Using Ecological Momentary Assessment (EMA) to understand occupation from the perspective of the experiencing self: An illustrative example in workers with type 1 diabetes.

In people, the experiencing, remembering, and believing selves are distinct modes of being that co-exist, though at any particular moment one mode can be dominant. While qualitative methods are effective for querying the remembering and believing selves, Ecological Momentary Assessment (EMA) methods may be better suited to capture the perspective of the experiencing self. Using EMA to investigate occupation allows participants to engage in their regular occupations in their natural environments, pausing to record information about experiences that occurred seconds or minutes prior.

The Role of Diabetes Distress and Self-Efficacy as Mediators of Barriers to Diabetes Self-Management in Young Adults With Type 1 Diabetes: A Cross-Sectional Study.

Objective: This study examined how structural and contextual barriers, including social needs and gender, influence diabetes self-management (DSM) through psychosocial pathways, particularly diabetes distress (DD) and self-efficacy (SE). Although these barriers are well documented, their interactions with psychosocial factors remain underexplored.

Research Design And Methods: We analyzed cross-sectional baseline data from the REAL-T (Resilient, Empowered, Active Living-Telehealth) study ( = 198).

Diabetes-Related Distress and Glycemic Dysregulation in Everyday Life With Type 1 Diabetes: Which Comes First?

Objective: In an observational study, we paired ecological momentary assessment (EMA) and continuous glucose monitoring (CGM) to examine lagged effects of glycemic regulation on diabetes-related distress (DD), and vice versa, among adults with type 1 diabetes (T1D).

Research Design And Methods: Participants (N = 182; median ± SD age 40 ± 14 years; 54% women; 41% Latino; 29% White and 15% Black) wore a blinded CGM device for 14 days and completed five to six EMA surveys per day. We tested expected associations between momentary DD ratings and relevant patient-reported outcomes on validated questionnaires.

Person-Centered Care and Telehealth Reduce Distress and A1C for Marginalized Adolescents and Young Adults With Type 1 Diabetes.

Compared with their peers, historically excluded and marginalized adolescents and young adults (AYAs) with type 1 diabetes experience more adverse diabetes outcomes. The Colorado Youth With Type 1 Diabetes (CoYoT1) Care program (offering person-centered care and virtual peer groups) provided via telehealth can serve the unique needs of diverse AYAs by increasing engagement and reducing A1C and physician-related diabetes distress.

Dynamic Relationships Among Continuous Glucose Metrics and Momentary Cognitive Performance in Diverse Adults With Type 1 Diabetes.

Objective: Despite established relationships between glycemia and cognition, few studies have evaluated within-person changes over time. We paired continuous glucose monitoring (CGM) with ambulatory cognitive testing to examine bidirectional associations among adults with type 1 diabetes (T1D).

Research Design And Methods: Participants wore blinded CGM and completed ambulatory tests of perceptual speed and sustained attention five or six times daily for 14 days.

Telehealth occupational therapy improves psychosocial well-being but not glycemia among young adults with type 1 diabetes: The Resilient, Empowered, Active Living-Telehealth (REAL-T) randomized controlled trial.

Background: Young adults with type 1 diabetes mellitus often face challenges managing their condition, leading to elevated glucose and heightened psychosocial distress. Diabetes care traditionally focuses on biomedical outcomes, with less emphasis on well-being. Occupational therapy offers a holistic approach to managing diabetes by integrating changes to daily habits and routines and psychosocial support.

Whole Day Workload: Evaluation of a New Outcome Measure in Occupational Therapy for Adults With Type 1 Diabetes.

Importance: Typical whole day workload is a metric with potential relevance to the occupational balance and well-being of individuals with chronic conditions.

Objective: To examine the reliability and validity of using multiple daily NASA Task Load Index measures (whole day TLX) as an indicator of typical whole day workload experienced by adults with Type 1 diabetes (T1D).

Design: Participants with T1D completed cross-sectional measures and 2 wk of ecological momentary assessments (EMA) and daily diaries.

Reliability and Validity of Ecological Momentary Assessment Response Time-Based Measures of Emotional Clarity: Secondary Data Analysis.

Background: Emotional clarity has often been assessed with self-report measures, but efforts have also been made to measure it passively, which has advantages such as avoiding potential inaccuracy in responses stemming from social desirability bias or poor insight into emotional clarity. Response times (RTs) to emotion items administered in ecological momentary assessments (EMAs) may be an indirect indicator of emotional clarity. Another proposed indicator is the drift rate parameter, which assumes that, aside from how fast a person responds to emotion items, the measurement of emotional clarity also requires the consideration of how careful participants were in providing responses.

Comparisons of Self-Report With Objective Measurements Suggest Faster Responding but Little Change in Response Quality Over Time in Ecological Momentary Assessment Studies.

Response times (RTs) to ecological momentary assessment (EMA) items often decrease after repeated EMA administration, but whether this is accompanied by lower response quality requires investigation. We examined the relationship between EMA item RTs and EMA response quality. In one data set, declining response quality was operationalized as decreasing correspondence over time between subjective and objective measures of blood glucose taken at the same time.

Young Adults with Type 1 Diabetes.

Young adults experience multiple developmental transitions across social, educational, vocational, residential, and financial life domains. These transitions are potential competing priorities to managing a chronic condition such as type 1 diabetes and can contribute to poor psychosocial and medical outcomes. In this narrative review, we describe population outcomes of young adult populations and the unique considerations associated with managing type 1 diabetes in young adulthood.

Perception of Whole Day Workload as a Mediator Between Activity Engagement and Stress in Workers with Type 1 Diabetes.

