The Role of Social Relationships and Self-Efficacy in Diabetes Management

社会关系和自我效能在糖尿病管理中的作用

基本信息

批准号：
7689938
负责人：
Linda Ann Wray
金额：
$ 19.68万
依托单位：
PENNSYLVANIA STATE UNIVERSITY, THE
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-20 至 2012-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7689938
关键词：
Address Adherence Adult Aging Area Attenuated Behavior Behavioral Birth Categories Characteristics Couples Cross-Sectional Studies Data Data Analyses Data Set Development Diabetes Mellitus Diabetes prevention Diagnosis Divorce Effectiveness Elderly Environment Environmental Risk Factor Equation Ethnic Origin Fostering Future Gender Goals Guidelines Health Health Personnel Health behavior Health behavior outcomes Healthy People 2010 Individual Intervention Interview Investigation Knowledge Life Life Style Link Literature Mails Marital Status Marriage Mediating Modeling Nature Never Married Non-Insulin-Dependent Diabetes Mellitus Obesity Outcome Pattern Play Population Population Heterogeneity Practice Guidelines Prevalence Process Psychosocial Factor Psychosocial Influences Public Health Quality of life Race Research Retirement Risk Role Sampling Self Efficacy Social Environment Social status Social support Spouses Surveys Testing Translating Unmarried Vacuum Woman age group base behavioral health cohort cost design diabetes management diet and exercise effective intervention glycemic control high risk men middle age person centered public health relevance social trend

项目摘要

DESCRIPTION (provided by applicant):This R21 application seeks support for an investigation of the roles of marital status, social support, and self- efficacy in the effectiveness of diabetes management in a diverse population of middle-aged and older adults in the U.S. The proposed research will use structural equation modeling to analyze data collected in 2002 and 2004 from core interviews of the nationally representative Health and Retirement Study (HRS), plus data from the 2003 supplemental diabetes-specific mail survey to examine these relationships by gender, age group, and major race-ethnicity categories. The significance of the proposed research lies in the skyrocketing rates of type 2 diabetes in the U.S. over the past few decades in all segments of the population, but primarily in middle aged and older adults. Concerns about obesity and physical inactivity and their links to the onset, complications, and societal costs of diabetes have led to public health mandates at the national level-such as those included in Healthy People 2010-aimed at reversing those trends. Although prevention of diabetes is certainly an important goal, more effective management for individuals already diagnosed with diabetes is also critical for reducing the risks of future complications. Currently, less than one in eight of all adults with diabetes follow the guidelines for good management; and older adults follow them at even lower rates. Many past studies showing that self-efficacy and social relationships are key factors in diabetes-related behavioral and health outcomes are limited by their use of non-representative data sets, cross-sectional analyses, and inadequate controls on other factors that may also be important to consider. This application's goal is to examine how social relationships (and particularly marriage) and self-efficacy influence adherence to diabetes-related lifestyle behaviors and health outcomes in order to develop and test interventions that provide more effective supports for adults living with diabetes. In particular, we will: (1) examine marital status as a predictor of behavioral (diet and exercise) and health outcomes (glycemic control and diabetes-related quality of life) in middle-aged and older adults living with diabetes; (2) investigate whether self-efficacy and diabetes support mediate the link between marital status and behavioral and health outcomes of diabetes; and (3) discern whether associations among marital status, diabetes support, self-efficacy, and behavioral and health outcomes are moderated by gender, age group, or race-ethnicity. Understanding more clearly the role of marriage and self-efficacy, and particularly if and how diabetes management differs between middle-aged and older married and unmarried adults, may inform the development of more effective interventions for adults living with diabetes. This knowledge may also be all the more important given recent studies showing spouses may be at increased risk for developing diabetes themselves because of the marital context and shared environment. PUBLIC HEALTH RELEVANCE Concerns about obesity and physical inactivity and their links to diabetes have led to public health mandates- such as those included in Healthy People 2010-aimed at reversing those trends. Although prevention of diabetes is an important goal, more effective management for individuals already diagnosed with diabetes is also critical for reducing the risks of future complications. Currently, less than one in eight adults with diabetes follow the guidelines for good management; and older adults follow them at even lower rates. Understanding how social relationships (and particularly marriage) and self-efficacy influence good diabetes management in middle-aged and older adults living with diabetes may be key to developing and testing interventions that provide more effective supports, and all the more important to married couples because spouses may be at higher risk for developing diabetes themselves if their partner has diabetes.

描述（由申请人提供）：此R21申请寻求支持调查婚姻状况，社会支持和自我效能在糖尿病管理有效性中的作用，在美国的中年和老年人中，拟议的研究将使用2002年和2004年核心代表性的研究（2004年访谈）研究（2004年）的研究（HERT）研究（REC）研究（RET）的研究（RECE）的研究（RECE）的研究（RECE）的2003年访谈（RET）。特定于糖尿病的邮件调查以性别，年龄段和主要种族种族类别来检查这些关系。拟议的研究的重要性在于在过去几十年中，在美国的所有人群中，美国2型糖尿病的速度飞涨，但主要在中年和老年人中。人们对肥胖和身体不活动的关注以及它们与糖尿病的发作，并发症和社会成本的联系已导致公共卫生在国家层面上的要求，例如，2010年健康人中的糖尿病阶段 - 在扭转这些趋势方面所包括的人。尽管预防糖尿病是一个重要的目标，但是对于已经诊断出患有糖尿病的人来说，更有效的管理对于降低未来并发症的风险也至关重要。目前，所有患有糖尿病的成年人中不到八分之一遵循良好管理的指南。老年人以更低的速度跟随他们。过去的许多研究表明，自我效能感和社会关系是与糖尿病相关行为和健康结果的关键因素，并且受其使用非代表性数据集，横断面分析以及对其他可能也要考虑的其他因素的控制不足的限制。该应用程序的目标是研究社会关系（尤其是婚姻）如何影响与糖尿病相关的生活方式行为和健康成果的依从性，以开发和测试干预措施，从而为糖尿病的成年人提供更有效的支持。特别是：（1）在糖尿病患有行为（饮食和运动）和健康结果（血糖控制和与糖尿病相关的生活质量质量质量的健康状况的预测指标）中，研究婚姻状况；（2）调查自我效能和糖尿病是否支持糖尿病的婚姻状况与行为和健康结果之间的联系；（3）识别婚姻状况，糖尿病支持，自我效能感以及行为和健康成果之间的关联是否受性别，年龄段或种族种族的缓解。更清楚地了解婚姻和自我效能感的作用，尤其是在中年和年长的已婚和未婚成年人之间以及糖尿病管理之间的不同之处可能会为糖尿病患者的成人开发更有效的干预措施。考虑到最近的研究表明，由于婚姻环境和共同的环境，这种知识也可能更重要。公共卫生有关肥胖和身体不活跃及其与糖尿病的联系的关注导致了公共卫生的任务 - 例如，在2010年健康人中包括的趋势扭转这些趋势。尽管预防糖尿病是一个重要目标，但对于已经诊断出患有糖尿病的人来说，更有效的管理对于降低未来并发症的风险也至关重要。目前，不到八分之一的糖尿病成年人遵循良好管理的指南。老年人以更低的速度跟随他们。了解社会关系（尤其是婚姻）和自我效能如何影响糖尿病患有糖尿病的中年和老年人的良好糖尿病管理可能是开发和测试提供更有效支持的干预措施的关键，并且对于已婚夫妇而言，这对已婚夫妇来说更为重要，因为如果他们的伴侣患有糖尿病，则配偶可能会更有患糖尿病的风险。