrative review, there are strong indications that spousal support is an important element affecting dietary adherence in T2D. To provide a synthesized review of this evidence, Google Scholar and PubMed were searched, 28 relevant studies were selected, and the results were narratively summarized. A framework for information synthesis was developed which categorized results into three major themes: how gender roles and spousal dynamics function in spousal support for dietary adherence, the role of race and ethnicity in the influence of spousal support on dietary adherence, and the extant interventional work specifically targeting spousal support for T2D. The reviewed studies indicate that gender role performance is the principal factor in the relationship between spousal support and dietary adherence in T2D, though race and ethnicity also contribute. Despite this evidence, interventions that specifically target spousal support to improve dietary adherence in T2D have had limited efficacy. A better understanding of the relationship between spousal support and dietary adherence, as well as a subsequent utilization of this information to create targeted and effective interventions, would be of great benefit to the field of diabetes management.
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Affiliation(s)
| | - Jeff C. Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Christopher M. Celano
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | | | - Deborah J. Wexler
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- MGH Diabetes Center, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | | | - Rachel A. Millstein
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
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Corona K, Campos B, Rook KS, Biegler K, Sorkin DH. Do cultural values have a role in health equity? A study of Latina mothers and daughters. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2019; 25:65-72. [PMID: 30714768 PMCID: PMC6499474 DOI: 10.1037/cdp0000262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Recently, there has been a call to better understand Latino health and arrive at effective approaches for achieving health equity via research focusing on the association between cultural factors and health. This study examined whether familism, a cultural value that emphasizes warm and close family relationships, would attenuate the negative effects that perceived stress, a psychological process that can worsen health, can have on two physical health indicators- number of health conditions and bodily pain. METHOD Latina mothers (n = 85, Mage = 52.68, SD = 6.60) with Type 2 diabetes and their daughters (n = 86, Mage = 27.69, SD = 7.61) whose weight put them at risk for also developing the condition were recruited to take part in a larger intervention study aimed at improving weight loss/dietary intake. Participants completed measures of familism, perceived stress, health conditions, and bodily pain. RESULTS Results indicated that in the daughters, familism and perceived stress interacted to predict health conditions and bodily pain. As familism decreased, stress was associated with more health conditions and more bodily pain. These interactions were not significant for the mothers. CONCLUSIONS First, familism has the potential to buffer the negative effect of stress in ways that are protective for health among Latinas at risk for diabetes. Second, this buffering effect has boundary conditions, suggesting that a better understanding is needed of how, for whom, and under what circumstances familism can be beneficial for health. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | - Belinda Campos
- Department of Chicano/Latino Studies, University of California, Irvine
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Karekla M, Kasinopoulos O, Neto DD, Ebert DD, Van Daele T, Nordgreen T, Höfer S, Oeverland S, Jensen KL. Best Practices and Recommendations for Digital Interventions to Improve Engagement and Adherence in Chronic Illness Sufferers. EUROPEAN PSYCHOLOGIST 2019. [DOI: 10.1027/1016-9040/a000349] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Abstract. Chronic illnesses cause considerable burden in quality of life, often leading to physical, psychological, and social dysfunctioning of the sufferers and their family. There is a growing need for flexible provision of home-based psychological services to increase reach even for traditionally underserved chronic illness sufferer populations. Digital interventions can fulfill this role and provide a range of psychological services to improve functioning. Despite the potential of digital interventions, concerns remain regarding users’ engagement, as low engagement is associated with low adherence rates, high attrition, and suboptimal exposure to the intervention. Human–computer interaction (e.g., theoretical models of persuasive system design, gamification, tailoring, and supportive accountability) and user characteristics (e.g., gender, age, computer literacy) are the main identified culprits contributing to engagement and adherence difficulties. To date, there have not been any clear and concise recommendations for improved utilization and engagement in digital interventions. This paper provides an overview of user engagement factors and proposes research informed recommendations for engagement and adherence planning in digital intervention development. The recommendations were derived from the literature and consensualized by expert members of the European Federation of Psychology Associations, Psychology and Health Standing Committee, and e-Health Task Force. These recommendations serve as a starting point for researchers and clinicians interested in the digitalized health field and promote effective planning for engagement when developing digital interventions with the potential to maximize adherence and optimal exposure in the treatment of chronic health conditions.
