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Hallaj S, Shah SJ, Cehelyk EK, Hock LE, Lee D, Razeghinejad R, Myers JS, Frasso R, Kolomeyer NN. Empowering Family Glaucoma Risk Communication Using QR-Code-Mediated Online Intervention. Ophthalmol Glaucoma 2024; 7:190-196. [PMID: 37838087 DOI: 10.1016/j.ogla.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/12/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE Attempts at engaging relatives of glaucoma patients in education and screening have had limited success. This study explores the feasibility of an electronic intervention to facilitate direct yet reliable glaucoma risk communication between open-angle glaucoma patients (probands) and their first-degree relatives (FDRs). DESIGN Prospective survey and assessment of intervention. PARTICIPANTS Fifty adult probands, engaging 140 FDRs. METHODS Phase I was an iterative process involving creating a customized website and Quick Response (QR)-code-based intervention designed with input from probands, FDRs of patients, community members, and researchers. In phase II, the intervention was deployed in a clinical setting; this involved recruiting probands who had a smartphone and were willing to use the QR-code to message their FDRs a standard message, including a website link about glaucoma risk in FDRs and the importance of getting examined. Follow-up interviews were conducted with probands 1 to 2 weeks after their clinic visit to assess the impact of the intervention. Demographic data, website analytics, and participant feedback were collected and analyzed. MAIN OUTCOME MEASURES Increased awareness of glaucoma risk among FDRs and enhanced discussions. RESULTS At the time of the first interview, probands reported that 70% of the FDRs were aware of the probands' glaucoma diagnosis, but only 26% had undergone glaucoma screening. Ninety percent of probands had no issues using the QR-codes. Website analytics recorded 73 visits from 51 distinct internet protocol addresses (IPs). After receiving the standard message, 95% of FDRs followed up with the probands, actively discussing glaucoma. Of the probands, 84% completed the follow-up interview 1 to 2 weeks after enrollment. Fifty-nine percent of the FDRs were reported to have scheduled screening appointments. The collected feedback revealed that 96% of probands found the intervention helpful, fostering glaucoma discussions with their FDRs and improving probands' comfort level in discussing health issues with FDRs from baseline (very comfortable: 88%, comfortable: 8%, neutral: 2%, and very uncomfortable: 2%) to the follow-up interview (very comfortable: 98% and comfortable: 2%). CONCLUSIONS This innovative online method of communicating the risk of glaucoma to FDRs of probands prompted and increased the comfort level of familial discussions of glaucoma. More than half of FDRs reported making an appointment to get screened for glaucoma. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Shahin Hallaj
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sagar J Shah
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois
| | - Eli K Cehelyk
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania; College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Lauren E Hock
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Daniel Lee
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Reza Razeghinejad
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jonathan S Myers
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Rosemary Frasso
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania; College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania; Asano-Gonnella Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Natasha Nayak Kolomeyer
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
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Urrunaga N, Montoya-Medina JE, Miranda JJ, Moscoso-Porras M, Cárdenas MK, Diez-Canseco F, Gilman RH, Bernabe-Ortiz A. Attitudes, health lifestyle behaviors and cardiometabolic risk factors among relatives of individuals with type 2 diabetes mellitus. Prim Care Diabetes 2021; 15:101-105. [PMID: 32739222 DOI: 10.1016/j.pcd.2020.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To describe and compare attitudes, lifestyle behaviors, and cardiometabolic risk factors between individuals with and without a relative with type 2 diabetes mellitus (T2DM) living in the same household. METHODS A secondary analysis of baseline data from an implementation study in Peru was conducted. The outcomes were attitudes towards changing lifestyle behaviors (e.g. intentions towards losing weight, increasing physical activity, reducing salt consumption, etc), profiles of health lifestyle behaviors (e.g. daily smoking, heavy drinking, and physical activity), and cardiometabolic risk factors (e.g., overweight [body mass index ≥25 kg/m2] and hypertension); whereas the exposure was the presence of at least one relative with known diagnosis of T2DM living in the same household. Multilevel logistic mixed effect regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS A total of 2298 records, 1134 (49.4%) males, mean age 43.3 (SD: 17.2) years, were analyzed. There was no evidence of a difference in lifestyle-changing attitudes, smoking, alcohol drinking, physical activity levels, and hypertension between individuals with and without relatives with T2DM. Overweight was 63% more common among individuals having a relative with a T2DM in multivariable model (OR = 1.63; 95% CI: 1.03-2.61). CONCLUSIONS Individuals with relatives with T2DM have higher probabilities of being overweight compared to those who did not have relatives with T2DM in the same household. The absence of differences on lifestyle-related attitudes and behaviors highlight the need of involving relatives of patients with T2DM on intervention strategies to further enhance diabetes prevention and management efforts.
