An examination of the association between spousal support and Type 2 diabetes self-management

The present study sought to explore the effects of spousal support on Type 2 diabetes self-management. Cross-sectional data from 305 spousal pairs, ages 30--70, were collected from a tailored self-management intervention study for type 2 diabetes entitled Prevention and Control of Diabetes in Families (PCDF). Three separate sub-studies were conducted in order to examine spousal support effects on three different self-management domains: behavioral (diet, physical activity), psychological (diabetes distress), and biological (BMI, HbA1c). The sub-studies were also designed to assess gender and race as moderators of the relationship between spousal support and self-management measures. Findings from Study 1 revealed that increased instrumental support and unsupportive behavior for physical activity was associated with decreased moderate physical activity levels. Additionally, increased appraisal support for physical activity was associated with higher levels of light activity. Individuals who had lower levels of acculturation and perceived higher levels of appraisal support reported higher levels of light physical activity. Findings from Study 2 revealed that for women, increased levels of instrumental support were associated with higher levels of diabetes distress. Further, higher levels of perceived unsupportive behavior for diet were associated with increased levels of diabetes distress, particularly when the non-diabetic spouse was healthier. Finally, findings from Study 3 revealed that increased unsupportive behavior for diet and emotional support for diet was associated with negative health outcomes, including increased BMI among Whites, and increased HbA1c levels. Findings support and expand prior research on spousal support literature, particularly regarding the negative impacts of support. Results indicate that support can have negative health outcomes, even if the provider has well-meaning intentions. Results emphasize the importance of contextual factors, such as gender and race, in addition to the social context when tailoring family-based interventions. Further, the role of unsupportive behavior and appraisal support in spousal relationships deserves further attention.