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Affiliation(s)
- Maria Karekla
- Department of Psychology, University of Cyprus, Nikosia, Cyprus
- Psychology and Health Standing Committee of the European Federation of Psychology Associations, Brussels, Belgium
- e-Health Task Force of the European Federation of Psychology Associations, Brussels, Belgium
| | | | - David Dias Neto
- Psychology and Health Standing Committee of the European Federation of Psychology Associations, Brussels, Belgium
- APPsyCI – Applied Psychology Research Center Capabilities & Inclusion, ISPA – Instituto Universitário, Lisbon, Portugal
| | - David Daniel Ebert
- e-Health Task Force of the European Federation of Psychology Associations, Brussels, Belgium
- Friedrich Alexander University, Erlangen-Nürnberg, Germany
| | - Tom Van Daele
- e-Health Task Force of the European Federation of Psychology Associations, Brussels, Belgium
- Thomas More University of Applied Sciences, Belgium
| | - Tine Nordgreen
- e-Health Task Force of the European Federation of Psychology Associations, Brussels, Belgium
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Stefan Höfer
- Psychology and Health Standing Committee of the European Federation of Psychology Associations, Brussels, Belgium
- Medical University Innsbruck, Austria
| | - Svein Oeverland
- e-Health Task Force of the European Federation of Psychology Associations, Brussels, Belgium
- SuperEgo AS, Norway
| | - Kit Lisbeth Jensen
- e-Health Task Force of the European Federation of Psychology Associations, Brussels, Belgium
- Clinical Psychology, Private Practice, Denmark
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Social aggravation: Understanding the complex role of social relationships on stress and health-relevant physiology. Int J Psychophysiol 2018; 131:13-23. [DOI: 10.1016/j.ijpsycho.2018.03.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 03/20/2018] [Accepted: 03/27/2018] [Indexed: 12/13/2022]
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Fitzsimons GM, Finkel EJ. Transactive-Goal-Dynamics Theory: A Discipline-Wide Perspective. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2018. [DOI: 10.1177/0963721417754199] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Theories of goal pursuit typically conceptualize goal pursuers as isolated actors; in contrast, empirical research from diverse areas of psychology has demonstrated that goal setting, pursuit, and achievement are deeply embedded within social relationships. Because much of this emerging literature is developing within subfields with minimal cross talk, the potential for integration and advances to basic theory has not been realized. The present article leverages transactive-goal-dynamics theory in an effort to bring these literatures together. In doing so, it distills a common set of primary research questions toward the goal of promoting a cumulative, integrative, interdisciplinary field of research on the ways in which goal pursuit is socially embedded.
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Sorkin DH, Rook KS, Campos B, Marquez B, Solares J, Mukamel DB, Marcus B, Kilgore D, Dow E, Ngo-Metzger Q, Nguyen DV, Biegler K. Rationale and study protocol for Unidas por la Vida (United for Life): A dyadic weight-loss intervention for high-risk Latina mothers and their adult daughters. Contemp Clin Trials 2018; 69:10-20. [PMID: 29597006 PMCID: PMC5964027 DOI: 10.1016/j.cct.2018.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/18/2018] [Accepted: 03/20/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Half of Mexican-American women are under-active and nearly 78% are overweight/obese. The high lifetime risk of developing type 2 diabetes necessitates a culturally appropriate lifestyle intervention. PURPOSE Unidas por la Vida is a novel dyadic intervention that capitalizes on the centrality of family in Latino culture to mobilize an existing family dyad as a resource for health behavior change. The intervention aims to improve health behaviors and promote weight loss in two at-risk members of the same family: mothers with type 2 diabetes and their overweight/obese adult daughters who are at risk for developing diabetes. METHODS Participants (N = 460 mother-adult daughter dyads) will be randomized into one of three conditions: 1) dyadic participation (mothers-daughters) in a lifestyle intervention; 2) individual participation (mothers alone; unrelated daughters alone) in a lifestyle intervention; and 3) mother-daughter dyads in a minimal intervention control group. RESULTS The primary outcome is weight loss. Secondary outcomes include physical activity, dietary intake, physiological measures (e.g. HbA1c), and body composition. Both the dyadic and individual interventions are expected to produce greater weight loss at 6, 12, and 18 months than those in minimal intervention control group, with women assigned to the dyadic intervention expected to lose more weight and to maintain the weight loss longer than women assigned to the individual intervention. CONCLUSION Because health risks are often shared by multiple members of at-risk families, culturally appropriate, dyadic interventions have the potential to increase the success of behavior change efforts and to extend their reach to multiple family members. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02741037.