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Affiliation(s)
- Nicole Urrunaga
- Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - José E Montoya-Medina
- Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Miguel Moscoso-Porras
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - María K Cárdenas
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Francisco Diez-Canseco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert H Gilman
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Universidad Científica del Sur, Lima, Peru.
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3
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Grabowski D, Andersen TH. Barriers to intra-familial prevention of type 2 diabetes: A qualitative study on horizons of significance and social imaginaries. Chronic Illn 2020; 16:119-130. [PMID: 30079742 DOI: 10.1177/1742395318789464] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives In families living with type 2 diabetes, relatives have a significantly heightened risk of developing the disease. In many families, both the person with type 2 diabetes and his/her relatives lack detailed knowledge about this risk. One obstacle to constructive intra-familial prevention and risk reduction is the lack of perceived familial disease relevance. The objective of the present study is to explore barriers to prevention in families with at least one adult with type 2 diabetes. Methods Data were gathered during eight problem assessment and ideation workshops with families. The data were analyzed using radical hermeneutics and interpreted using Taylor’s concepts of social imaginaries and horizons of significance. Results The analysis revealed three main barriers: (1) Sole responsibilities and the absence of collective practices, (2) intra-familial differences in perceptions of risks and future health, and (3) lack of perceived disease significance and the ensuing lack of mutual care. The participating families all experienced one or more of the three identified primary barriers. Discussion The study has produced important knowledge about barriers to familial prevention of type 2 diabetes. The findings confirm that familial prevention is indeed a complex matter that calls for the use of complexity-oriented approaches in health care practice.
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4
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Badlishah-Sham SF, Ramli AS, Isa MR, Mohd-Zaki N, Whitford DL. Are Malaysian Type 2 Diabetes patients willing to be trained to speak to their offspring about risk of diabetes and preventive measures? BMC FAMILY PRACTICE 2020; 21:50. [PMID: 32160862 PMCID: PMC7066836 DOI: 10.1186/s12875-020-01121-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 03/03/2020] [Indexed: 11/24/2022]
Abstract
Background Offspring of type 2 diabetes patients have an absolute risk of 20–40% of developing the condition. Type 2 diabetes patients should be encouraged to speak to their offspring regarding diabetes risk and prevention strategies. The Health Belief Model conceptualises that the higher the perceived risk, the more likely an individual will modify their behaviour. The objectives of this study were to i) determine the distribution of type 2 diabetes patients regarding their willingness to accept training to speak to their offspring, ii) determine the distribution of type 2 diabetes patients regarding their willingness to accept training based on the HBM and iii) to determine the factors associated with their willingness to accept training. Methods This was a cross-sectional study amongst type 2 diabetes patients attending two primary care clinics in Malaysia. Sociodemographic data and knowledge of diabetes risk factors were collected. The adapted, translated and validated Diabetes Mellitus in the Offspring Questionnaire-Malay version (DMOQ-Malay) was self-administered. Statistical analysis included descriptive statistics, univariate and multiple logistic regression (MLogR). Results A total of 425 participants were recruited. Of these, 61.6% were willing to accept training. In MLogR, six variables were found to be significantly associated with willingness to accept training. These were i) positive family history [Adj. OR 2.06 (95% CI: 1.27, 3.35)], ii) having the correct knowledge that being overweight is a risk factor [Adj. OR 1.49 (95%CI: 1.01, 2.29)], iii) correctly identifying age ≥ 40 years old as a risk factor [Adj. OR 1.88 (95%CI: 1.22, 2.90)], iv) agreeing that speaking to their offspring would help them to prevent type 2 diabetes [Adj. OR 4.34 (95%: 1.07, 17.73)], v) being neutral with the statement ‘I do not have much contact with my offspring’ [Adj. OR: 0.31 (95% CI: 0.12, 0.810] and vi) being neutral with the statement ‘my offspring are not open to advice from me’ [Adj. OR: 0.63 (95% CI: 0.31, 0.84]. Conclusion The majority of type 2 diabetes patients were willing to accept training to speak to their offspring to prevent diabetes. A training module should be designed to enhance their knowledge, attitude and skills to become family health educators.
