SUGAR HIGH: PSYCHOSOCIAL FACTORS OF PATIENTS WITH TYPE 2 DIABETES IN AN INTEGRATED CARE SETTING

Type 2 diabetes (T2D) places considerable strain on patients , their families , and the healthcare system. To promote improved outcomes , it is necessary to assess psychosocial factors that impede or enhance T2D self-management. Through six chapters , this dissertation project sought to understand associations within the context of rural places of residence and integrated behavioral healthcare (IBHC) settings. The first chapter introduces the key psychosocial factors of interests and the organizational model used to guide the review and analysis. The second chapter is a publishable systematic review of the literature examining psychosocial factors of patients with T2D living in rural places of residence. Gaps found in the literature included the need for research that included multiple psychosocial factors , better measures of social support , and measures of online support. The third chapter and fourth chapter include the literature and methodology that informed the original research in fifth chapter. The fifth chapter is a cross-sectional study examining the associations of psychosocial factors of patients within an IBHC setting. Significant findings included evidence of an association between support from children and improved T2D outcomes. The sixth chapter identifies future research direction , implications for clinical settings , and identifying a place for medical family therapists in this ongoing effort