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Affiliation(s)
- Dara H Sorkin
- Department of Medicine, University of California, Irvine, Irvine, CA, USA.
| | - Karen S Rook
- Department of Psychology and Social Behavior, University of California Irvine, Irvine, CA, USA
| | - Belinda Campos
- Department of Chicano/Latino Studies, University of California Irvine, Irvine, CA, USA
| | - Becky Marquez
- School of Public Health, Brown University, Providence, RI, USA
| | | | - Dana B Mukamel
- Department of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Bess Marcus
- School of Public Health, Brown University, Providence, RI, USA
| | - David Kilgore
- Department of Family Medicine, University of California Irvine, Irvine, CA, USA
| | - Emily Dow
- Department of Family Medicine, University of California Irvine, Irvine, CA, USA
| | - Quyen Ngo-Metzger
- Department of Medicine, University of California, Irvine, Irvine, CA, USA; US Preventive Services Task Force, Agency for Healthcare Research and Quality, Rockville, MD, USA
| | - Danh V Nguyen
- Department of Medicine, University of California, Irvine, Irvine, CA, USA; Biostatistics, Epidemiology and Research Design, University of California Irvine, Irvine, CA, USA
| | - Kelly Biegler
- Department of Medicine, University of California, Irvine, Irvine, CA, USA
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Culley L, Law C, Hudson N, Mitchell H, Denny E, Raine-Fenning N. A qualitative study of the impact of endometriosis on male partners. Hum Reprod 2018. [PMID: 28637285 PMCID: PMC5850214 DOI: 10.1093/humrep/dex221] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
STUDY QUESTION What is the impact of endometriosis on male partners of women with the condition? SUMMARY ANSWER Endometriosis significantly impacts men across several life domains and can negatively impact emotional well-being. WHAT IS KNOWN ALREADY Endometriosis has been shown to negatively impact women's quality of life and may strain intimate relationships. Little is known about the impact on male partners. STUDY DESIGN, SIZE, DURATION The ENDOPART study was a cross-sectional, qualitative study of 22 women with endometriosis and their male partners (n = 44) in the UK (2012–2013). PARTICIPANTS/MATERIALS, SETTING, METHODS Inclusion criteria: laparoscopic diagnosis of endometriosis; the presence of symptoms for at least a year; partners living together. Data were collected via face to face, semi structured interviews with partners interviewed separately. Data were analysed thematically, assisted by NVivo 10. MAIN RESULTS AND THE ROLE OF CHANCE Men reported that endometriosis affected many life domains including sex and intimacy, planning for and having children, working lives and household income. It also required them to take on additional support tasks and roles. Endometriosis also had an impact on men's emotions, with responses including helplessness, frustration, worry and anger. The absence of professional or wider societal recognition of the impact on male partners, and a lack of support available to men, results in male partners having a marginalized status in endometriosis care. LIMITATIONS REASONS FOR CAUTION Self-selection of participants may have resulted in a sample representing those with more severe symptoms. Couples included are in effect ‘survivors’ in relationship terms, therefore, findings may underestimate the contribution of endometriosis to relationship breakdown. WIDER IMPLICATIONS OF THE FINDINGS The study extends knowledge about the impact of endometriosis on relationships, which thus far has been drawn largely from studies with women, by providing new insights about how this condition affects male partners. Healthcare practitioners need to take a more couple-centred, biopsychosocial approach toward the treatment of endometriosis, inclusive of partners and relationship issues. The findings demonstrate a need for information and support resources aimed at partners and couples. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the Economic and Social Research Council (reference ES/J003662/1). The authors have no conflicts of interest.
