Operating Grant : Diabetes, Psychosocial Health, Prevention and Self-Management
Well-being, Health and Biomedical Discovery
Deadlines
Academic Unit: inquire with unit
Memorial Deadline: Thursday 27th, October 2022
External Deadline: Tuesday 1st, November 2022
Description
Research has shown an increasingly clear relationship between diabetes (both type 1 [T1D] and type 2 diabetes [T2D]) and a variety of psychosocial factors. Psychosocial factors are defined as complex environmental, social, behavioural, and emotional factors and these can influence living well with diabetes, achieving satisfactory diabetes-related medical outcomes and psychological well-being (1). Diabetes has been associated with diagnosable mental health disorders, and other problems that are specific to the experience of living with diabetes. “Diabetes distress” is a clinical condition that refers to the negative emotions and burden of self-management related to living with diabetes. In fact, in one of the largest cohort studies to date (MILES-2), severe diabetes distress (score of ≥40 in the Problem Areas in Diabetes [PAID] questionnaire) was reported in one of four people with T1D, one in five people with insulin-treated T2D, and one in ten people with non-insulin treated T2D (2). Diabetes Canada Clinical Practice Guidelines state that people with diabetes should be regularly screened for the presence of diabetes distress as well as symptoms of common psychiatric disorders, and recommend the use of various approaches to address diabetes distress and other mental health challenges.
Mental health disorders and psychosocial issues remain an under-researched yet frequent aspect of T1D. There is evidence that clinical depression, for example, is suffered disproportionately by people with T1D (3), and that among people with T1D, depression is associated with poor adherence to treatment (4-5). Optimum solutions to address mental health disorders and psychosocial issues may differ throughout life with the disease, for example, within the first year of diagnosis, during periods of waning self-management and transitions of life, and with aging and the onset of complications. Family conflict and higher levels of parental stress, anxiety and depression are also associated with worse outcomes in youth with T1D (6-7). Several behavioral health interventions (e.g., family-based interventions, cognitive behavioral therapy, others) have been tested in various populations of people with T1D. Some of these have provided evidence that behavioral health interventions can improve mental health issues such as clinical depression and diabetes distress, as well as diabetes self-management in people with T1D, setting the stage for further research to develop, validate and implement into practice interventions that offer long-lasting, scalable solutions.
T2D has a disproportionate impact on youth of racialized and Indigenous (First Nations, Inuit and Métis) communities, and individuals from disadvantaged socioeconomic backgrounds. The prevalence of T2D in children and adolescents in these populations is on the rise. A Canadian prospective national surveillance study found that from 2006–2008, the incidence of childhood-onset T2D in Canada (per 100,000 per year) was 23.2 amongst Indigenous Peoples, 7.7 in Asian, 1.9 in African/Caribbean and 0.54 in Caucasian (8). In children with T2D, neuropsychiatric disorders and the use of psychiatric medications are more common compared to the general pediatric population (9). One study noted that First Nations adolescents with a diagnosis of T2D experience associated stigma and shame, which are substantial barriers to diabetes self-care (10). These complex psychosocial and cultural environments make lifestyle change challenging and adherence to medical recommendations a struggle.
The Operating Grants in Diabetes, Psychosocial Health, Prevention and Self-Management will support research into approaches that will build on successful models of care, knowledge mobilization, and optimization of self-management. Specific to T1D, this funding opportunity will support research that is focused on interventions and models of care that address psychosocial issues and mental health disorders in people with T1D and thereby improve mental health and associated quality of life and/or clinical outcomes. Specific to T2D, this funding opportunity will support psychosocial health research focused on prevention and treatment in youth and young adults (YYA), with a focus on Indigenous and racialized, ethnocultural and low socio-economic status (SES) communities that are disproportionately affected by T2D.
See ResearchNet for more information.