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Impact of a Dyadic Intervention on Family Supporter Involvement in Helping Adults Manage Type 2 Diabetes.
Zupa, Margaret F; Lee, Aaron; Piette, John D; Trivedi, Ranak; Youk, Ada; Heisler, Michele; Rosland, Ann-Marie.
Affiliation
  • Zupa MF; VA Pittsburgh Center for Health Equity Research and Promotion, Pittsburgh, PA, USA. zupamf@upmc.edu.
  • Lee A; Department of Medicine, Division of Endocrinology and Metabolism, University of Pittsburgh Medical School, Pittsburgh, PA, USA. zupamf@upmc.edu.
  • Piette JD; Department of Psychology, University of Mississippi, Oxford, MS, USA.
  • Trivedi R; VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, USA.
  • Youk A; University of Michigan School of Public Health, Ann Arbor, MI, USA.
  • Heisler M; Center for Innovation to Implementation, VA Palo Alto Health Care System, Livermore, CA, USA.
  • Rosland AM; Division of Public Mental Health and Population Sciences, Stanford University, Stanford, CA, USA.
J Gen Intern Med ; 37(4): 761-768, 2022 03.
Article in En | MEDLINE | ID: mdl-34240285
ABSTRACT

BACKGROUND:

Family support for adults' diabetes care is associated with improved self-management and outcomes, but healthcare providers lack structured ways to engage those supporters.

OBJECTIVE:

Assess the impact of a patient-supporter diabetes management intervention on supporters' engagement in patients' diabetes care, support techniques, and caregiving experience.

DESIGN:

Multivariate regression models examined between-group differences in support-related measures observed as part of a larger trial randomizing participants to a dyadic intervention versus usual care.

PARTICIPANTS:

A total of 239 adults with type 2 diabetes and either A1c >8% or systolic blood pressure >160mmHg enrolled with a family supporter. INTERVENTION Health coaches provided training on positive support techniques and facilitated self-management information sharing and goal-setting. MAIN

MEASURES:

Patient and supporter reports at baseline and 12 months of supporter roles in diabetes care and caregiving experience.

RESULTS:

At 12 months, intervention-assigned patients had higher odds of reporting increased supporter involvement in remembering medical appointments (AOR 2.74, 95% CI 1.44, 5.21), performing home testing (AOR 2.40, 95% CI 1.29, 4.46), accessing online portals (AOR 2.34, 95% CI 1.29, 4.30), deciding when to contact healthcare providers (AOR 2.12, 95% CI 1.15, 3.91), and refilling medications (AOR 2.10, 95% CI 1.14, 3.89), but not with attending medical appointments or with healthy eating and exercise. Intervention-assigned patients reported increased supporter use of autonomy supportive communication (+0.27 points on a 7-point scale, p=0.02) and goal-setting techniques (+0.30 points on a 5-point scale, p=0.01). There were no differences at 12 months in change scores measuring supporter distress about patients' diabetes or caregiving burden. Intervention-assigned supporters had significantly larger increases in satisfaction with health system support for their role (+0.88 points on a 10-point scale, p=0.01).

CONCLUSIONS:

A dyadic patient-supporter intervention led to increased family supporter involvement in diabetes self-management and increased use of positive support techniques, without increasing caregiver stress.
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Full text: 1 Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / Self-Management Type of study: Clinical_trials / Prognostic_studies Limits: Adult / Humans Language: En Journal: J Gen Intern Med Journal subject: MEDICINA INTERNA Year: 2022 Type: Article Affiliation country: United States

Full text: 1 Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / Self-Management Type of study: Clinical_trials / Prognostic_studies Limits: Adult / Humans Language: En Journal: J Gen Intern Med Journal subject: MEDICINA INTERNA Year: 2022 Type: Article Affiliation country: United States