Improving diabetes outcomes: A couples intervention

描述(由申请人提供)： 研究表明，强化血糖控制可以减少或预防糖尿病引起的严重并发症。然而，需要开发和测试创新的干预措施，将这些发现转化为实际的临床实践。虽然研究强调了家庭和婚姻支持在改善血糖控制等医疗结果方面的重要性，但在家庭层面对患有2型糖尿病的成年人进行干预的工作很少。这是一项试验性建议，旨在开发和测试一种干预措施，旨在争取糖尿病患者伴侣的支持，并增强和改善这种支持的质量，以便这种关系将对医疗、行为和情感结果产生积极影响。这项干预措施在针对这对夫妇方面具有创新性，还因为它将通过电话实施，以增强该项目接触到更广泛患者样本的能力。具体目标是(1)评估电话管理的行为改变/心理社会干预对2型糖尿病患者个人的可能效果，以及(2)评估与仅针对个人患者的干预相比，同时针对2型糖尿病患者和他/她的伴侣的干预是否可能导致糖尿病结果的改善。将招募45对夫妻，其中一人患有2型糖尿病。在基线评估和基本的糖尿病教育之后，他们将被分配到个人干预组、夫妇干预组或常规护理对照组。11个电话联系将包括关于糖尿病、行为改变、心理社会问题或夫妇沟通的教育，以及解决问题的技巧。手册将包括阅读资料、有组织的家庭作业和自我监控日志。再评估将在干预后2周和3个月进行。作为R34，这是一个试验性提案，旨在开发夫妇方法的可行性和有效性的初步数据，以便未来的全面试验可以作为R18提案提交。

DESCRIPTION (provided by applicant): Studies have shown that intensive blood glucose control can reduce or forestall the serious complications that often develop due to diabetes. However, innovative interventions need to be developed and tested that will translate these findings into actual clinical practice. While research highlights the importance of family and marital support in improving medical outcomes like glycemic control, little has been done to intervene at the family level with adults who have type 2 diabetes. This is a pilot proposal to develop and test an intervention that aims to both enlist the support of partners of diabetes patients, and to enhance and improve the quality of that support so that the relationship will have a positive impact on medical, behavioral and emotional outcomes. The intervention is innovative in targeting the couple, and also because it will be implemented by telephone, in order to enhance the project's ability to reach a broader sample of patients. The specific aims are (1) to assess the likely efficacy of a telephone-administered behavior change/psycho-social intervention for individuals with type 2 diabetes, and (2) to assess whether an intervention that targets both the individual with type 2 diabetes and his/her partner is likely to result in improved diabetes outcomes when compared to an intervention that targets the individual patient alone. Forty-five couples will be recruited in which one partner has type 2 diabetes. After baseline assessment and basic diabetes education, they will be assigned to an individual intervention group, a couples intervention group, or a usual care control group. Eleven telephone contacts will include education about diabetes, behavior change, psycho-social issues or couples communication, and problem-solving techniques. A manual will include readings, structured homework assignments and self-monitoring logs. Reassessment will occur 2 weeks and 3 months post intervention. As an R34, this is a pilot proposal to develop preliminary data on the feasibility and efficacy of he couples approach so that a future full-scale trial may be submitted as an R18 proposal.