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CHOICE Study Looking at How Couples Cope with Diabetes
By Vanessa Orr

People who have been diagnosed with Type 2 diabetes need to make a lot of adjustments in their lives—managing the disease can mean taking medicine, eating a healthy diet and keeping track of blood glucose levels, among other things. But when a person with diabetes lives with someone else, the disease can also affect his or her partner's life. The CHOICE (Communal Health of Interacting Couples Exchange) study, which was started in September of 2012, is designed to determine how couples deal with diabetes. "A lot of research has been done about how individuals with diabetes cope, but it is really a disease best seen in the context of families," explained Vicki Helgeson, professor of psychology, Carnegie Mellon University. "We decided to narrow that down to a study of couples as a way to try to determine how partners can make life either easier or more difficult for someone diagnosed with the disease."

The study, which is still accepting participants, is also designed to look at the way different races deal with the disease. "There has been some research done, but usually out of 100 couples, 80 are white, 10 are black, six are Asian and four are Hispanic, so basically, these studies show how middle-class white couples deal with the disease," said Helgeson. "Our goal is to have an equal number of black and white couples participate in the study; of the 112 couples now enrolled, 66 couples are white, 41 are black and five are mixed race." To be eligible to take part in the study, one of the partners must have been diagnosed with diabetes in the last three years.

According to Helgeson, it is believed that couples who approach diabetes in a communal way and work together will have better outcomes. "When the study is completed, we hope that it will enable us to give couples ideas about what is helpful and what is not helpful, and will guide us in developing interventions," she said.

Helgeson gave the example of a partner who might think that she is being helpful by reminding her husband to take his medicine every day. "Unfortunately, this might really annoy him, and he may stop taking his medications to show that he is not influenced by his wife," she explained. "While these reminders may be helpful to some couples, others may see it as controlling, which may call for a more subtle approach.

"What do you do to help your partner eat well?" she continued. "If the support partner eats well, that can go a long way. But some more subtle ways to help may include buying healthier groceries, or going to a restaurant where there are healthy selections."

Couples who take part in the study are asked to undergo a two-hour, in-person interview, and will have a height, weight and blood pressure screening. The person with diabetes will also undergo a finger prick to test blood glucose control. The couple must also complete a short questionnaire on a table computer (provided by the study) once a day for two weeks. For completing the study, each couple receives $400.

"We decided to participate because we thought it would help people," said Shirley Carney, who recently completed the study with her husband, Rick. "It's really easy to do, and the nurses who came to visit us were awesome." Shirley credits Rick with helping her to manage her diabetes by keeping her motivated, encouraging her to exercise and by helping her keep track of her diet.

When the study is complete, the findings will be published in scientific journals, as well as shared with clinics and health centers, and through other public outlets. "Depending on where people are first diagnosed, they may not receive all of the education they need," said Helgeson. "Patients don't get the same information from a primary care physician, emergency room doctor, clinic nurse or endocrinologist, so they have varying degrees of understanding."

The study is still accepting more participants. To learn more, call Pamela Snyder at 412-268-2784 or email ps3x@andrew.cmu.edu.

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