Article

Behavioral science in diabetes. Contributions and opportunities

AMC Cancer Research Center, Denver, Colorado 80214, USA.
Diabetes Care (Impact Factor: 8.57). 06/1999; 22(5):832-43. DOI: 10.2337/diacare.22.5.832
Source: PubMed

ABSTRACT To summarize the current status of behavioral research and practice in diabetes and to identify promising future directions.
We review behavioral science contributions to diabetes in self-management and patient empowerment, interventions with children and adolescents, and special problems including blood glucose awareness training and complications such as depression. We also identify emerging areas in which behavioral science stands to make significant contributions, including quality of life, worksite and community programs, interventions using new information technologies, and translation research evaluating practical programs in representative settings. We then discuss the gap between the generally encouraging research on behavioral contributions to diabetes and the infrequent incorporation of such contributions in practice. Suggestions are made for how to close this gap, including ways to increase understanding of behavioral issues, opportunities for funding of key research and implementation questions, and how behavioral science principles can become more integrated into diabetes organizations and care.
Changes are required on the part of behavioral scientists in how they organize and present their research and on the part of potential users of this knowledge, including other health professions, organizations, and funding agencies. Integrating behavioral science advances with other promising genetic, medical, nutritional, technology, health care, and policy opportunities promises not only to broaden our understanding of diabetes but also to improve patient care, quality of life, and public health for persons with diabetes.

Download full-text

Full-text

Available from: Edwin B Fisher, Jun 29, 2015
1 Follower
 · 
99 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Self-management of diabetes is challenging, especially for adolescents who face multiple changes, including closer peer relationships. Few studies have explored how friends can provide constructive support in this effort. The present research investigated, in two qualitative studies, the perceptions of adolescents with diabetes and their friends with respect to the positive social support that friends can offer. In study 1, 28 adolescents aged 12-15 with type 1 diabetes participated in online focus groups. In study 2, 11 of these adolescents were interviewed in person together with their best friends. The data were analysed by means of content analysis. In study 1, the adolescents with diabetes identified various supportive behaviours of friends, particularly concerning emotional support: treating them normally, showing interest, having fun, providing a distraction, and taking their diabetes into account. They differed in their attitude towards support, and this influenced which behaviours they perceived as supportive. Study 2 showed that the adolescents with diabetes and their friends often had similar opinions on the desired degree of support. Fear of stigmatization and sense of autonomy withheld some adolescents with diabetes from soliciting more support. These insights can be useful in patient education aiming to promote social support.
    01/2014; 2014:415849. DOI:10.1155/2014/415849
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To employ a risk and resistance framework to examine changes in metabolic control over early to middle adolescence. We interviewed 70 girls and 62 boys (mean age 12 years) annually for 4 years. Risk and resistance factors, including demographics, disease-related variables, self-care behavior, and psychosocial variables were assessed. Hemoglobin A1c was obtained from medical records. Multilevel modeling showed metabolic control deteriorated with age. Self-care behavior interacted with age to predict the decline, such that self-care was more strongly related to poor metabolic control for older adolescents. Eating disturbances, depression, and peer relations were related to poor metabolic control, whereas good family relations were related to better metabolic control for girls. Independent risk factors for poor metabolic control included poor self-care, disturbed eating behavior, depression, and peer relations; parental support was an independent resistance factor for girls. Future research should examine mechanisms by which these relations emerge.
    Journal of Pediatric Psychology 08/2008; 34(3):254-70. DOI:10.1093/jpepsy/jsn079 · 2.91 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We examined the implications of illness centrality for psychological and physical health among male and female early adolescents with type 1 diabetes. We interviewed 132 adolescents before or after a routine clinic appointment. We measured the extent to which they defined themselves in terms of their illness, their views of the illness, psychological well-being, self-care behavior, and metabolic control. Females scored higher on illness centrality than males. Illness centrality was related to poor psychological well-being when the illness was perceived in negative terms, but only for females. For males, illness centrality was unrelated to psychological well-being. Illness centrality was related to poor metabolic control. The extent to which adolescent females define themselves in terms of their illness is most problematic when the illness is perceived in highly negative terms. Future research should examine how illness centrality and views of illness change over the course of adolescence.
    Journal of Pediatric Psychology 05/2007; 32(3):260-72. DOI:10.1093/jpepsy/jsl018 · 2.91 Impact Factor