Talking About Diabetes: Pharmacy professor uses communication to improve health outcomes

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More than 30 million Americans suffer from diabetes, including approximately 193,000 under the age of 20. With the problem so prevalent, the Harrison School of Pharmacy’s Jan Kavookjian is using an innovative approach to work with adolescents suffering from the disease.

Considered one of the leading experts in the country in motivational interviewing training of health care providers, Kavookjian, an associate professor in the Department of Health Outcomes Research and Policy, is applying the technique to adolescents and parents dealing with the disease to improve their health outcomes.

Originating in the 1980s in the substance abuse and counseling field, motivational interviewing is a communication skill set that empowers a person to find internal motivation to engage in healthy and positive behaviors. Since then, its use has expanded to cover a variety of behaviors, conditions and populations in the context of chronic disease management or prevention.

“Most parents, myself included, will tell you that the process of learning to communicate constructively with adolescents involves trial and error. This is exacerbated in the dynamic that is created when a worried parent has a teen with a serious chronic condition that requires self-management behaviors,” said Kavookjian. “Learning how to communicate in a way that empowers an adolescent to get to his or her own internal motivation for these changes could be a key to prevention of complications and advanced disease.”

In recognition of her work in the field, Kavookjian was recently awarded a Competitive Outreach Scholarship Grant from the Auburn University Office of the Vice President for University Outreach. The $25,000 award is funding her project titled “Motivational Interviewing communication skills training for parents of adolescents with diabetes: Training development and assessment of parent perceptions and outcomes.”

“This project intends to take the evidence-based training model that has been used for training thousands of health care providers for their communication encounters with patients and revise/adapt the communications skills set and way of being training to the context of a concerned parent of a child or adolescent with diabetes,” said Kavookjian. “Motivational interviewing is about interviewing the person in a way that helps them get to their own internal motivation for the target behavior, elicits from themselves the reasons for making the change and supports their autonomy to choose and set goals, among other important premises.”

Kavookjian’s program will develop a training model in the context of parents “coaching” their children in the self-management behaviors and goal setting that are required to keep the illness under control and prevent complications. The training program is intended to equip parents with constructive communication skills and specific messaging and tools to use when the stress of a conflict or concern arises.

“Parents have a role in their adolescent's life that can be so influential if constructive communication is a part of it, but can be just the opposite if destructive communication patterns exist,” said Kavookjian, who was recently named to the board of directors for the American Association of Diabetes Educators (AADE). “I am hoping to help parents get the tools they need that will bring about the outcomes they are hoping for.”

Kavookjian’s plan is to initiate a pilot project to train parents with children who have either type 1 or type 2 diabetes. The next step would be to adapt the training for parents of children with pre-diabetes, to engage them in a diabetes prevention initiative to prevent onset of type 2 diabetes by empowering their children/adolescents through lifestyle change counseling and goal setting. She also recently completed the Centers for Disease Control/AADE Diabetes Prevention Program Lifestyle Coach certification.

Partnering with Kavookjian on the project is Dr. Neil Schaffner, an endocrinologist with the Diabetes and Nutrition Center (DANC) at the East Alabama Medical Center. He and his staff will help recruit parents into the first phase of the project and will house the second phase. The first phase of the project includes parent interviews and a focus group. During phase two, the training will be developed and implemented on location at the DANC facility.

“Having the opportunity to develop and validate the model is the first step in establishing its credibility and potential to expand in two ways,” said Kavookjian. “First, extending the currently funded model out to other parent venues throughout the state and potentially beyond will be a next step. Second, it is hoped that the parent communication skills training model will also allow for pursuing additional funding to adapt the model to other target contexts parents and their adolescent might face, including prevention of onset of type 2 diabetes in adolescents identified as having pre-diabetes.”

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Auburn University's Harrison College of Pharmacy is ranked among the top 20 percent of all pharmacy schools in the United States, according to U.S. News & World Report. Fully accredited by the Accreditation Council for Pharmacy Education (ACPE), the School offers doctoral degrees in pharmacy (Pharm.D.) and pharmaceutical sciences (Ph.D.) while also offering a master's in pharmaceutical sciences. For more information about the School, please call 334.844.8348 or visit the Harrison College of Pharmacy website.