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Affiliation(s)
- L Culley
- School of Applied Social Sciences, Faculty of Health and Life Sciences, The Gateway, De Montfort University, Hawthorn Building, Leicester LE1 9BH, UK
| | - C Law
- School of Applied Social Sciences, Faculty of Health and Life Sciences, The Gateway, De Montfort University, Hawthorn Building, Leicester LE1 9BH, UK
| | - N Hudson
- School of Applied Social Sciences, Faculty of Health and Life Sciences, The Gateway, De Montfort University, Hawthorn Building, Leicester LE1 9BH, UK
| | - H Mitchell
- School of Applied Social Sciences, Faculty of Health and Life Sciences, The Gateway, De Montfort University, Hawthorn Building, Leicester LE1 9BH, UK
| | - E Denny
- Faculty of Health, Education and Life Sciences, Birmingham City University, Westbourne Road, Edgbaston, Birmingham B15 3TN, UK
| | - N Raine-Fenning
- Nurture Fertility, East Midlands Fertility Centre, 25 Business Park, Bostocks Lane, Sandiacre, Nottingham NG10 5QS, UK.,Division of Obstetrics and Gynaecology, School of Clinical Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK
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Abstract
Social support has been linked with many health outcomes, ranging from heart disease to depression. Although its importance has been recognized, less is known about how individuals with chronic illnesses may use social media to provide and seek social support. This chapter's focus is on the way in which people with Type 1 diabetes (T1D) use social media to provide and solicit social support. A mixed-methods approach is utilized. First, posts from two social media platforms were qualitatively content analyzed. Second, the data were quantitatively analyzed to provide a finer-grained understanding of the messages. The results show informational support as the most prevalent on both sites, although there are some differences in content and use. This chapter's implications highlight the importance of social media as a conduit for social support among caregivers and individuals affected by T1D.
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Fincham FD, Seibert GS, May RW, Wilson CM, Lister ZD. Religious Coping and Glycemic Control in Couples with Type 2 Diabetes. JOURNAL OF MARITAL AND FAMILY THERAPY 2018; 44:138-149. [PMID: 28589560 DOI: 10.1111/jmft.12241] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
This study examines the role of religious coping in couples' diabetes management processes. Eighty-seven couples where one spouse had type 2 diabetes were surveyed. The relationships between religious coping (positive and negative), shared glycemic control activities (e.g., planning a healthy diet), and glycemic control were examined using repeated measures ANOVA and SEM. Findings show spousal engagement in shared activities is significantly associated with glycemic control. Furthermore, the use of negative religious coping by the diabetic spouse, and positive religious coping by the nondiabetic spouse, related to lower levels and higher levels of shared glycemic control activities, respectively. Religious coping and shared glycemic control activities appear integral to couples managing type 2 diabetes and, may serve as useful points of intervention.
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Affiliation(s)
| | | | - Ross W May
- Family Institute, The Florida State University, Florida
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Smith Slep AM, Heyman RE, Mitnick DM, Lorber MF, Beauchaine TP. Targeting couple and parent-child coercion to improve health behaviors. Behav Res Ther 2017; 101:82-91. [PMID: 29108651 DOI: 10.1016/j.brat.2017.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/29/2017] [Accepted: 10/09/2017] [Indexed: 02/07/2023]
Abstract
This phase of the NIH Science of Behavior Change program emphasizes an "experimental medicine approach to behavior change," that seeks to identify targets related to stress reactivity, self-regulation, and social processes for maximal effects on multiple health outcomes. Within this framework, our project focuses on interpersonal processes associated with health: coercive couple and parent-child conflict. Diabetes and poor oral health portend pain, distress, expense, loss of productivity, and even mortality. They share overlapping medical regimens, are driven by overlapping proximal health behaviors, and affect a wide developmental span, from early childhood to late adulthood. Coercive couple and parent-child conflict constitute potent and destructive influences on a wide range of adult and child health outcomes. Such interaction patterns give rise to disturbed environmental stress reactivity (e.g., disrupted sympathetic nervous and parasympathetic nervous systems) and a wide range of adverse health outcomes in children and adults, including dental caries, obesity, and diabetes-related metabolic markers. In this work, we seek to identify/develop/validate assays assessing coercion, identify/develop and test brief interventions to reduce coercion, and test whether changes in coercion trigger changes in health behaviors.
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41
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August KJ, Dowell A, Sorkin DH. Disease factors associated with spousal influence on diabetic diet: An exploratory comparison of Vietnamese American and White older adults. Health Psychol Open 2017; 4:2055102917738658. [PMID: 29379626 PMCID: PMC5779944 DOI: 10.1177/2055102917738658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
This study examined whether disease-specific factors were important for how and how often White versus Vietnamese American spouses influenced their partners' diabetic diet. Results from a cross-sectional survey of 145 older adult spouses whose partners had type 2 diabetes revealed that Vietnamese American spouses used more frequent spousal influence (positive and negative) than White spouses. In addition, most of the factors associated with spousal influence differed for Vietnamese American and White spouses. Findings from this study highlight the importance of proximal and sociocultural factors in understanding older spouses' influence on their partners' diabetic diet.
