Abstract
Purpose of Review
Interests have been emerging in using positive psychology interventions (PPIs) to improve diabetes self-management (DSM) behaviors (e.g., blood glucose monitoring, physical activity). To explore the impact of those interventions on DSM behaviors, we summarized the evidence of PPIs on self-management behaviors among both type 1 diabetes (T1D) and type 2 diabetes (T2D) patients between 2012 and 2022.
Recent Findings
Among the eight studies identified, different study designs and types of PPIs were apparent. Typical PPIs (e.g., activities enhancing positive affect/gratitude/self-affirmation/optimism) were usually applied to T1D patients (N = 5); PPIs were usually combined with motivational interviewing for T2D patients (N = 3). Contrary to expectations, PPIs did not consistently demonstrate positive effects on self-management behaviors’ change regardless of the types of diabetes patients, compared to the control groups.
Summary
Improvements in diabetes patients’ self-management behaviors from PPIs are still unclear. Future studies should more rigorously evaluate and identify the active ingredients of PPIs for behavioral changes among diabetes patients.
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References
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Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2021;183:109119. https://doi.org/10.1016/j.diabres.2021.109119.
ADA. 5. Lifestyle management: standards of medical care in diabetes—2019. Diabetes Care. 2019;42(Supplement 1):S46–60. https://doi.org/10.2337/dc19-s005.
Hilliard ME, Powell PW, Anderson BJ. Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families. Am Psychol. 2016;71(7):590–601. https://doi.org/10.1037/a0040359.
Stetson B, Minges KE, Richardson CR. New directions for diabetes prevention and management in behavioral medicine. J Behav Med. 2017;40(1):127–44. https://doi.org/10.1007/s10865-016-9802-2.
Huffman JC, Dubois CM, Millstein RA, Celano CM, Wexler D. Positive psychological interventions for patients with type 2 diabetes: rationale, theoretical model, and intervention development. J Diabetes Res. 2015;2015:1–18. https://doi.org/10.1155/2015/428349.
Seligman MEP, Csikszentmihalyi M. Positive psychology: an introduction. Am Psychol. 2000;55(1):5–14. https://doi.org/10.1037/0003-066X.55.1.5.
Seligman MEP, Rashid T, Parks AC. Positive psychotherapy. Am Psychol. 2006;61(8):774–88. https://doi.org/10.1037/0003-066x.61.8.774.
Pressman SD, Cohen S. Does positive affect influence health? Psychol Bull. 2005;131(6):925–71. https://doi.org/10.1037/0033-2909.131.6.925.
Fredrickson BL, Branigan C. Positive emotions broaden the scope of attention and thought-action repertoires. Cogn Emot. 2005;19(3):313–32. https://doi.org/10.1080/02699930441000238.
Kent D, Haas L, Randal D, Lin E, Thorpe CT, Boren SA, et al. Healthy coping: issues and implications in diabetes education and care. Popul Health Manag. 2010;13(5):227–33. https://doi.org/10.1089/pop.2009.0065.
Al-Khawaldeh OA, Al-Hassan MA, Froelicher ES. Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus. J Diabet Complicat. 2012;26(1):10–6. https://doi.org/10.1016/j.jdiacomp.2011.11.002.
Yao J, Wang H, Yin X, Yin J, Guo X, Sun Q. The association between self-efficacy and self-management behaviors among Chinese patients with type 2 diabetes. PLoS ONE. 2019;14(11):e0224869. https://doi.org/10.1371/journal.pone.0224869.
Tharek Z, Ramli AS, Whitford DL, Ismail Z, MohdZulkifli M, Ahmad Sharoni SK, et al. Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting. BMC Fam Pract. 2018;19(1):1–10. https://doi.org/10.1186/s12875-018-0725-6.
Iannotti RJ, Schneider S, Nansel TR, Haynie DL, Plotnick LP, Clark LM, et al. Self-efficacy, outcome expectations, and diabetes self-management in adolescents with type 1 diabetes. J Dev Behav Pediatr. 2006;27(2):98–105. https://doi.org/10.1097/00004703-200604000-00003.
