About 1 in 10 people in the United States are currently affected by diabetes, an illness that demands constant self-management with respect to diet, physical activity, glucose monitoring, and medication adherence. Diabetes does not affect everyone equally?non-Hispanic Blacks unfortunately suffer a disproportionate burden of diabetes prevalence, mortality, and complications compared to non-Hispanic Whites. Across racial/ethnic group, family members often provide social support for individuals with type 2 diabetes, resulting in better diabetes self-care and lower HbA1c among both of these racial/ethnic groups. These support behaviors are often distinguished based on type, such as whether family members provided emotional or instrumental support. However, studies of supportive interactions within parent-child relationships suggests that there are Black-White differences in other dimensions of support, such as whether the support was unsolicited (i.e., unasked for) or overprotective (i.e., underestimates the individual?s capabilities). These dimensions, along with other dimensions yet to be identified, merit further examination in an adult chronic health population. The proposed study will utilize a mixed methods approach to examine other dimensions of support that have rarely been examined, such as whether support received from family is unsolicited or overprotective in nature.
In Aim 1, qualitative interviews will be conducted to better characterize differences in support received by Black and White individuals with type 2 diabetes. Then, ecological momentary assessment (EMA) will be used to investigate Black-White differences in dimensions of daily support received from family. Unsolicited support, overprotective support, and other salient dimensions identified through the qualitative interviews will be measured. It is expected that Black individuals will report receiving higher levels of unsolicited support and overprotective support than White individuals.
In Aim 2, EMA will be used to explore Black-White differences in the link between dimensions of received support and health. Given the different perceptions of these support behaviors, it is expected that unsolicited and overprotective support will be associated with worse mood and self-care among White individuals, but unrelated or related to better mood and self-care for Black individuals. Links between other dimensions identified in the qualitative interviews and health outcomes will also be examined. Utilizing qualitative methods will ground the research in participants? lived experiences, and ecological momentary assessment will allow for more precise measurement of supportive interactions as they occur in real time. To support the completion of the proposed project, the applicant will receive personalized instruction from a team of leading researchers in health disparities, qualitative methods, and quantitative methods, and conduct the research in an exceptional training environment. The training team and the proposed project will sufficiently prepare the applicant for future work as a researcher examining racial/ethnic differences in the link between social support processes and health.
Type 2 diabetes is prevalent, costly, and difficult to manage, and non-Hispanic Blacks experience a disproportionate burden of diabetes-related mortality and complications. As family members often play an important role in illness management, the proposed project seeks to better characterize dimensions of family support among Black and White individuals with type 2 diabetes, and examine Black-White differences in the impact of support on psychological and behavioral health. This research will provide a more in-depth examination of social support processes and promote the development of culturally sensitive interventions for individuals with diabetes and their families.