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Affiliation(s)
- Siti Fatimah Badlishah-Sham
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selayang Campus, Jalan Prima Selayang 7, 68100, Batu Caves, Selangor, Malaysia
| | - Anis Safura Ramli
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selayang Campus, Jalan Prima Selayang 7, 68100, Batu Caves, Selangor, Malaysia. .,Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia.
| | - Mohamad Rodi Isa
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
| | - Nurzakiah Mohd-Zaki
- Department of Medicine, Hospital Kuala Lumpur, Ministry of Health, Jalan Pahang, 50586, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - David Leonard Whitford
- RCSI & UCD Malaysia Campus, 4, Jalan Sepoy Lines, 10450, George Town, Pulau Pinang, Malaysia
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Bennich BB, Munch L, Overgaard D, Konradsen H, Knop FK, Røder M, Vilsbøll T, Egerod I. Experience of family function, family involvement, and self‐management in adult patients with type 2 diabetes: A thematic analysis. J Adv Nurs 2019; 76:621-631. [DOI: 10.1111/jan.14256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 08/20/2019] [Accepted: 10/22/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Birgitte B. Bennich
- Clinical Metabolic Physiology Steno Diabetes Center Copenhagen Copenhagen University Hospital Gentofte Hospital Hellerup Denmark
- Institute of Nursing University College Copenhagen Copenhagen N Denmark
| | - Lene Munch
- Clinical Metabolic Physiology Steno Diabetes Center Copenhagen Copenhagen University Hospital Gentofte Hospital Hellerup Denmark
| | - Dorthe Overgaard
- Institute of Nursing University College Copenhagen Copenhagen N Denmark
| | - Hanne Konradsen
- Department of Neurobiology, Care Sciences and Society NVS Huddinge Sweden
- Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Copenhagen N Denmark
- Department of Gastroenterology Herlev and Gentofte University Hospital Herlev Denmark
| | - Filip K. Knop
- Clinical Metabolic Physiology Steno Diabetes Center Copenhagen Copenhagen University Hospital Gentofte Hospital Hellerup Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research Faculty of Health and Medical Sciences University of Copenhagen Copenhagen N Denmark
- Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Copenhagen N Denmark
- Center for Clinical Metabolic Research Department of Medicine Gentofte Hospital University of Copenhagen Hellerup Denmark
| | - Michael Røder
- Clinical Metabolic Physiology Steno Diabetes Center Copenhagen Copenhagen University Hospital Gentofte Hospital Hellerup Denmark
- Steno Diabetes Center Odense Odense University Hospital Odense C Denmark
| | - Tina Vilsbøll
- Clinical Metabolic Physiology Steno Diabetes Center Copenhagen Copenhagen University Hospital Gentofte Hospital Hellerup Denmark
- Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Copenhagen N Denmark
| | - Ingrid Egerod
- Intensive Care Unit Copenhagen University Hospital Rigshospitalet Denmark
- Faculty of Health & Medical Sciences University of Copenhagen Copenhagen N Denmark
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Mutual Involvement in Families Living with Type 2 Diabetes: Using the Family Toolbox to Address Challenges Related to Knowledge, Communication, Support, Role Confusion, Everyday Practices and Mutual Worries. SOCIAL SCIENCES-BASEL 2019. [DOI: 10.3390/socsci8090257] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Family involvement plays a key role in diabetes management. Challenges related to type 2 diabetes (T2D) often affect the whole family, and relatives are at increased risk of developing diabetes themselves. Creating family involvement in families living with T2D is a complex matter. This article studies potential effects of working with dialogue tools specifically developed to create family involvement. The data consist of 18 semi-structured family interviews. The data were analyzed using radical hermeneutics and theories on family identity and healthcare authenticity. The analysis revealed five themes: (1) Working with the tools created better and broader intra-familial involvement; (2) the tools enabled new roles and self-understandings for all family members; (3) the tools facilitated mutual insights into each other’s thoughts and worries; (4) after working with the tools, it was easier to discover potential challenges and possible behavior change; and (5) gaining new knowledge and the motivation to seek more knowledge was easier after working with the tools. Working with the tools changed how the families perceive themselves and the ways in which they can affect their own T2D-related health behavior together. This has direct implications for healthcare practitioners working with people with T2D.
