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



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).



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.



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.
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA Center for Diabetes Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA lindsay.mayberry@vanderbilt.edu.
Lindsay Satterwhite
LS
Mayberry
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA.
Kryseana J
KJ
Harper
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA Center for Diabetes Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.
Chandra Y
CY
Osborn
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D004032:Diet; D015444:Exercise; D005191:Family Characteristics; D005195:Family Relations; D005260:Female; D017144:Focus Groups; D006442:Glycated Hemoglobin / Q000378:metabolism; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011203:Poverty; D012648:Self Care; D012923:Social Class; D012944:Social Support; D011795:Surveys and Questionnaires
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
Type 2 diabetes; family involvement; intervention; social environment; social support