Strategies to Improve Well-Being and Diabetes Management

Over 37 million people in the United State have diabetes, and this high prevalence rate has contributed to diabetes becoming the seventh highest leading cause of mortality. Because the majority of people with diabetes are diagnosed with T2 diabetes mellitus (type 2 diabetes) and higher body weight is a primary risk factor, risk-reduction efforts have largely focused on weight management. Unfortunately, public health and health care professionals often use fear and stigma as tools when trying to motivate the uptake of health ­promoting behaviors. It is therefore not surprising that 42% of U.S. adults report experiencing weight stigma. Weight and diabetes stigma have been shown to be significantly associated with adverse physiological, psychological and behavioral consequences, however, reducing stigma is not part of the clinical treatment paradigm for type 2 diabetes. Mitigating stigma therefore represents a key barrier to engaging individuals with type 2 diabetes in health-promoting behaviors and condition management. Self-affirmation, the process of explicitly of reinforcing sources of self-worth, is an evidence-based strategy for buffering one's self-integrity from psychological threats, like stigma. Interventions using self-affirmation theory have been shown to effectively promote a wide range of health behavior changes, including decreased alcohol use, improved nutrition, tobacco treatment, and HIV risk-reduction. The overall objective of the proposed project is to implement a self-affirmation intervention for stigma in a sample of patients receiving care for type 2 diabetes. My central hypothesis is that use of a self-affirmation intervention for weight and diabetes stigma will reduce the negative psychosocial impacts of stigma, encourage intentions to engage in condition management behaviors, and counter mechanistic pathways underlying the disease. This project facilitates the long-term goals of my program of research focusing on understanding how individuals perceive and respond to stigma-related stressors, and developing multifaceted interventions to mitigate stigma and improve the quality of life and clinical outcomes of patients with metabolic conditions like diabetes.