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Schmittdiel JA, Cunningham SA, Adams SR, Nielsen J, Ali MK. Influence of a New Diabetes Diagnosis on the Health Behaviors of the Patient's Partner. Ann Fam Med 2018; 16:290-295. [PMID: 29987075 PMCID: PMC6037527 DOI: 10.1370/afm.2259] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 02/23/2018] [Accepted: 03/21/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE When a person is given a diagnosis of diabetes, the changes in his or her health behaviors may influence the behaviors of his or her partner. The diabetes diagnosis may affect household members' perceptions of their own health risks, which could trigger behavioral change. The purpose of this study was to assess whether partners of persons with newly diagnosed diabetes changed their health behaviors compared with partners of persons without diabetes. METHODS The study population consisted of Kaiser Permanente Northern California health plan members from 2007 to 2011. This cohort study assessed differences in change of 8 health behaviors. The study compared coresiding partners of persons with newly diagnosed diabetes before and after a diabetes diagnosis with a 5 to 1 matched sample of coresiding partners of persons without diabetes. RESULTS A total of 180,910 couples were included in the analysis. After adjusting for baseline characteristics, partners of persons with newly diagnosed diabetes had significantly higher rates of participation in weight management-related health education classes (risk ratio [RR] = 1.50; 95% CI, 1.39-1.63); smoking cessation medication use (RR = 1.25; 95% CI, 1.05-1.50); glucose screening (RR = 1.07; 95% CI, 1.05-1.08); clinically meaningful weight loss (RR = 1.06; 95% CI, 1.02-1.11); lipid screening (RR = 1.05; 95% CI, 1.04-1.07); influenza vaccination (RR = 1.03; 95% CI, 1.02-1.04); and blood pressure screening (RR = 1.02; 95% CI, 1.02-1.03) compared with partners of persons without diabetes. CONCLUSIONS There were small but significant differences in health-related behavioral changes among partners of persons with newly diagnosed diabetes compared with partners of persons without diabetes, even when no intervention occurred. This finding suggests a diabetes diagnosis within a family may be a teachable moment to improve health behaviors at the household level.
