Roddy McKenzie K, Spieker Andrew J, Nelson Lyndsay A, Greevy Robert A, LeStourgeon Lauren M, Bergner Erin M, El-Rifai Merna, Elasy Tom A, Aikens James E, Wolever Ruth Q, Mayberry Lindsay S
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN.
medRxiv. 2023 Sep 12:2023.09.11.23295375. doi: 10.1101/2023.09.11.23295375.
Type 2 diabetes self-management occurs within social contexts. We sought to test the effects of Family/friends Activation to Motivate Self-care (FAMS), a self-care support intervention delivered via mobile phones, on psychosocial outcomes for persons with diabetes (PWDs) and their support persons.
PWDs had the option to enroll with a friend/family member as a support person in a 15-month RCT to evaluate FAMS versus enhanced usual care. FAMS included 9-months of monthly phone coaching and text message support for PWDs, and text message support for enrolled support persons.
PWDs (N=329) were 52% male and 39% from minoritized racial or ethnic groups; 50% enrolled with elevated diabetes distress. Support persons (N=294) were 26% male and 33% minoritized racial or ethnic groups. FAMS improved PWDs' diabetes distress ( =-0.19) and global well-being ( =0.21) during the intervention, with patterns of larger effects among minoritized groups. Post-intervention and sustained (15-month) improvements were driven by changes in PWDs' self-efficacy, self-care behaviors, and autonomy support. Among support persons, FAMS improved helpful involvement without increasing burden or harmful involvement.
FAMS improved PWDs' psychosocial well-being, with post-intervention and sustained improvements driven by improved self-efficacy, self-care, and autonomy support. Support persons increased helpful involvement without adverse effects.
2型糖尿病自我管理发生在社会环境中。我们试图测试通过手机提供的自我护理支持干预措施——家庭/朋友激活以促进自我护理（FAMS）对糖尿病患者（PWD）及其支持人员心理社会结局的影响。
糖尿病患者可以选择让朋友/家庭成员作为支持人员参加一项为期15个月的随机对照试验，以评估FAMS与强化常规护理的效果。FAMS包括为糖尿病患者提供9个月的每月电话指导和短信支持，以及为登记的支持人员提供短信支持。
糖尿病患者（N = 329）中52%为男性，39%来自少数种族或族裔群体；50%登记时糖尿病困扰程度较高。支持人员（N = 294）中26%为男性，33%为少数种族或族裔群体。在干预期间，FAMS改善了糖尿病患者的糖尿病困扰（=-0.19）和总体幸福感（=0.21），在少数群体中的效果更为明显。干预后及持续（15个月）的改善是由糖尿病患者自我效能、自我护理行为和自主支持的变化推动的。在支持人员中，FAMS增加了有益的参与，而没有增加负担或有害的参与。
FAMS改善了糖尿病患者的心理社会幸福感，干预后及持续的改善是由自我效能、自我护理和自主支持的改善推动的。支持人员增加了有益的参与，且没有不良影响。
