Abstract
This study examined the effects of sequentially introducing self-monitoring, goal setting, and behavioral contracting procedures on increasing the regimen compliance of nonadherent adolescent diabetics. For each of three insulin-dependent subjects, a multiple-baseline across-behaviors design was used to study three of the following target behaviors: urine testing, insulin injections, exercise, wearing diabetic identification, and home blood glucose testing. In addition to self-monitoring of adherence, measures of metabolic control of diabetes were collected before and after an 8-week treatment and at a 2-month follow-up. Adherence increased and was maintained at desired levels for two of the subjects following introduction of goal setting procedures. Metabolic control measures also showed substantial improvement for these subjects. The third subject, whose family was experiencing a variety of severe problems, did not show reliable improvement. The data suggest that graduated goal setting is a promising approach for improving adherence to diabetic regimens.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bandura, A. (1977).Social Learning Theory, Prentice-Hall, Englewood Cliffs, N.J.
Drash, A. L. (1981). Psychological and behavioral aspects of diabetes mellitus in the child.Behav. Med. Update 2(3): 18–20.
Dunbar, J. M., and Stunkard, A. J. (1979). Adherence to diet and drug regimen. In Levy, R., Rifkind, B., Dennis, B., and Ernst, N. (eds.),Nutrition, Lipids and Coronary Heart Disease, Raven Press, New York.
Haynes, R. B. (1979). Determinants of compliance: The disease and the mechanics of treatment. In Haynes, R. B., Taylor, D. W., and Sackett, L. (eds.),Compliance in Health Care, Johns Hopkins University Press, Baltimore.
Krall, L. P. (1978).Joslin Diabetes Manual, 11th ed., Lea & Febinger, Philadelphia.
Locke, E. A., Shaw, K. N., Saari, L. M., and Latham, G. P. (1981). Goal setting and task performance: 1969–1980.Psychol. Bull. 90: 125–152.
Lowe, K., and Lutzker, J. R. (1979). Increasing compliance to a medical regimen with a juvenile diabetic.Behav. Ther. 10: 57–64.
Skyler, J. S., Lasky, I. A., Skyler, D. L., Robertson, E. G. and Mintz, D. H. (1978). Home glucose monitoring as an aid in diabetes management.Diabetes Care 1: 150–157.
Author information
Authors and Affiliations
Additional information
This study fulfilled part of the requirements for a master's degree for the first author. The project was supported in part by NIAMD Grant 28318. We would like to acknowledge the help of Drs. George Johnson, Al Kenien, and Juan Munoz of the Fargo Clinic and Fran Schindler, R.N.
Rights and permissions
About this article
Cite this article
Schafer, L.C., Glasgow, R.E. & McCaul, K.D. Increasing the adherence of diabetic adolescents. J Behav Med 5, 353–362 (1982). https://doi.org/10.1007/BF00846162
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00846162