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Affiliation(s)
- Julie A Schmittdiel
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | | | - Sara R Adams
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Jannie Nielsen
- Hubert Department of Global Health, Emory University, Atlanta, Georgia.,Global Health Section, Department of Public Health, University of Copenhagen, Denmark
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Vitger T, Langberg H, Grabowski D. Mutual Involvement in Families With Type 2 Diabetes Through Web-Based Health Care Solutions: Quantitative Survey Study of Family Preferences, Challenges, and Potentials. JMIR Diabetes 2017; 2:e23. [PMID: 30291067 PMCID: PMC6238855 DOI: 10.2196/diabetes.7456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 07/19/2017] [Accepted: 08/09/2017] [Indexed: 11/25/2022] Open
Abstract
Background Type 2 diabetes (T2D) is a prevalent chronic disease that affects not just patients but entire families. Both the patient and the rest of the family may benefit from gaining knowledge about the disease and from supportive interfamilial interaction. The Internet is becoming a widely-used resource for health information, so a Web-based solution could potentially promote awareness and knowledge on how to manage T2D as a family, while also providing support for the family. Objective We aim to assess the usage of online diabetes information by patients with T2D and their relatives, and explore the families’ needs and preferences regarding online information on diabetes. Methods A quantitative self-reported questionnaire survey was performed with Danish families that had at least one family member diagnosed with T2D. The survey consisted of 36 closed questions on demographics, usage of the Internet, preferences in the source of information, interest in online information on six problem domains within family life related to T2D, preferences towards the delivery format of online information, and peer-to-peer communication. Two open-ended questions were also included to elicit any additional comments or suggestions about improving online information on T2D regarding family life. Results Fifty participants from 22 families with T2D answered the questionnaire individually. Relatives (25/28, 89%) and patients (22/22, 100%) indicated that information on T2D is relevant for them, while indicating that the Internet is the first or second preferred source when in need of information on T2D (25/28, 89% vs 21/22, 95%). Only a minority of the participants indicated that they had searched the Internet to gain knowledge on T2D regarding family life (9/28, 32% vs 10/22, 46%). Also, patients were more likely to have used the Internet to gain information on T2D (P=.027). Both groups indicated a preference for watching videos or reading about T2D in relation to family life while a minority of the participants indicated an interest in peer-to-peer communication. Regarding the six problem domains, the domains Support, Knowledge, and Everyday Life were slightly more popular. These three domains were considered interesting by at least 79% (22/28) and 73% (16/22) of the relatives and patients respectively, while the domains Communication, Worries, and Roles were considered interesting by at least 46% (20/28) and 50% (11/22). Conclusions Despite an interest in online information on T2D, there appears to be an unsatisfied need for more supportive online information on T2D aimed at Danish families with T2D. Based on family preferences, online information should focus on the six problem domains and be presented through text and videos by health care practitioners and peers. Peer-to-peer communication elements may be beneficial, but are only expected to be used by a very limited number of families.
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Affiliation(s)
- Tobias Vitger
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Henning Langberg
- CopenRehab, Department of Public Health, Section of Social Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dan Grabowski
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
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9
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Grabowski D, Andersen TH, Varming A, Ommundsen C, Willaing I. Involvement of family members in life with type 2 diabetes: Six interconnected problem domains of significance for family health identity and healthcare authenticity. SAGE Open Med 2017; 5:2050312117728654. [PMID: 28839943 PMCID: PMC5564858 DOI: 10.1177/2050312117728654] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 08/03/2017] [Indexed: 12/02/2022] Open
Abstract
Objectives: Family involvement plays a key role in diabetes management. Problems and challenges related to type 2-diabetes often affect the whole family, and relatives are at increased risk of developing diabetes themselves. We highlight these issues in our objectives: (1) to uncover specific family problems associated with mutual involvement in life with type 2-diabetes and (2) to analytically look at ways of approaching these problems in healthcare settings. Methods: Qualitative data were gathered in participatory problem assessment workshops. The data were analysed in three rounds using radical hermeneutics. Results: Problems were categorized in six domains: knowledge, communication, support, everyday life, roles and worries. The final cross-analysis focusing on the link between family identity and healthcare authenticity provided information on how the six domains can be approached in healthcare settings. Conclusion: The study generated important knowledge about problems associated with family involvement in life with type 2 diabetes and about how family involvement can be supported in healthcare practice.