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42
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Dennick K, Sturt J, Speight J. What is diabetes distress and how can we measure it? A narrative review and conceptual model. J Diabetes Complications 2017; 31:898-911. [PMID: 28274681 DOI: 10.1016/j.jdiacomp.2016.12.018] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/21/2016] [Accepted: 12/23/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Diabetes distress is the negative emotional impact of living with diabetes. It has tangible clinical importance, being associated with sub-optimal self-care and glycemic control. Diabetes distress has been operationalized in various ways and several measures exist. Measurement clarity is needed for both scientific and clinical reasons. OBJECTIVES To clarify the conceptualization and operationalization of diabetes distress, identify and distinguish relevant measures, and evaluate their appropriateness for this purpose. RESULTS Six measures were identified: Problem Areas in Diabetes (PAID) scale, Diabetes Distress Scale (DDS); Type I Diabetes Distress Scale (T1-DDS), Diabetes-specific Quality of Life Scale-Revised (DSQoLs-R) 'Burden and Restrictions-Daily Hassles' sub-scale, Well-being Questionnaire 28 (W-BQ 28) 'Diabetes Well-being' sub-scale, and Illness Perceptions Questionnaire-Revised (IPQ-R) 'Emotional Representations' sub-scale. Across these measures a broad spectrum of diabetes distress is captured, including distress associated with treatment regimen, food/eating, future/complications, hypoglycemia, social/interpersonal relationships, and healthcare professionals. No single measure appears fully comprehensive. Limited detail of the qualitative work informing scale design is reported, raising concerns about content validity. CONCLUSIONS Across the available measures diabetes distress is seemingly comprehensively assessed and measures should be considered in terms of their focus and scope to ensure the foci of interventions are appropriately targeted.
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MESH Headings
- Combined Modality Therapy/adverse effects
- Combined Modality Therapy/psychology
- Cost of Illness
- Diabetes Complications/prevention & control
- Diabetes Complications/psychology
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/psychology
- Diabetes Mellitus, Type 1/therapy
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/psychology
- Diabetes Mellitus, Type 2/therapy
- Humans
- Models, Psychological
- Psychosocial Support Systems
- Quality of Life
- Self-Management/psychology
- Stress, Psychological/complications
- Stress, Psychological/etiology
- Stress, Psychological/psychology
- Validation Studies as Topic
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Affiliation(s)
- Kathryn Dennick
- Florence Nightingale Faculty of Nursing and Midwifery, Kings College London, 57 Waterloo Road, London, SE1 8WA, UK.
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing and Midwifery, Kings College London, 57 Waterloo Road, London, SE1 8WA, UK
| | - Jane Speight
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia; The Australian Centre for Behavioral Research in Diabetes, Diabetes Victoria, 570 Elizabeth Street, Melbourne, Victoria 3000, Australia; AHP Research, 16 Walden Way, Hornchurch, Essex, UK
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Knutsen IR, Foss IC, Todorova E, Roukova P, Kennedy A, Portillo MC, Regaira E, Serrano-Gil M, Lionis C, Angelaki A, Rogers A. Negotiating Diet in Networks: A Cross-European Study of the Experiences of Managing Type 2 Diabetes. QUALITATIVE HEALTH RESEARCH 2017; 27:299-310. [PMID: 26515920 DOI: 10.1177/1049732315610318] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Food and diet are central aspects of diabetes self-management but the relevance of social networks for the way people are supported in their management of type 2 diabetes is often under-acknowledged. In this article, we aimed to explore the coalescences between these two phenomena among people with type 2 diabetes to increase knowledge of interactions within social network related to daily diet. The article is based on 125 qualitative interviews with individuals with type 2 diabetes from five European countries. Based on assumptions that people with chronic illnesses reshape relationships through negotiation, we analyzed negotiations of food at different levels of network. The respondents' reflections indicate that there are complex negotiations that influence self-management and food, including support, knowledge, and relationships within families; attention and openness in social situations; and the premises and norms of society.
