Habit and diabetes self-management in adolescents with type 1 diabetes.

Abstract

Objective: The development of habit (i.e., behavioral automaticity, the extent to which a behavior is performed with decreased thresholds for time, attention [effort], conscious awareness, and goal dependence), for goal-directed health behaviors facilitates health behavior engagement in daily life. However, there is a paucity of research examining automaticity for Type 1 diabetes self-management in adolescence. This study examined if greater perceived automaticity for diabetes self-management was associated with increased daily selfmanagement, decreased daily self-regulation failures in glucose checking, and more optimal daily glycemic levels in adolescents with Type 1 diabetes. Method: Adolescents aged 13-17 and diagnosed with Type 1 diabetes (n = 79) completed the Self-Report Behavioral Automaticity Index, a measure of automaticity of diabetes self-management (i.e., automaticity of glucose checking, carbohydrate counting, and insulin dosing), and a measure of perceived self-management at baseline. One to 3 months later, a subsample of teens (n = 42) also completed a daily diary for a 7-day period including perceptions of daily self-management, daily selfregulation failures in glucose checking, and daily glucose levels. Results: Greater overall automaticity of diabetes self-management was associated with greater baseline and daily self-management, fewer daily self-regulation failures in glucose checking, and lower average daily mean blood glucose levels but not more optimal daily variations in blood glucose levels. Conclusions: Greater automaticity for diabetes self-management may support more optimal daily diabetes self-management in adolescence. Further research is needed to clarify the benefits and mechanisms of automaticity and explore possible interventions.

Psychometric evaluation of the Self-Report Habit Index for assessing habitual e-cigarette use behavior in high school adolescents

“…First, we did not conduct qualitative research like cognitive interviews with adolescents prior to adapting the measure for use with e-cigarettes, so we cannot confirm that adolescents understood the measure’s content as intended. However, the study team rated the vaping-specific SRHI items as appropriate for administration to high school students, supported in part by prior research showing that the SRHI has been used to assess other habitual behaviors in children and adolescents including diabetes management (e.g., Cummings et al, 2022 ), reading (e.g., Schmidt and Retelsdorf, 2016 ), fruit and vegetable consumption (e.g., Albani et al, 2018 ), and physical activity (e.g., Kremers and Burg, 2008 ; Kremers et al, 2008 ) among others. Concerns were also mitigated by the middle school reading level of the scale (7th grade) and the results indicating that adolescents utilized the full range of response options and that the items captured meaningful differences in habitual e-cigarette use behavior.…”

Habit and persistence

“…Instead, it is a process that makes a behavior that is effective in a specific setting efficient and automatic. These attributes of habitual performance are just as important as “persistence.” Thus, the practitioner should encourage the development of habit and automaticity in an effort to maintain healthy behavior, such as regular exercise or diabetes self‐management (e.g., Cummings et al, 2021). And the efficiency of habits—for example, by virtue of their gluing or chunking different behaviors together (e.g., Dezfouli & Balleine, 2012; Graybiel, 2008; Smith et al, 2012; Turner et al, 2022)—makes them easier to deploy rapidly.…”

Smartphone Bolus Feature Increases Number of Insulin Boluses in People With Low Bolus Frequency

“…This minimized risk of confusion and tapping into a degree of automaticity to program a bolus of insulin for users already familiar with the workflow. 6 Implementing the bolus calculator on a smartphone further required thinking about broader context of smartphone app design, as well as ways to prioritize safety. The initial design used native iPhone entry fields, which assumed the user understood that they could edit existing values.…”