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Behavioral Science Research in the Prevention of Diabetes

Status and opportunities

¹ Departments of Psychology, Medicine, and Pediatrics, Washington University, St. Louis, Missouri
² Diabetes Research and Training Center, Albert Einstein College of Medicine, Bronx, NY
³ School of Public Policy, Georgia Institute of Technology, Atlanta, Georgia
⁴ Department of Engineering and Public Policy, Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania
⁵ Department of Community Health, School of Public Health, Saint Louis University, St. Louis, Missouri
⁶ Center for Pediatric Psychology and Family Studies, University of Florida Health Sciences Center, Gainesville, Florida

Recent studies show diabetes can be prevented. Growing knowledge of its biological bases opens further prevention opportunities. This article focuses on behavioral science research that may advance these opportunities. An ecological model guides attention to how prevention research may be pursued at the individual, group, or community levels. Three key areas are reviewed: risk communication, screening, and preventive interventions. Research on diabetes risk communication is limited but suggests that many are relatively unaware of risks and may have misconceptions about the disease. Amid policy debates and research regarding the potential benefits and costs of screening, identification of diabetes may itself be risky in terms of psychological and social consequences. The Diabetes Prevention Program and other studies make clear that diabetes can be prevented, both by the combination of weight loss and physical activity and by medications. Research needs to address promoting these methods to individuals as well as to groups and even whole communities. Fundamental as well as applied research should address how risks of diabetes are understood and may be communicated; how to enhance benefits and minimize psychological and other risks of screening; how to promote healthy eating and weight loss, physical activity, and appropriate use of medications to prevent diabetes; and how to reduce socioeconomic and cultural disparities in all these areas.

Abbreviations: ADA, American Diabetes Association • AHRQ, Agency for Healthcare Research and Quality • DPP, Diabetes Prevention Program • FPG, fasting plasma glucose • IGT, impaired glucose tolerance • NIDDK, National Institute of Diabetes and Digestive and Kidney Diseases • OGTT, oral glucose tolerance test

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