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Affiliation(s)
| | | | - Elka Todorova
- 2 University of World and National Economy, Sofia, Bulgaria
| | - Poli Roukova
- 3 Bulgarian Academy of Sciences, Sofia, Bulgaria
| | | | | | | | | | | | | | - Anne Rogers
- 4 University of Southampton, Southampton, UK
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44
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Wiebe DJ, Helgeson V, Berg CA. The social context of managing diabetes across the life span. AMERICAN PSYCHOLOGIST 2016; 71:526-538. [PMID: 27690482 PMCID: PMC5094275 DOI: 10.1037/a0040355] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Diabetes self-management is crucial to maintaining quality of life and preventing long-term complications, and it occurs daily in the context of close interpersonal relationships. This article examines how social relationships are central to meeting the complex demands of managing Type I and Type 2 diabetes across the life span. The social context of diabetes management includes multiple resources, including family (parents, spouses), peers, romantic partners, and health care providers. We discuss how these social resources change across the life span, focusing on childhood and adolescence, emerging adulthood, and adulthood and aging. We review how diabetes both affects and is affected by key social relationships at each developmental period. Despite high variability in how the social context is conceptualized and measured across studies, findings converge on the characteristics of social relationships that facilitate or undermine diabetes management across the life span. These characteristics are consistent with both Interpersonal Theory and Self-Determination Theory, 2 organizing frameworks that we utilize to explore social behaviors that are related to diabetes management. Involvement and support from one's social partners, particularly family members, is consistently associated with good diabetes outcomes when characterized by warmth, collaboration, and acceptance. Underinvolvement and interactions characterized by conflict and criticism are consistently associated with poor diabetes outcomes. Intrusive involvement that contains elements of social control may undermine diabetes management, particularly when it impinges on self-efficacy. Implications for future research directions and for interventions that promote the effective use of the social context to improve diabetes self-management are discussed. (PsycINFO Database Record
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45
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Nelson LA, Mayberry LS, Wallston K, Kripalani S, Bergner EM, Osborn CY. Development and Usability of REACH: A Tailored Theory-Based Text Messaging Intervention for Disadvantaged Adults With Type 2 Diabetes. JMIR Hum Factors 2016; 3:e23. [PMID: 27609738 PMCID: PMC5034151 DOI: 10.2196/humanfactors.6029] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/11/2016] [Accepted: 08/21/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Among adults with type 2 diabetes mellitus (T2DM), adherence to recommended self-care activities is suboptimal, especially among racial and ethnic minorities with low income. Self-care nonadherence is associated with having worse glycemic control and diabetes complications. Text messaging interventions are improving the self-care of adults with T2DM, but few have been tested with disadvantaged populations. OBJECTIVE To develop Rapid Education/Encouragement And Communications for Health (REACH), a tailored, text messaging intervention to support the self-care adherence of disadvantaged patients with T2DM, based on the Information-Motivation-Behavioral skills model. We then tested REACH's usability to make improvements before evaluating its effects. METHODS We developed REACH's content and functionality using an empirical and theory-based approach, findings from a previously pilot-tested intervention, and the expertise of our interdisciplinary research team. We recruited 36 adults with T2DM from Federally Qualified Health Centers to participate in 1 of 3 rounds of usability testing. For 2 weeks, participants received daily text messages assessing and promoting self-care, including tailored messages addressing users' unique barriers to adherence, and weekly text messages with adherence feedback. We analyzed quantitative and qualitative user feedback and system-collected data to improve REACH. RESULTS Participants were, on average, 52.4 (SD 9.5) years old, 56% (20/36) female, 63% (22/35) were a racial or ethnic minority, and 67% (22/33) had an income less than US $35,000. About half were taking insulin, and average hemoglobin A1c level was 8.2% (SD 2.2%). We identified issues (eg, user concerns with message phrasing, technical restrictions with responding to assessment messages) and made improvements between testing rounds. Overall, participants favorably rated the ease of understanding (mean 9.6, SD 0.7) and helpfulness (mean 9.3, SD 1.4) of self-care promoting text messages on a scale of 1-10, responded to 96% of assessment text messages, and rated the helpfulness of feedback text messages 8.5 (SD 2.7) on a scale of 1-10. User feedback led to refining our study enrollment process so that users understood the flexibility in message timing and that computers, not people, send the messages. Furthermore, research assistants' feedback on the enrollment process helped improve participants' engagement with study procedures. CONCLUSIONS Testing technology-delivered interventions with disadvantaged adults revealed preferences and concerns unique to this population. Through iterative testing and multiple data sources, we identified and responded to users' intervention preferences, technical issues, and shortcomings in our research procedures.