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10
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Følling IS, Solbjør M, Midthjell K, Kulseng B, Helvik AS. Exploring lifestyle and risk in preventing type 2 diabetes-a nested qualitative study of older participants in a lifestyle intervention program (VEND-RISK). BMC Public Health 2016; 16:876. [PMID: 27557801 PMCID: PMC4997726 DOI: 10.1186/s12889-016-3559-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 08/19/2016] [Indexed: 11/25/2022] Open
Abstract
Background Lifestyle intervention may reduce the development of type 2 diabetes among high-risk individuals. The aim of this study was to explore how older adults perceived their own lifestyle and being at increased risk for type 2 diabetes while they participated in a lifestyle intervention programme. Methods A nested qualitative study was performed with 26 participants (mean age 68 years) in the VEND-RISK Study. Participants had previously participated in the HUNT3 Study and the HUNT DE-PLAN Study, where their risk for developing type 2 diabetes (FIND-RISC ≥ 15) had been identified. The data were analysed using systematic text condensation. Results Two main themes were identified. The first theme was having resources available for an active lifestyle, which included having a family and being part of a social network, having a positive attitude toward life, and maintaining established habits from childhood to the present. The second theme was being at increased risk for type 2 diabetes, which included varied reactions to the information on increased risk, how lifestyle intervention raised awareness about risk behaviour, and health-related worries and ambitions as type 2 diabetes prevention. Conclusions Assessing a participant’s resources could improve the outcomes of lifestyle intervention programmes. Both family history and risk perception could be used in preventive strategies to enhance changes in lifestyle. Trial registration The VEND-RISK Study was registered in ClinicalTrials.gov on April 26, 2010, with the registration number NCT01135901.
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Affiliation(s)
- Ingrid S Følling
- Department of Health Sciences, Nord University, Røstad, N-7600, Levanger, Norway. .,Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Postboks 8905, MTFS, 7491, Trondheim, Norway.
| | - Marit Solbjør
- St. Olavs University Hospital, Trondheim, Norway.,Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Kristian Midthjell
- Department of Community Health and General Practice, HUNT Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bård Kulseng
- Obesity Research Centre, St. Olavs University Hospital, Forsyningssenteret, 7006, Trondheim, Norway.,Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Postboks 8905, N-7491, Trondheim, Norway
| | - Anne-S Helvik
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Postboks 8905, MTFS, 7491, Trondheim, Norway.,St. Olavs University Hospital, Trondheim, Norway.,Norwegian National Advisory Unit for Aging and Health, Vestfold Health Trust, Tønsberg, 3103, Norway
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11
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Senier L, Shields M, Lee R, Nicoll L, Falzon D, Wiecek E. Community-Based Family Health History Education: The Role of State Health Agencies in Engaging Medically Underserved Populations in Understanding Genomics and Risk of Chronic Disease. Healthcare (Basel) 2015; 3:995-1017. [PMID: 27417809 PMCID: PMC4934627 DOI: 10.3390/healthcare3040995] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 10/05/2015] [Accepted: 10/14/2015] [Indexed: 12/22/2022] Open
Abstract
Although family health history (FHH) collection has been recognized as an influential method for assessing a person's risk of chronic disease, studies have shown that people who are low-income, from racial and ethnic minorities, and poorly educated are less likely to collect their FHH or share it with a medical professional. Programs to raise public awareness about the importance of FHH have conventionally targeted patients in primary care clinics or in the general community, but few efforts have been made to coordinate educational efforts across settings. This paper describes a project by the Connecticut Department of Public Health's Genomics Office to disseminate training materials about FHH as broadly as possible, by engaging partners in multiple settings: a local health department, a community health center, and two advocacy organizations that serve minority and immigrant populations. We used a mixed methods program evaluation to examine the efficacy of the FHH program and to assess barriers in integrating it into the groups' regular programming. Our findings highlight how a state health department can promote FHH education among underserved communities.
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Affiliation(s)
- Laura Senier
- Department of Sociology and Anthropology, Northeastern University, 360 Huntington Ave Boston, MA 02115, USA.
- Department of Health Sciences, Northeastern University, 360 Huntington Ave Boston, MA 02115, USA.
| | - Michael Shields
- Department of Sociology and Anthropology, Northeastern University, 360 Huntington Ave Boston, MA 02115, USA.
| | - Rachael Lee
- Department of Sociology and Anthropology, Northeastern University, 360 Huntington Ave Boston, MA 02115, USA.
| | - Lauren Nicoll
- Department of Sociology and Anthropology, Northeastern University, 360 Huntington Ave Boston, MA 02115, USA.
| | - Danielle Falzon
- Department of Sociology and Anthropology, Northeastern University, 360 Huntington Ave Boston, MA 02115, USA.
| | - Elyssa Wiecek
- School of Pharmacy, Northeastern University, 140 Fenway, 360 Huntington Ave Boston, MA 02115, USA.
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