Associations between various forms of activity engagement (e.g. work, leisure) and the experience of stress in workers have been widely documented.

Research design and baseline participant characteristics of the Resilient, Empowered, Active Living with Diabetes - Telehealth (REAL-T) Study: A randomized controlled trial for young adults with type 1 diabetes.

Background: Type 1 diabetes (T1D) is a chronic condition affecting nearly 1.9 million people in the United States. Young adults (YAs) with T1D face unique challenges in managing their condition, experiencing poorer health and well-being than other age groups.

Integrating psychosocial and behavioral interventions into type 1 diabetes care.

Purpose Of Review: To identify recent literature evaluating the efficacy of psychosocial and behavioral interventions for people with type 1 diabetes (T1D).

Recent Findings: Interventions generally produce benefits for psychosocial and behavioral outcomes, and some also positively impact glycemia. Addressing psychosocial concerns during routine provider visits had mixed results; some studies found that structured tools improved well being, while others found they could derail conversations, or contribute to worsening glycemia due to a lack of time to review medical concerns.

Within-person relationships of sleep duration with next-day stress and affect in the daily life of adults with Type-1 diabetes.

Objective: The objective of this study is to examine the within-person relationships between sleep duration and next-day stress and affect in the daily life of individuals with T1D.

Methods: Study participants were recruited in the Function and Emotion in Everyday Life with Type 1 Diabetes (FEEL-T1D) study. Sleep duration was derived by synthesizing objective (actigraphy) and self-report measures.

Workers' whole day workload and next day cognitive performance.

Workload experienced over the whole day, not just work periods, may impact worker cognitive performance. We hypothesized that experiencing greater than typical whole day workload would be associated with lower visual processing speed and lower sustained attention ability, on the next day. To test this, we used dynamic structural equation modeling to analyze data from 56 workers with type 1 diabetes.

Across and Within- Individual Associations Between Everyday Activities and Quality of Life Relevant Measures, in Workers with Type 1 Diabetes.

Unlabelled: Relationships between activity engagement and health related quality of life (HRQOL) can differ based on the level of analyses. For instance, greater exercise on average may be linked with lower fatigue across individuals (between-person level), whereas the momentary experience of exercise may be associated with increased fatigue within an individual (within-person level). Disentangling the between- and within-person associations between everyday activities and HRQOL outcomes may provide insights for personalized lifestyle-oriented health promotion efforts for individuals with chronic conditions.

Virtual Peer Groups Reduce HbA1c and Increase Continuous Glucose Monitor Use in Adolescents and Young Adults with Type 1 Diabetes.

Adolescents and young adults (AYA) from diverse and marginalized backgrounds with type 1 diabetes (T1D) generally have higher hemoglobin A1c (HbA1c) levels and less frequent continuous glucose monitor (CGM) use than AYA from more privileged backgrounds. Further, scant data address the impact of virtual peer groups (VPG) on health-related outcomes for ethnically and racially diverse AYA with T1D. CoYoT1 to California was a 15-month randomized controlled trial for AYA aged 16-25 years.

Reliability and Validity of Noncognitive Ecological Momentary Assessment Survey Response Times as an Indicator of Cognitive Processing Speed in People's Natural Environment: Intensive Longitudinal Study.

Background: Various populations with chronic conditions are at risk for decreased cognitive performance, making assessment of their cognition important. Formal mobile cognitive assessments measure cognitive performance with greater ecological validity than traditional laboratory-based testing but add to participant task demands. Given that responding to a survey is considered a cognitively demanding task itself, information that is passively collected as a by-product of ecological momentary assessment (EMA) may be a means through which people's cognitive performance in their natural environment can be estimated when formal ambulatory cognitive assessment is not feasible.

Glycemic Risk Index Profiles and Predictors Among Diverse Adults With Type 1 Diabetes.

Background: The Glycemia Risk Index (GRI) was introduced as a single value derived from the ambulatory glucose profile that identifies patients who need attention. This study describes participants in each of the five GRI zones and examines the percentage of variation in GRI scores that is explained by sociodemographic and clinical variables among diverse adults with type 1 diabetes.

Methods: A total of 159 participants provided blinded continuous glucose monitoring (CGM) data over 14 days (mean age [SD] = 41.

Movement matters: short-term impacts of physical activity on mood and well-being.

Few studies have investigated the short-term, momentary relationships between physical activity (PA) and well-being. This study focuses on investigating the dynamic relationships between PA and affective well-being among adults with type 1 diabetes. Participants (n = 122) wore an accelerometer and completed daily EMA surveys of current activities and affective states (e.

Optimizing Occupations, Habits, and Routines for Health and Well-Being With Lifestyle Redesign®: A Synthesis and Scoping Review.

Importance: Lifestyle Redesign® originated as a preventive occupational therapy intervention for healthy older adults, and it was found to be both effective and cost effective in the Well Elderly Studies initiated in the 1990s. Building on that empirical foundation, the scope of Lifestyle Redesign has been greatly expanded as a general intervention framework addressing prevention and chronic condition management in a wide range of populations, settings, and conditions. Yet until now, its full scope, defining characteristics, and supporting evidence have not been clearly and succinctly described, limiting its potential reach and impact.

Validation of the National Aeronautics and Space Administration Task Load Index (NASA-TLX) adapted for the whole day repeated measures context.

Our objective was to investigate the validity of four-item and six-item versions of the National Aeronautics and Space Administration Task Load Index (NASA-TLX, or TLX for short) for measuring workload over a in the context. We analysed data on 51 people with type 1 diabetes from whom we collected ecological momentary assessment and daily diary data over 14 days. The TLX was administered at the last survey of every day.