Motivational Interviewing support for a behavioral health internet intervention for drivers with type 1 diabetes

Ingersoll, Karen S.; Banton, Thomas; Gorlin, Eugenia I.; Vajda, Karen; Singh, Harsimran; Peterson, Ninoska; Gönder-Frederick, Linda; Cox, Daniel J.

doi:10.1016/j.invent.2015.02.001

Cited by 13 publications

(12 citation statements)

References 28 publications

(30 reference statements)

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“…The most discriminating questions regarding accident risk were those that quantified annual mileage, identified a history of hypoglycemia-related vehicle collision, elicited poor self-management of hypoglycemic episodes and screened for the presence of lower limb neuropathy. An Internet-based management program undertaken by drivers with type 1 diabetes reduced the frequency of driving mishaps in highrisk drivers (25).…”

Section: Driving Risks Associated With Diabetesmentioning

confidence: 99%

Diabetes and Driving

Houlden¹,

Berard²,

Lakoff³

et al. 2018

Canadian Journal of Diabetes

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The fitness of people with diabetes to drive should be assessed on an individual basis. • All drivers with diabetes should undergo a medical examination at least every 2 years to assess fitness to drive. Commercial drivers should undergo an assessment at the time of application for a commercial license and as per provincial requirements thereafter. • People with diabetes should play an active role in assessing their fitness to drive. • Health-care professionals should educate people with diabetes about strategies to reduce their risks for hypoglycemia while driving. They should also identify and inform individuals with diabetes at higher risk for motor vehicle accidents. KEY MESSAGES FOR PEOPLE WITH DIABETES • If you take insulin and/or an insulin secretagogue and intend to drive: • Immediately notify your health-care provider and your driving licensing body if you experience any episode of severe hypoglycemia while driving or you experience more than 1 episode of severe hypoglycemia while awake but not driving in the past 6 months if you are a private driver, or in the past 12 months if you are a commercial driver. Conflict of interest statements can be found on page S152. Can J Diabetes 42 (2018) S150-S153 Contents lists available at ScienceDirect Canadian Journal of Diabetes j o u r n a l h o m e p a g e : w w w. c a n a d i a n j o u r n a l o f d i a b e t e s. c o m

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Section: Driving Risks Associated With Diabetesmentioning

confidence: 99%

Diabetes and Driving

Houlden¹,

Berard²,

Lakoff³

et al. 2018

Canadian Journal of Diabetes

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“…No significant differences were found between the DD.com and DD.com + MI groups on any outcome variables (number of units completed, daily progress notes completed, completion rate of DD.com, or number of driving mishaps [33]). Therefore, treatment outcomes are presented with these participants collapsed into a single intervention group, DD.com All .…”

Section: Resultsmentioning

confidence: 99%

Predicting and Reducing Driving Mishaps Among Drivers With Type 1 Diabetes

et al. 2017

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OBJECTIVETwo aims of this study were to develop and validate A) a metric to identify drivers with type 1 diabetes at high risk of future driving mishaps and B) an online intervention to reduce mishaps among high-risk drivers.RESEARCH DESIGN AND METHODSTo achieve aim A, in study 1, 371 drivers with type 1 diabetes from three U.S. regions completed a series of established questionnaires about diabetes and driving. They recorded their driving mishaps over the next 12 months. Questionnaire items that uniquely discriminated drivers who did and did not have subsequent driving mishaps were assembled into the Risk Assessment of Diabetic Drivers (RADD) scale. In study 2, 1,737 drivers with type 1 diabetes from all 50 states completed the RADD online. Among these, 118 low-risk (LR) and 372 high-risk (HR) drivers qualified for and consented to participate in a 2-month treatment period followed by 12 monthly recordings of driving mishaps. To address aim B, HR participants were randomized to receive either routine care (RC) or the online intervention “DiabetesDriving.com” (DD.com). Half of the DD.com participants received a motivational interview (MI) at the beginning and end of the treatment period to boost participation and efficacy. All of the LR participants were assigned to RC. In both studies, the primary outcome variable was driving mishaps.RESULTSRelated to aim A, in study 1, the RADD demonstrated 61% sensitivity and 75% specificity. Participants in the upper third of the RADD distribution (HR), compared with those in the lower third (LR), reported 3.03 vs. 0.87 mishaps/driver/year, respectively (P < 0.001). In study 2, HR and LR participants receiving RC reported 4.3 and 1.6 mishaps/driver/year, respectively (P < 0.001). Related to aim B, in study 2, MIs did not enhance participation or efficacy, so the DD.com and DD.com + MI groups were combined. DD.com participants reported fewer hypoglycemia-related driving mishaps than HR participants receiving RC (P = 0.01), but more than LR participants receiving RC, reducing the difference between the HR and LR participants receiving RC by 63%. HR drivers differed from LR drivers at baseline across a variety of hypoglycemia and driving parameters.CONCLUSIONSThe RADD identified higher-risk drivers, and identification seemed relatively stable across time, samples, and procedures. This 11-item questionnaire could inform patients at higher risk, and their clinicians, that they should take preventive steps to reduce driving mishaps, which was accomplished in aim B using DD.com.

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“…Over 30 years of research have established MI, a patient-centered method for identifying and enhancing intrinsic motivation, as an effective and straightforward technique for promoting behavioral change[ 54 , 55 ]. MI is effective and can be delivered remotely by different avenues with good fidelity[ 56 , 57 ]. MI interventions have led to improved health behaviors in patients with cardiac risk factors, including increased physical activity in patients with diabetes[ 58 ] and hypertension[ 59 ].…”

Section: Standard Health Behavior Interventions and Their Impact In Cmentioning

confidence: 99%

Sleep, health behaviors, and behavioral interventions: Reducing the risk of cardiovascular disease in adults

Kaar¹,

Luberto²,

Campbell³

et al. 2017

WJC

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Numerous health behaviors, including physical activity, diet, smoking, and sleep, play a major role in preventing the development and progression of cardiovascular disease (CVD). Among these behaviors, sleep may play a pivotal role, yet it has been studied somewhat less than other behaviors and there have been few well-designed sleep intervention studies targeting CVD. Furthermore, despite the fact that these behaviors are often interrelated, interventions tend to focus on changing one health behavior rather than concurrently intervening on multiple behaviors. Psychological constructs from depression to positive affect may also have a major effect on these health behaviors and ultimately on CVD. In this review, we summarize the existing literature on the impact of sleep and other cardiac health behaviors on CVD onset and prognosis. We also describe interventions that may promote these behaviors, from established interventions such as motivational interviewing and cognitive behavioral therapy, to more novel approaches focused on mindfulness and other positive psychological constructs. Finally, we outline population-health-level care management approaches for patients with psychiatric conditions (e.g., depression) that may impact cardiac health, and discuss their potential utility in improving mental health, promoting health behaviors, and reducing CVD-related risk. Much work is still needed to better understand how sleep and other health behaviors may uniquely contribute to CVD risk, and additional high-quality studies of interventions designed to modify cardiac health behaviors are required to improve cardiovascular health in individuals and the population at large.

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Motivational Interviewing support for a behavioral health internet intervention for drivers with type 1 diabetes

Cited by 13 publications

References 28 publications

Diabetes and Driving

Diabetes and Driving

Predicting and Reducing Driving Mishaps Among Drivers With Type 1 Diabetes

Sleep, health behaviors, and behavioral interventions: Reducing the risk of cardiovascular disease in adults

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