Family behaviors and type 2 diabetes: What to target and how to address in interventions for adults with low socioeconomic status

Chronic Illn. 2016 Sep;12(3):199-215. doi: 10.1177/1742395316644303. Epub 2016 Apr 19.

Abstract

Objectives: Diabetes-specific family behaviors are associated with self-care and glycemic control among adults with type 2 diabetes. Formative research is needed to inform assessment of these behaviors and interventions to address obstructive family behaviors (sabotaging and nagging/arguing), particularly among racial/ethnic minorities and low-income adults who struggle most with self-care adherence.

Methods: We conducted a mixed-methods study with adults with type 2 diabetes at a Federally Qualified Health Center to better understand experiences with diabetes-specific family behaviors and willingness to engage family members in diabetes interventions. Participants completed a phone survey (N = 53) and/or attended a focus group (n = 15).

Results: Participants were 70% African American and had low socioeconomic status (96% annual income <US$20K, 51% uninsured). Although 62% lived with family members, only 48% lived with the person providing the most diabetes-specific support. Participants' family living situations were diverse and multigenerational. Most (64%) experienced both supportive and obstructive family behaviors from the same person(s). Some participants (40%) said engaging family in interventions would positively affect all members; others (27%) did not want to involve family.

Discussion: Findings can inform the design and content of interventions targeting family involvement in adults' type 2 diabetes, with implications for assessing family behaviors, intervention modalities, and who to engage.

Keywords: Type 2 diabetes; family involvement; intervention; social environment; social support.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / therapy*
  • Diet
  • Exercise
  • Family Characteristics
  • Family Relations*
  • Female
  • Focus Groups
  • Glycated Hemoglobin / metabolism
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Interpersonal Relations
  • Male
  • Middle Aged
  • Patient Compliance
  • Poverty
  • Self Care*
  • Social Class
  • Social Support*
  • Surveys and Questionnaires

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • hemoglobin A1c protein, human