Guo J, Yang J, Wiley J, Ou X, Zhou Z, Whittemore R. Perceived stress and self-efficacy are associated with diabetes self-management among adolescents with type 1 diabetes: a moderated mediation analysis. J Adv Nurs. 2019;75(12):3544–53. https://doi.org/10.1111/jan.14179.
Lee Duckworth A, Steen TA, Seligman MEP. Positive psychology in clinical practice. Annu Rev Clin Psychol. 2005;1(1):629–51. https://doi.org/10.1146/annurev.clinpsy.1.102803.144154.
Sin NL, Lyubomirsky S. Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: a practice-friendly meta-analysis. J Clin Psychol. 2009;65(5):467–87. https://doi.org/10.1002/jclp.20593.
Lyubomirsky S, King L, Diener E. The benefits of frequent positive affect: does happiness lead to success? Psychol Bull. 2005;131(6):803–55. https://doi.org/10.1037/0033-2909.131.6.803.
Bolier L, Haverman M, Westerhof GJ, Riper H, Smit F, Bohlmeijer E. Positive psychology interventions: a meta-analysis of randomized controlled studies. BMC Public Health. 2013;13(1):119. https://doi.org/10.1186/1471-2458-13-119.
•• Carr A, Cullen K, Keeney C, Canning C, Mooney O, Chinseallaigh E, et al. Effectiveness of positive psychology interventions: a systematic review and meta-analysis. J Posit Psychol. 2021;16(6):749–69. https://doi.org/10.1080/17439760.2020.1818807. This meta-analysis of 347 studies (including over 72000 clinical and non-clinical populations) found that PPIs had a significant small to medium effect on wellbeing, strengths, QoL, depression, anxiety, and stress.
DuBois CM, Millstein RA, Celano CM, Wexler DJ, Huffman JC. Feasibility and acceptability of a positive psychological intervention for patients with type 2 diabetes. Primary Care Companion CNS Disord. 2016;18(3):27111. https://doi.org/10.4088/PCC.15m01902.
Huffman JC, Beale EE, Celano CM, Beach SR, Belcher AM, Moore SV, et al. Effects of optimism and gratitude on physical activity, biomarkers, and readmissions after an acute coronary syndrome. Circ: Cardiovasc Qual Outcomes. 2016;9(1):55–63. https://doi.org/10.1161/circoutcomes.115.002184.
•• Feig EH, Madva EN, Millstein RA, Zambrano J, Amonoo HL, Longley RM, et al. Can positive psychological interventions improve health behaviors? A systematic review of the literature. Prev Med. 2022;163:107214. https://doi.org/10.1016/j.ypmed.2022.107214. This systematic review of 27 studies examines the existing literature on positive psychological interventions (PPIs) and their potential to improve health behavior adherence. The review focuses on studies that measured physical activity, medication adherence, diet, and smoking habits.
Ogedegbe GO. A randomized controlled trial of positive-affect intervention and medication adherence in hypertensive African Americans. Arch Intern Med. 2012;172(4):322. https://doi.org/10.1001/archinternmed.2011.1307.
Peterson JC. A randomized controlled trial of positive-affect induction to promote physical activity after percutaneous coronary intervention. Arch Intern Med. 2012;172(4):329. https://doi.org/10.1001/archinternmed.2011.1311.
Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393–403. https://doi.org/10.1056/NEJMoa012512.
Anderson BJ, Svoren B, Laffel L. Initiatives to promote effective self-care skills in children and adolescents with diabetes mellitus. Dis Manag Health Out. 2007;15(2):101–8. https://doi.org/10.2165/00115677-200715020-00005.
• Davis J, Fischl AH, Beck J, Browning L, Carter A, Condon JE, et al. 2022 National standards for diabetes self-management education and support. Diabetes Care. 2022;45(2):484–94. https://doi.org/10.2337/dc21-2396. The 2022 National Standards for Diabetes Self-Management Education and Support provide a comprehensive list of the key components of DSMES, which include assessment of educational needs, individualized education and support, ongoing support, and evaluation of outcomes. These components are further broken down into specific standards and criteria that DSMES programs should meet to ensure high-quality care.
Ferrari R. Writing narrative style literature reviews. Med Writ. 2015;24(4):230–5. https://doi.org/10.1179/2047480615Z.000000000329.
