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Social Support and Lifestyle vs. Medical Diabetes Self-Management in the Diabetes Study of Northern California (DISTANCE)

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

In chronic illness self-care, social support may influence some health behaviors more than others.

Purpose

Examine social support’s association with seven individual chronic illness self-management behaviors: two healthy “lifestyle” behaviors (physical activity, diet) and five more highly skilled and diabetes-specific (medical) behaviors (checking feet, oral medication adherence, insulin adherence, self-monitored blood glucose, primary care appointment attendance).

Methods

Using cross-sectional administrative and survey data from 13,366 patients with type 2 diabetes, Poisson regression models estimated the adjusted relative risks (ARR) of practicing each behavior at higher vs lower levels of social support.

Results

Higher emotional support and social network scores were significantly associated with increased ARR of both lifestyle behaviors. Both social support measures were also associated with increased ARR for checking feet. Neither measure was significantly associated with other medical behaviors.

Conclusions

Findings suggest that social support diminished in importance as self-care progresses from lifestyle to more skilled “medical” behaviors.

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Acknowledgments

We thank Lisa Berkman for sharing analytic code for scoring the SNI.

Ann-Marie Rosland is a VA HSR&D Career Development Awardee. John D. Piette is a VA HSR&D Senior Research Career Scientist. The Diabetes Study of Northern California (DISTANCE) was funded by NIH R01s (DK080726, DK086178, DK065664, DK081796 and HD46113). This study was also supported by two Centers for Diabetes Translational Research (Grant Numbers P30DK092926 and P30DK092924).

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Authors Dr. Rosland, Dr. Piette, Dr. Lyles, Ms. Parker, Mr. Moffet, Dr. Adler, Dr. Schillinger, and Dr. Karter declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. The institutional review boards at the Kaiser Foundation Research Institute and University of California, San Francisco approved this study.

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Authors and Affiliations

  1. VA Ann Arbor Center for Clinical Management Research, 2800 Plymouth Road, NCRC Building 16, 3rd Floor, Ann Arbor, MI, 48109, USA

    Ann Marie Rosland MD MS & John D. Piette PhD

  2. Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, MI, USA

    Ann Marie Rosland MD MS

  3. Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA

    John D. Piette PhD

  4. Division of General Internal Medicine, University of California San Francisco School of Medicine, San Francisco, CA, USA

    Courtney R. Lyles PhD & Dean Schillinger MD

  5. San Francisco General Hospital, UCSF Center for Vulnerable Populations, San Francisco, CA, USA

    Courtney R. Lyles PhD & Dean Schillinger MD

  6. Department of Psychiatry, University of California San Francisco School of Medicine, San Francisco, CA, USA

    Nancy E. Adler PhD

  7. Kaiser Permanente Northern California, Division of Research, Oakland, CA, USA

    Melissa M. Parker MS, Howard H. Moffet MPH & Andrew J. Karter PhD

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  1. Ann Marie Rosland MD MS
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Corresponding author

Correspondence to Ann Marie Rosland MD MS.

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Rosland, A.M., Piette, J.D., Lyles, C.R. et al. Social Support and Lifestyle vs. Medical Diabetes Self-Management in the Diabetes Study of Northern California (DISTANCE). ann. behav. med. 48, 438–447 (2014). https://doi.org/10.1007/s12160-014-9623-x

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  • DOI: https://doi.org/10.1007/s12160-014-9623-x

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