Symposia
Couples / Close Relationships
McKenzie K. Roddy, Ph.D.
VA Tennessee Valley Healthcare System
Nashville, Tennessee
Merna E-Rifai, MA
Clinical/Translational Research Coordinator II
Vanderbilt University Medical Center
Nashville, Tennessee
James Aikens, PhD
Professor
University of Michigan
Ann Arbor, Michigan
Ruth Wolever, PhD
Professor
Vanderbilt University Medical Center
Nashville, Tennessee
Lindsay S. Mayberry, M.S., Ph.D.
Associate Professor of Medicine & Biomedical Informatics
Vanderbilt University Medical Center
Nashville, Tennessee
Introduction: Type 2 diabetes (T2D) requires daily self-care behaviors that occur within social contexts. T2D management support from friends and family is longitudinally associated with better self-management. Nonetheless, clinical trials encouraging inclusion of a family member or friend with whom the patient would discuss diabetes management and health goals may discourage engagement from those who lack social support. Further, family and friends declining invitations to participate in research could decrease patient motivation and increase feelings of isolation.
Methods: Patients identified through the electronic medical record at a Southeastern academic medical center were purposively recruited for a diverse sample. Patients who were potentially eligible were mailed explanatory materials and recruited via telephone by research staff. Eligible patients were asked to invite a support person to co-participate and share their contact information for research staff to recruit. While all patients were asked to invite a support person, they could participate in the RCT if they declined or their identified support person declined.
Results: Of (N = 379) consented patients, 344 (90.8%) invited a support person to co-participate. Almost all invited support persons consented to participate (315/344; 91.6%), and early (pre-randomization) withdrawal was comparatively unlikely among patients whose invitee consented to participate (19/315; 6.0%). In contrast, for patients who invited a support person who did not consent (29/344; 8.4%), around one-third withdrew prior to randomization (10/29; 34.5%). Most patients who did not invite a support person withdrew prior to randomization (21/35; 60.0%). Early withdrawal was significantly lower among patients who had a consenting support person than among those who did not [Χ2(2) = 85.5, p < 01].
Discussion: Patients with a co-participating support person were more likely than those without one to be randomized for the RCT. Given the importance of social support for T2D self-management, individuals with less support may be especially at risk for poor management and in the greatest need of intervention. Although allowing T2D patients to enroll without a support person may have enhanced our patient recruitment rate; those who enrolled alone were at significantly elevated risk for early (pre-randomization) dropout. Findings indicate opportunity to improve this approach further for patients without support persons so they can benefit from research.