Health outcomes are poor among young adults with type 1 diabetes (T1DM) and type 2 diabetes (T2DM). Urban, low-SES Latino young adults with diabetes may be at particularly high risk. Community-based lifestyle interventions have been effective in reducing health declines and improving quality of life among patient populations with, or at risk for, chronic disease or disability, and may have potential for improving health outcomes among young Latino adults with diabetes. This study sought to address the following three research questions, with the overarching goal of improving diabetes care for this population: (1) How do lifestyle factors influence urban, low-SES Latino young adults’ ability to effectively manage diabetes? (2) What are the key lifestyle factors to address in an intervention aimed at this population? (3) Would such an intervention approach have the potential to improve health and quality of life outcomes in this population?
Journal Articles
Carandang, K. M., & Pyatak, E. A. (2018). Feasibility of a manualized occupation-based diabetes management intervention. American Journal of Occupational Therapy, 72(2), 7202345040p1–7202345040p6. https://doi.org/10.5014/ajot.2018.021790 Show abstract
Objective. We investigated the feasibility and acceptability of an occupational therapy intervention targeting diabetes management for underserved young adults.
Method. Eight participants completed the intervention and a battery of assessments at baseline and after the intervention. At completion, the participants and occupational therapist were interviewed about their experiences with the study. Four categories of assessment questions were used to guide the study: process, resource, management, and scientific.
Results. Successes included recruitment; fulfillment of tasks by staff and partnering clinics; adequate space, financial support, and equipment; and meaningfulness of the intervention for participants. Challenges included scheduling participants for the intervention and follow-up focus groups and providing client centeredness and flexibility while reducing burden on the intervener.
Conclusion. This feasibility study allowed us to make necessary revisions to our study protocol before implementing a larger pilot study.
Pyatak, E. A., Carandang, K., & Davis, S. (2015). Developing a manualized occupational therapy diabetes management intervention: Resilient, Empowered, Active Living with Diabetes. OTJR: Occupation, Participation and Health, 35(3), 187-194. https://doi.org/10.1177/1539449215584310 Show abstract
This article reports on the development of a manualized occupational therapy intervention for diabetes management. An initial theoretical framework and core content areas for a Stage 1 intervention manual were developed based on an in-depth needs assessment and review of existing literature. After evaluation by a panel of experts and completion of a feasibility study, the intervention was revised into a Stage 2 manual in preparation for a randomized study evaluating the intervention's efficacy. In developing the initial manual, we delineated core theoretical principles to allow for flexible application and tailoring of the intervention's content areas. Expert panel feedback and feasibility study results led to changes to the intervention structure and content as we developed the Stage 2 manual. Through describing this process, we illustrate the dynamic evolution of intervention manuals, which undergo revisions due to both theoretical and practical considerations at each stage of the research-to-clinical practice pipeline.
Pyatak, E. A., Florindez, D., Peters, A. L., & Weigensberg, M. J. (2014). “We are all gonna get diabetic these days:” The impact of a living legacy of type 2 diabetes on Hispanic young adults' diabetes care. The Diabetes Educator, 40(5), 648-658. https://doi.org/10.1177/0145721714535994 Show abstract
Purpose. The purpose of this study was to investigate how an intergenerational legacy of type 2 diabetes affected the knowledge, attitudes, and treatment strategies of Hispanic young adults with diabetes.
Methods. Eight Hispanic young adults (ages 18-30 years) participated in a series of in-home longitudinal qualitative interviews, and 11 of their family members completed single in-home interviews, regarding their diabetes management practices. Interview transcripts were analyzed thematically by a team of researchers.
Results. Five themes emerged that characterized the influence of an intergenerational legacy of diabetes on young adults: food and family (how meal preparation and eating are shared within families), doing together (activity participation is contingent on others’ participation), knowledge and expectations (expectations for the future and understandings of diabetes are shaped by family members), miscarried helping (well-intentioned actions have negative consequences), and reciprocal support (children and parents support each other’s diabetes care).
Conclusions. Hispanic young adults’ knowledge, attitudes, and self-care practices related to diabetes are strongly influenced by the diabetes management practices of family members with diabetes, which often depart from current standards of diabetes care. Care providers should consider family members as a potentially significant influence, either positive or negative, on the diabetes self-care practices of this population.
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