Two for one? Effects of a couples intervention on partners of persons with Type 2 diabetes: a randomized controlled trial. Issue 4 (8th January 2019)

• Record Type: Journal Article
• Authors: Trief, P. M.; Fisher, L.; Sandberg, J.; Hessler, D. M.; Cibula, D. A.; Weinstock, R. S.
• Is Part Of: Diabetic medicine. Volume 36:Issue 4(2019)
• Page Start: 473
• Page End: 481
• Publication Date: 2019-01-08
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.13871
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: Aims: To compare the outcomes of partners who participated in a telephone couples behavioural intervention to improve glycaemic control in persons with Type 2 diabetes with those of untreated partners of participants in an individual intervention or education; to explore 'ripple effects', i.e. positive behaviour changes seen in untreated partners. Methods: The Diabetes Support Project was a three‐arm randomized telephone intervention trial comparing outcomes of couples calls (CC), individual calls (IC) and diabetes education calls (DE). Couples included one partner with Type 2 diabetes and HbA1c ≥ 58 mmol/mol (7.5%). All arms received self‐management education (two calls). CC and IC arms participated in 10 additional behaviour change calls. CC included partners, emphasizing partner communication, collaboration and support. Blinded assessments were performed at 4, 8 and 12 months. Partner outcomes were psychosocial (diabetes distress, relationship satisfaction, depressive symptoms), medical (BMI, blood pressure) and behavioural (fat intake, activity). Results: Partners' ( N = 268) mean age was 55.8 years, 64.6% were female and 29.9% were from minority ethnic groups. CC (vs. IC and DE) partners had greater reductions in diabetes distress, greater increases in marital satisfaction (4 and 8 months), and some improvements in diastolic BP. There were no consistent differences among arms in other outcomes. There was no evidence of a dietary or activity behaviour ripple effect on untreated partners, i.e. comparing partners in the IC and DE arms. Conclusions: A collaborative couples intervention resulted in significant improvements in partner diabetes distress and relationship satisfaction. There were no consistent effects on behavioural or medical partner outcomes, and no evidence of diet or activity behaviour ripple effects, suggesting that partners should be targeted directly to achieve these changes. (Clinical Trial Registry No: NCT01017523) What's new?: Interdependence theory suggests that couples interventions may have beneficial effects on both persons with diabetes and their participating partners, but couples interventions must be compared with equivalent individual interventions to validly assess these effects. The Diabetes Support Project (DSP) provided an opportunity to assess partner effects. The DSP collaborative couples intervention resulted in significant improvements in partner diabetes distress and relationship satisfaction. There was no consistent effect on partner behavioural or medical outcomes. A 'ripple effect' refers to a positive effect of an individual behavioural intervention on the untreated partners; we found no evidence of a dietary or activity behaviour ripple effect. Engaging partners can benefit them emotionally and enhance the relationship. To help partners change behaviour, it may be necessary to target their behaviours directly.