CHOICE BEHAVIORS PERFORMED BY PERSONS WITH TYPE II DIABETES PARTICIPATING IN BEHAVIORAL ANALYSIS WITH NURSES.
Contributors: University of Michigan.
Published: 1994
Number of pages: 477
Subjects: Health Sciences, Nursing.; Psychology, Behavioral.
Description: The purpose of this study was to use existing data to investigate the choice behaviors performed by 117 type II diabetic subjects participating in behavioral analysis with nurses. Social cognitive theory guided the description of the choice behaviors in contingency contracts and the test of the relationship between regimen behavior shaping and health outcomes. Valid and reliable instruments (Choice Behaviors Schedule and Target Behavior Shaping Scale) were developed and pilot tested.

Subjects had a high rate of completion of choice behaviors (90.9%) and performed choice behaviors of diet and exercise the most. Subjects performed few choice behaviors overall (median = 6.0) and few choice behaviors of the regimen behaviors (medians $<$ or = 3.0). Many subjects shaped diet and exercise, however they concentrated their shaping on either diet or exercise. Few subjects shaped blood glucose (BG) testing, medication taking, appointment keeping, and smoking cessation. Many subjects identified one regimen behavior (diet, exercise, and BG testing) or diet plus exercise. Subjects infrequently identified complex combinations of regimen behaviors. The most frequent combinations of behavioral strategies were breaking the regimen behavior into steps, self-monitoring, and a combination of these behavioral strategies; the frequencies differed depending on the regimen behaviors. Stimulus control was occasionally specified, and self-reinforcement was seldom specified. Subjects with high shaping of diet and exercise identified more complex combinations of behavioral strategies. More shaping of diet and exercise did not produce reductions in glycosylated hemoglobin and body mass index.

The results suggest that the contingency contracting intervention should be modified to be more comprehensive. Behavioral analysis and regimen behavior shaping can be used with increased recognition of the time and effort required for changing diet and exercise together. Nurses can reinforce diet changes by obese type II diabetic persons who choose to shape diet and can provide direction and encouragement for exercise changes to obese type II diabetic persons who choose not to shape exercise. Nurses can improve their understanding and acceptance of self-reinforcement to promote its use by type II diabetic persons.
Notes: Source: Dissertation Abstracts International, Volume: 55-04, Section: B, page: 1380.

Thesis (PH.D.)--THE UNIVERSITY OF MICHIGAN, 1994.

School code: 0127.