Assessing helpful and harmful family and friend involvement in adults' type 2 diabetes self-management

Abstract

Objective: Develop and evaluate a measure assessing helpful and harmful family/friends' involvement in adults' type 2 diabetes (T2D) self-management.

Methods: Prior mixed-methods research, cognitive interviews, and expert input informed measure development. We administered the measure in two studies (N = 392 and N = 512) to evaluate its factor structure, internal consistency reliability, test-retest reliability, and construct, criterion and predictive validity.

Results: Analyses supported a two-factor solution: helpful and harmful involvement with internal consistency reliability α = .86 and .72, respectively. Three-month test-retest reliability was rho = 0.64 for helpful and rho = 0.61 for harmful (both p < 0.001). Over 90% reported at least one instance of family/friend involvement in the past month. Associations with other measures of diabetes involvement were as anticipated (all p < .01). Helpful and harmful involvement were independently associated with diabetes self-efficacy, diet, blood glucose testing and medication adherence cross-sectionally [βs 0.13-0.39 helpful, -0.12--0.33 harmful; all p < .05]. Harmful involvement independently predicted worse HbA1c (β = 0.08), and worsening HbA1c over three months (β = 0.12, both p < 0.05).

Conclusion: The Family and Friend Involvement in Adults' Diabetes (FIAD) is a reliable and valid measure assessing family/friend involvement in adults' T2D.

Practice implications: FIAD use can inform interventions to improve social contexts in which adults manage diabetes.

Keywords: Family; Glycemic control; Health behavior; Social support; Type 2 diabetes.

Conflict of interest statement

Competing Interests Statements:

The authors have no competing interests to declare.

Copyright © 2019 Elsevier B.V. All rights reserved.

Figures

Figure 1.. Confirmatory factor analysis (Study 2).

Standardized factor loadings are shown on the paths from the latent variable to each indicator (item), all p<.001; squared multiple correlations are shown on the paths from each indicator to each error term, all p<.001. Curved arrows depict correlations between error terms that were not constrained to zero based on hypothesized shared error variance for certain items (correlations non-significant at p<.05 are grayed). Mean (standard deviations) and percent reporting a score > 1 = “never in the past month” for each item are shown across the bottom.