Open AccessAutonomy support from informal health supporters: links with self-care activities, healthcare engagement, metabolic outcomes, and cardiac risk among Veterans with type 2 diabetes
Author(s) -
Aaron A. Lee,
Michele Heisler,
Ranak Trivedi,
Patric Leukel,
Maria K. Mor,
AnnMarie Rosland
Publication year - 2020
Publication title -
journal of behavioral medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 94
eISSN - 1573-3521
pISSN - 0160-7715
DOI - 10.1007/s10865-020-00196-5
Subject(s) - autonomy , health psychology , social support , medicine , diabetes mellitus , type 2 diabetes , health care , psychology , gerontology , nursing , public health , social psychology , endocrinology , political science , law , economic growth , economics
This study examined the role of autonomy support from adults' informal health supporters (family or friends) in diabetes-specific health behaviors and health outcomes. Using baseline data from 239 Veterans with type 2 diabetes at risk of complications enrolled in behavioral trial, we examined associations between autonomy support from a support person and that support person's co-residence with the participant's diabetes self-care activities, patient activation, cardiometabolic measures, and predicted risk of a cardiac event. Autonomy support from supporters was associated with significantly increased adherence to healthy lifestyle behaviors (diet, p < .001 and exercise, p = .003); higher patient activation (p < .001); greater patient efficacy in interacting with healthcare providers, and lower 5-year (p = .044) and 10-year (p = .027) predicted cardiac risk. Autonomy support was not significantly associated with diabetes-specific behaviors (checking blood glucose, foot care, or medication taking); or hemoglobin A1c, systolic blood pressure, or non-HDL cholesterol. There was a significant interaction of autonomy support and supporter residence in one model such that lack of autonomy support was associated with lower patient activation only among individuals with in-home supporters. No other interactions were significant. Findings suggest that autonomy support from family and friends may play a role in patient self-management, patient activation, and lower cardiac risk.