Diabetes affects 25% of Department of Veterans Affairs (VA) patients and is among the leading causes of morbidity and mortality. Self-management, including healthy eating, being physically active, and taking medications, is critical to preventing diabetes complications, but many Veterans do not adhere to self-management recommendations. Enhancing the quality and quantity of existing social support resources is a promising strategy to improve self-management among Veterans, as self-management behaviors are influenced by a patient's social network. However, little is known about Veterans' existing social support resources for self-management, how to best leverage social support to facilitate self-management, and whether there are differences by gender.
The proposed research will adapt and pilot test a virtual intervention that includes Veterans with diabetes and support persons, which aims to reduce unsupportive and enhance supportive behaviors to facilitate Veterans' self-management.
Aim 1. Characterize social support resources, perceptions of supportive and unsupportive behaviors related to diabetes self-management, and facilitators and barriers to engaging in a partnered self-management intervention.
Aim 2. Identify support person perceptions of supportive and unsupportive behaviors for Veterans' self-management and facilitators and barriers to engaging in a partnered self-management intervention.
Aim 3. Evaluate feasibility, acceptability, and preliminary clinical improvement of a partnered diabetes self-management intervention in a single-arm pilot trial (n=20 men, n=20 women) employing a mixed methods approach.
Aim 1 will utilize individual qualitative telephone interviews with Veterans (n=32) to characterize social support resources for self-management. Aim 2 will involve individual qualitative telephone interviews with support persons identified by Veterans in Aim 1 (e.g., spouses, adult children, and friends; n=16) to understand their perceptions of helpful and harmful support. Lastly, Aim 3 will use both qualitative and quantitative methods to pilot test modifications to an existing partnered self-management intervention and evaluate feasibility, acceptability, and preliminary clinical improvement in self-management behaviors and hemoglobin A1c (HbA1c) overall and by gender.
Not yet available.
Diabetes is highly prevalent among Veterans with profound impacts on health and wellbeing. Innovative, Veteran-centric interventions are needed to improve diabetes self-management. The proposed research has the potential to fill this gap, particularly for women Veterans who are often included in very limited numbers in VA intervention studies. If effective, this strategy could be tailored to other chronic diseases or disease prevention. The project aims align with VA's Blueprint for Excellence strategies of anticipating and meeting the unique needs of Veterans; delivering high-quality, Veteran-centered care; and advancing personalized, proactive, and patient-driven care.
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Diabetes and Other Endocrine Disorders