Jaser SS, Patel N, Rothman RL, Choi L, Whittemore R. Check It! A randomized pilot of a positive psychology intervention to improve adherence in adolescents with type 1 diabetes. Diabetes Educ. 2014;40(5):659–67. https://doi.org/10.1177/0145721714535990.
Jaser SS, Whittemore R, Choi L, Nwosu S, Russell WE. Randomized trial of a positive psychology intervention for adolescents with type 1 diabetes. J Pediatr Psychol. 2019;44(5):620–9. https://doi.org/10.1093/jpepsy/jsz006.
Hilliard ME, Cao VT, Eshtehardi SS, Minard CG, Saber R, Thompson D, et al. Type 1 doing well: pilot feasibility and acceptability study of a strengths-based mHealth app for parents of adolescents with type 1 diabetes. Diabetes Technol Ther. 2020;22(11):835–45. https://doi.org/10.1089/dia.2020.0048.
Zhang S, Hamburger E, Kahanda S, Lyttle M, Williams R, Jaser SS. Engagement with a text-messaging intervention improves adherence in adolescents with type 1 diabetes: brief report. Diabetes Technol Ther. 2018;20(5):386–9. https://doi.org/10.1089/dia.2018.0015.
Huffman JC, Golden J, Massey CN, Feig EH, Chung WJ, Millstein RA, et al. A positive psychology-motivational interviewing intervention to promote positive affect and physical activity in type 2 diabetes: the BEHOLD-8 controlled clinical trial. Psychosom Med. 2020;82(7):641–9. https://doi.org/10.1097/psy.0000000000000840.
Huffman JC, Golden J, Massey CN, Feig EH, Chung W-J, Millstein RA, et al. A positive psychology-motivational interviewing program to promote physical activity in type 2 diabetes: the BEHOLD-16 pilot randomized trial. Gen Hosp Psychiatry. 2021;68:65–73. https://doi.org/10.1016/j.genhosppsych.2020.12.001.
Cohn MA, Pietrucha ME, Saslow LR, Hult JR, Moskowitz JT. An online positive affect skills intervention reduces depression in adults with type 2 diabetes. J Posit Psychol. 2014;9(6):523–34. https://doi.org/10.1080/17439760.2014.920410.
Schache KR, Hofman PL, Serlachius AS. A pilot randomized controlled trial of a gratitude intervention for adolescents with type 1 diabetes. Diabet Med. 2020;37(8):1352–6. https://doi.org/10.1111/dme.14078.
Ghosh A, Deb A. Positive psychology interventions for chronic physical illnesses: a systematic review. Psychol Stud. 2017;62(3):213–32. https://doi.org/10.1007/s12646-017-0421-y.
Hood KK, Hilliard M, Piatt G, Ievers-Landis CE. Effective strategies for encouraging behavior change in people with diabetes. Diabetes Manag. 2015;5(6):499–510. https://doi.org/10.2217/dmt.15.43.
Carson S, Cook A, Peabody S, Scheinbaum S, Williamson L. The impact of positive psychology on behavioral change and healthy lifestyle choices. Lifestyle Medicine. CRC Press; 2019. 229–39. https://doi.org/10.1201/9781315201108-19
Belete AM, Gemeda BN, Akalu TY, Aynalem YA, Shiferaw WS. What is the effect of mobile phone text message reminders on medication adherence among adult type 2 diabetes mellitus patients: a systematic review and meta-analysis of randomized controlled trials. BMC Endocr Disord. 2023;23(1):1–12. https://doi.org/10.1186/s12902-023-01268-8.
Vojtila L, Sherifali D, Dragonetti R, Ashfaq I, Veldhuizen S, Naeem F, et al. Technology-enabled collaborative care for concurrent diabetes and distress management during the COVID-19 pandemic: protocol for a mixed methods feasibility study. JMIR Res Protocols. 2023;12:e39724. https://doi.org/10.2196/39724.
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Pan, L., Yeung, N.C.Y. Positive Psychology Interventions for Improving Self-management Behaviors in Patients with Type 1 and Type 2 Diabetes: a Narrative Review of Current Evidence. Curr Diab Rep 23, 329–345 (2023). https://doi.org/10.1007/s11892-023-01525-z
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DOI: https://doi.org/10.1007/s11892-023-01525-z