title: Family involvement is helpful and harmful to patients' self-care and glycemic control.
abstract: OBJECTIVE
  We assessed the relationships between supportive and obstructive family behaviors and patients' diabetes self-care activities and HbA1C, and potential interaction effects and differences by demographic characteristics.
  
  
  METHODS
  In a cross-sectional study, 192 adults with type 2 diabetes completed the Diabetes Family Behavior Checklist-II, the Summary of Diabetes Self-Care Activities, and a glycemic control (HbA1C) test.
  
  
  RESULTS
  Participants reported similar rates of supportive and obstructive behaviors that were positively correlated (rho=0.61, p<0.001). In adjusted analyses, supportive family behaviors were associated with adherence to different self-care behaviors (β=0.20 to 0.50, p<0.05), whereas obstructive family behaviors were associated with less adherence to self-care behaviors (β=-0.28 to -0.39, p<0.01) and worse HbA1C (β=0.18, p<0.05). Supportive behaviors protected against the detrimental effect of obstructive behaviors on HbA1C (interaction β=-0.22, p<0.001). Non-Whites reported more supportive and obstructive behaviors than Whites, but race did not affect the relationships between family behaviors and self-care or HbA1C.
  
  
  CONCLUSIONS
  Involving family members in patients' diabetes management may impede patients' self-care and compromise their glycemic control unless family members are taught to avoid obstructive behaviors.
  
  
  CONCLUSIONS
  Our findings endorse interventions that help family members develop actionable plans to support patients' self-care and train them to communicate productively about diabetes management.
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA. Electronic address: lindsay.mayberry@vanderbilt.edu.
authors.forename: Lindsay Satterwhite
authors.initials: LS
authors.lastname: Mayberry
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
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; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology* / Q000628:therapy*; D005190:Family / Q000523:psychology*; D005260:Female; 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
keywords: Family; Glycemic control; HbA1C; Self-care; Social support; Type 2 diabetes