Improving diabetes outcomes: A couples intervention

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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.