Association of Social Problem Solving With Glycemic Control in a Sample of Urban African Americans With Type 2 Diabetes

Abstract

The Social Problem-Solving Inventory--Revised, Short Form, was administered to 65 urban African Americans with type 2 diabetes to examine association of generic problem-solving styles and orientation with hemoglobin A1C (A1C). Eighty-five percent of participants had total social problem-solving scores in the Average range or higher. In linear regression models adjusted for education, each interquartile increase in impulsive/careless score was associated with a 0.82 increase in A1C (%) (p = 0.01), and each interquartile increase in avoidant score was associated with a 1.62 increase in A1C (%) (p = 0.004). After adjusting for depressive symptoms, the association of impulsive/careless style with A1C was attenuated, while the association of avoidant problem solving with A1C remained significant (p = 0.01). Associations of rational problem-solving style, positive orientation, and negative orientation with A1C and health behaviors were not statistically significant. Ineffective problem-solving styles may prove to be important targets for intervention to improve glycemic control.

Problem Solving and Diabetes Self-Management

“…These data also replicate and extend prior research with more homogenous and largely non-Hispanic white samples (14,15), as well as an entirely AfricanAmerican sample (19), and indicate that the linkage between problem-solving skill and diabetes outcomes occurs across diverse ethnic groups. One caveat is that the mean education level was fairly high, and results may not generalize to less educated populations.…”

Getting (the Most) Out of the Research Business: Interventions for Youth with T1DM

“…The potential importance of problem-solving skills for youth with T1DM has been highlighted through associations found between measures of problem solving and glycemic control [11,12]. Although problem solving has been emphasized as a skill necessary for effective diabetes management [13], and the American Association of Diabetes Educators has included problem solving in their plan of necessary self-care behaviors [14], there is a paucity of treatment outcome research that has examined the independent contributions of problem-solving training to improving diabetes treatment outcomes.…”

Associations of Patient Health-Related Problem Solving with Disease Control, Emergency Department Visits, and Hospitalizations in HIV and Diabetes Clinic Samples

“…Differential associations of subscales with CD4, HbA1c, hospitalizations, and ED visits suggest that problem-solving skill, learning, and motivation components, may differ in their contribution to outcomes 14,17. This finding reinforces the importance of addressing multiple problem-solving components, not just rational problem-solving skill, for efficacy of problem-solving interventions 8…”

“…Second, there are currently no measures of patient health-related problem solving for use across chronic diseases or for patients with multiple health conditions. Although generic measures (Problem-Solving Inventory13 and Social Problem-Solving Inventory14) are available, generic scales are generally less sensitive to disease-specific clinical outcomes than disease- or health-specific measures 15–17. Finally, although improved disease control is often a desired intervention outcome, studies of associations between patient problem solving and clinical measures of disease control are few.…”