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Affiliation(s)
- Lyndsay A Nelson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
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Mayberry LS, Harper KJ, Osborn CY. Family behaviors and type 2 diabetes: What to target and how to address in interventions for adults with low socioeconomic status. Chronic Illn 2016; 12:199-215. [PMID: 27099387 PMCID: PMC4996706 DOI: 10.1177/1742395316644303] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/20/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Diabetes-specific family behaviors are associated with self-care and glycemic control among adults with type 2 diabetes. Formative research is needed to inform assessment of these behaviors and interventions to address obstructive family behaviors (sabotaging and nagging/arguing), particularly among racial/ethnic minorities and low-income adults who struggle most with self-care adherence. METHODS We conducted a mixed-methods study with adults with type 2 diabetes at a Federally Qualified Health Center to better understand experiences with diabetes-specific family behaviors and willingness to engage family members in diabetes interventions. Participants completed a phone survey (N = 53) and/or attended a focus group (n = 15). RESULTS Participants were 70% African American and had low socioeconomic status (96% annual income <US$20K, 51% uninsured). Although 62% lived with family members, only 48% lived with the person providing the most diabetes-specific support. Participants' family living situations were diverse and multigenerational. Most (64%) experienced both supportive and obstructive family behaviors from the same person(s). Some participants (40%) said engaging family in interventions would positively affect all members; others (27%) did not want to involve family. DISCUSSION Findings can inform the design and content of interventions targeting family involvement in adults' type 2 diabetes, with implications for assessing family behaviors, intervention modalities, and who to engage.
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Affiliation(s)
- Lindsay Satterwhite Mayberry
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA Center for Diabetes Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kryseana J Harper
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Chandra Y Osborn
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA Center for Diabetes Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
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47
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Janevic MR, Piette JD, Ratz DP, Kim HM, Rosland AM. Correlates of family involvement before and during medical visits among older adults with high-risk diabetes. Diabet Med 2016; 33:1140-8. [PMID: 26642179 PMCID: PMC4896854 DOI: 10.1111/dme.13045] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2015] [Indexed: 11/27/2022]
Abstract
AIMS To examine the characteristics of patients with diabetes who regularly receive help from a supporter in preparing for and attending medical visits, and the association between this help and clinical risk factors for diabetes complications. METHODS We linked survey data about family involvement for patients in the Veterans Health Administration system with poorly controlled Type 2 diabetes (n = 588; mean 67 years; 97% male) with health record data on blood pressure, glycaemic control and prescription-fill gaps. We used multivariable regression to assess whether supporter presence and, among patients with supporters, supporter role (visit preparation, accompaniment to medical visit or no involvement) were associated with concurrent trends in clinical risk factors over 2 years, adjusting for sociodemographic and health characteristics. RESULTS Most patients (78%) had a main health supporter; of these, more had regular support for preparing for appointments (69%) than were regularly accompanied to them (45%). Patients with preparation help only were younger and more educated than accompanied patients. Support presence and type was not significantly associated with clinical risk factors. CONCLUSIONS Family help preparing for appointments was common among these patients with high-risk diabetes. In its current form, family support for medical visits may not affect clinical factors in the short term. Supporters helping patients engage in medical visits may need training and assistance to have an impact on the clinical trajectory of patients with diabetes.
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Affiliation(s)
- M R Janevic
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - J D Piette
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, USA
| | - D P Ratz
- VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, USA
| | - H M Kim
- Center for Statistical Consultation and Research, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - A-M Rosland
- VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, USA
- Division of General Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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48
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Newton-John TRO, Ventura AD, Mosely K, Browne JL, Speight J. ‘Are you sure you’re going to have another one of those?’: A qualitative analysis of the social control and social support models in type 2 diabetes. J Health Psychol 2016; 22:1819-1829. [DOI: 10.1177/1359105316642005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
While there is evidence that spouses can impact the self-management of adults with type 2 diabetes mellitus, less is known about the influence of the wider social network. This qualitative study explored the perceived impact of the family as well as friends and work colleagues on type 2 diabetes mellitus self-management. A total of 25 adults with type 2 diabetes mellitus participated in semi-structured interviews regarding their social experiences of living with diabetes. Deductive thematic analysis was applied to the data. Pre-existing themes of health-related social control and social support were identified in the wider social network, with additional themes of non-involvement and unintentional undermining also emerging.
