title: Family support, medication adherence, and glycemic control among adults with type 2 diabetes.
abstract: OBJECTIVE
  We used a mixed-methods approach to explore the relationships between participants' perceptions of family members' diabetes self-care knowledge, family members' diabetes-specific supportive and nonsupportive behaviors, and participants' medication adherence and glycemic control (A1C).
  
  
  METHODS
  Adults with type 2 diabetes participated in focus group sessions that discussed barriers and facilitators to diabetes management (n = 45) and/or completed surveys (n = 61) to collect demographic information, measures of diabetes medication adherence, perceptions of family members' diabetes self-care knowledge, and perceptions of family members' diabetes-specific supportive and nonsupportive behaviors. Most recent A1C was extracted from the medical record.
  
  
  RESULTS
  Perceiving family members were more knowledgeable about diabetes was associated with perceiving family members performed more diabetes-specific supportive behaviors, but was not associated with perceiving family members performed fewer nonsupportive behaviors. Perceiving family members performed more nonsupportive behaviors was associated with being less adherent to one's diabetes medication regimen, and being less adherent was associated with worse glycemic control. In focus groups, participants discussed family member support and gave examples of family members who were informed about diabetes but performed sabotaging or nonsupportive behaviors.
  
  
  CONCLUSIONS
  Participant reports of family members' nonsupportive behaviors were associated with being less adherent to one's diabetes medication regimen. Participants emphasized the importance of instrumental help for diabetes self-care behaviors and reported that nonsupportive family behaviors sabotaged their efforts to perform these behaviors. Interventions should inform family members about diabetes and enhance their motivation and behavioral skills around not interfering with one's diabetes self-care efforts.
authors.affiliation: Human and Organizational Development, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Lindsay S
authors.initials: LS
authors.lastname: Mayberry
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D012648:Self Care / Q000523:psychology* / Q000706:statistics & numerical data; D012944:Social Support; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human