Spouse Involvement in Everyday Type 2 Diabetes Care: Effects of Social Control on Continuously Measured Glucose

配偶参与日常 2 型糖尿病护理：社会控制对连续测量血糖的影响

• 批准号: 9683380
• 负责人: EMILY C SORIANO
• 金额: $ 4.45万
• 依托单位: UNIVERSITY OF DELAWARE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9683380
• 关键词: Address; Baseline Surveys; Belief; Caring; Cause of Death; Complications of Diabetes Mellitus; Couples; Data; Delaware; Development; Diabetes Mellitus; Discipline; Distress; Emotional; Emotions; Fellowship; Foundations; Glucose; Glycemic Index; Glycosylated hemoglobin A; Goals; Health; Health Psychology; Health behavior; Healthcare Systems; Intervention; Knowledge; Lead; Link; Longitudinal Studies; Measures; Mentors; Methodology; Modeling; New York; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Patient Self-Report; Patients; Persons; Process; Public Health; Reporting; Research; Research Activity; Research Training; Self Management; Site; Social Controls; Spouses; Surveys; Testing; Time; Training; Training Activity; Translating; Translational Research; Universities; Work; career; clinical application; diabetes management; diet and exercise; effective intervention; exercise adherence; experience; glucose monitor; glycemic control; innovation; interest; medication compliance; physical conditioning; predictive modeling; prevent; programs; public health relevance; secondary analysis; skills; standard measure

7. PROJECT SUMMARY/ABSTRACT Type 2 diabetes (T2D) self-management, which includes diet, exercise, and medication adherence, is critical to prevent potentially fatal complications. Spouses often attempt to influence T2D patients’ health behavior—termed social control—which has been shown to both facilitate and impede self-management. A critical barrier to developing effective T2D interventions that include spouses is the current lack of knowledge of precisely how and under what conditions spouses facilitate or impede T2D management. The proposed research aims to identify the conditions that lead social control to impede T2D glycemic control, which was objectively measured using continuous glucose monitoring (CGM). A key advantage of CGM over traditional glycemic indices (e.g., HbA1c) is its ability not only to summarize average glycemic control, but also glucose variability, which has been independently linked to T2D complications. Social control is hypothesized to associate with greater glucose variability under conditions of patient distress and poor relationship quality. This proposal involves secondary analysis of a longitudinal study of partnered T2D patients: After baseline surveys, patients wore CGMs and completed 5 surveys per day for a 7-day period. These data will be used to accomplish the following aims: Aim 1. To examine the between-person interactions among baseline social control, distress, and relationship quality as predictors of model-implied glucose variability over the subsequent 7 days. Aim 2. To examine the within-person interactions among momentary social control, distress, and relationship quality as dynamic predictors of within-person model-implied glucose variability. Results of the proposed research will inform when and for whom social control is detrimental and the development of targeted couples T2D self-management interventions. The proposed Fellowship will provide the Applicant with the training needed to launch a productive, rigorous, independent program of research in pursuit of her overarching career goal—to advance understanding of mechanisms that underlie the association between close relationships and physical health. The proposed research and training will address the Applicant’s lack of prior research experience in physical health outcomes, provide her with powerful methodological skills tailor-made for her interests, fill gaps in her discipline-specific conceptual knowledge in health psychology, and enhance her dissemination and professional skills. The proposed Fellowship Mentors and training sites (University of Delaware, Christiana Care Health System, and New York Regional Center for Diabetes Translation Research) are ideally suited for the proposed research and training activities. The integrated research and training plan described in this proposal will satisfy critical training needs and enhance the Applicant’s potential for an independent research career.

7.项目摘要/摘要 2型糖尿病(T2D)自我管理，包括饮食、锻炼和服药依从性， 对于防止潜在的致命并发症至关重要。配偶经常试图影响T2D患者的健康 行为--被称为社会控制--已被证明既促进自我管理，也阻碍自我管理。一个 制定包括配偶在内的有效T2D干预措施的关键障碍是目前缺乏知识 配偶如何以及在什么条件下促进或阻碍T2D管理。建议数 研究旨在确定导致社会控制阻碍T2D血糖控制的条件，这是 使用连续血糖监测(CGM)进行客观测量。CGM相对于传统产品的一个关键优势 血糖指数(例如，HbA1c)是指它不仅能概括平均血糖控制情况，还能概括血糖 变异性，这已经独立地与T2D并发症联系在一起。社会控制被假设为 在患者痛苦和人际关系质量差的情况下，血糖变异性更大。这 该提案涉及对配对T2D患者的纵向研究进行二次分析：在基线调查之后， 患者佩戴CGM，并在7天内每天完成5次调查。这些数据将用于 实现以下目标：目标1.考察基线社会群体之间的人与人之间的互动 控制、痛苦和关系质量作为模型隐含的血糖变异性的预测因子 7天。目的2.考察瞬间社会控制、痛苦和焦虑之间的人与人之间的交互作用 人际关系质量作为人内模型的动态预测因子--隐含的血糖变异性。评选结果 拟议的研究将告知何时以及对谁来说社会控制是有害的，并制定有针对性的 夫妇T2D自我管理干预。 拟议的奖学金将为申请者提供必要的培训，以启动富有成效的， 严格、独立的研究计划，以追求她的首要职业目标--进步 理解亲密关系和身体健康之间联系的机制。 拟议的研究和培训将解决申请者在物理方面缺乏先前研究经验的问题 健康结果，为她提供为她的兴趣量身定做的强大方法技能，填补她的空白 健康心理学特定学科的概念知识，并加强她的传播和 专业技能。拟议的研究金导师和培训地点(特拉华大学，克里斯蒂安娜 CARE Health System和纽约地区糖尿病翻译研究中心)非常适合 拟议的研究和培训活动。本文件中描述的综合研究和培训计划 建议书将满足关键的培训需求，并增强申请人进行独立研究的潜力 职业生涯。