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Affiliation(s)
| | | | | | | | - Jane Speight
- Diabetes Victoria, Australia
- Deakin University, Australia
- AHP Research, UK
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49
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Vissenberg C, Stronks K, Nijpels G, Uitewaal PJM, Middelkoop BJC, Kohinor MJE, Hartman MA, Nierkens V. Impact of a social network-based intervention promoting diabetes self-management in socioeconomically deprived patients: a qualitative evaluation of the intervention strategies. BMJ Open 2016; 6:e010254. [PMID: 27075842 PMCID: PMC4838721 DOI: 10.1136/bmjopen-2015-010254] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE There is a need for effective interventions that improve diabetes self-management (DSM) among socioeconomically deprived patients with type 2 diabetes. The group-based intervention Powerful Together with Diabetes (PTWD) aimed to increase social support for DSM and decrease social influences hindering DSM (eg, peer pressure, social norms) in patients living in deprived neighbourhoods. Through a qualitative process evaluation, this paper aims to study whether this intervention changed social support and social influences, and which elements of the intervention contributed to this. METHODS The intervention group (IG) was compared with a standard group-based educational intervention (control group, CG). 27 qualitative in-depth interviews with participants (multiethnic sample) and 24 interviews with group leaders were conducted. Interviews were coded and analysed using MAXQDA according to framework analysis. RESULTS Patients in the IG experienced more emotional support from group members and more instrumental and appraisal support from relatives than those in the CG. Also, they were better able to recognise and cope with influences that hinder their DSM, exhibited more positive norms towards DSM and increased their priority regarding DSM and their adherence. Finally, the engagement in DSM by relatives of participants increased. Creating trust between group members, skills training, practising together and actively involving relatives through action plans contributed to these changes. CONCLUSIONS A group-based intervention aimed at creating trust, practising together and involving relatives has the potential to increase social support and diminish social influences hindering DSM in socioeconomically deprived patients with diabetes. Promising elements of the intervention were skills training and providing feedback using role-playing exercises in group sessions with patients, as well as the involvement of patients' significant others in self-management tasks, and actively involving them in making an action plan for self-management. These positive results justify the value of further evaluating the effectiveness of this intervention in a larger sample. TRIAL REGISTRATION NUMBER NTR1886, Results.
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Affiliation(s)
- C Vissenberg
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - K Stronks
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - G Nijpels
- Department of General Practice, EMGO Institute VU University Medical Center, Amsterdam, The Netherlands
| | - P J M Uitewaal
- Department of Public Health, The Hague's Public Health Department, The Hague, The Netherlands
| | - B J C Middelkoop
- Department of Public Health, Leiden University Medical Center, Leiden, The Netherlands
| | - M J E Kohinor
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M A Hartman
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - V Nierkens
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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50
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Mayberry LS, Berg CA, Harper KJ, Osborn CY. The Design, Usability, and Feasibility of a Family-Focused Diabetes Self-Care Support mHealth Intervention for Diverse, Low-Income Adults with Type 2 Diabetes. J Diabetes Res 2016; 2016:7586385. [PMID: 27891524 PMCID: PMC5116505 DOI: 10.1155/2016/7586385] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 09/04/2016] [Indexed: 11/17/2022] Open
Abstract
Family members' helpful and harmful actions affect adherence to self-care and glycemic control among adults with type 2 diabetes (T2D) and low socioeconomic status. Few family interventions for adults with T2D address harmful actions or use text messages to reach family members. Through user-centered design and iterative usability/feasibility testing, we developed a mHealth intervention for disadvantaged adults with T2D called FAMS. FAMS delivers phone coaching to set self-care goals and improve patient participant's (PP) ability to identify and address family actions that support/impede self-care. PPs receive text message support and can choose to invite a support person (SP) to receive text messages. We recruited 19 adults with T2D from three Federally Qualified Health Centers to use FAMS for two weeks and complete a feedback interview. Coach-reported data captured coaching success, technical data captured user engagement, and PP/SP interviews captured the FAMS experience. PPs were predominantly African American, 83% had incomes <$35,000, and 26% were married. Most SPs (n = 7) were spouses/partners or adult children. PPs reported FAMS increased self-care and both PPs and SPs reported FAMS improved support for and communication about diabetes. FAMS is usable and feasible and appears to help patients manage self-care support, although some PPs may not have a SP.
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Affiliation(s)
- Lindsay Satterwhite Mayberry
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA
- *Lindsay Satterwhite Mayberry:
| | - Cynthia A. Berg
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Kryseana J. Harper
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Chandra Y. Osborn
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
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