# Real-World Assessment of Daily Functioning in Veterans with Type 2 Diabetes

> **NIH VA IK2** · VA SAN DIEGO HEALTHCARE SYSTEM · 2022 · —

## Abstract

Type 2 diabetes (T2D) is associated with considerable functional impairment and reduced quality of life.
Consistent daily engagement in self-management behaviors, such as physical activity, medication adherence,
and monitoring blood glucose is required to maintain daily functioning, quality of life, and glucose control.
However, most Veterans do not meet daily self-management targets, particularly physical activity. This is
problematic as physical activity is a cornerstone of T2D self-management and represents a fundamental
component of functioning. Self-management occurs in the context of patients’ own environments. Thus,
assessments at healthcare visits likely miss significant amounts of variability in self-management behaviors as
well as daily fluctuations in comorbid symptoms and social contextual factors that influence self-management.
 The conceptual model guiding the proposal is based on temporal self-regulation theory and posits that
because T2D is generally asymptomatic, consequences of poor self-management and benefits of consistent
self-management are not salient in the moment. For Veterans with T2D, comorbid symptoms such as mood,
pain, and stress are common time-varying momentary barriers to self-management that may particularly
impact physical activity. Social context is another well-established set of factors related to self-management
among people with T2D. Most research on barriers and facilitators of T2D self-management is cross-sectional
and assumes comorbid symptoms and contextual factors are static. Current research does not address the
time-varying nature in which these comorbid symptoms and social contextual factors impact physical activity
and other self-management behaviors within individuals. Thus, the overarching aim of the current proposal is
to understand daily, time-varying factors (comorbid symptoms, social context) that are particularly relevant to
Veterans and that influence physical activity, T2D self-management, daily functioning, and quality of life.
 We will enroll 95 (5 test participants and 90 for the analytic sample) Veterans with T2D and will use
ecological momentary assessment (EMA), a method of real-time data collection. Participants will receive 5
momentary EMA surveys and 1 daily EMA survey per day, in which Veterans will report on comorbid
symptoms (mood, stress, pain, PTSD), social support, social interactions, physical activity and other self-
management behaviors, randomly, during pre-programmed intervals in their natural environment over a 14-day
sampling period. Accelerometry will also assess physical activity. With these data, we will address 4 aims: Aim
1) Use EMA to examine within-person time-varying relationships among daily comorbid symptoms (depressed
mood, stress, pain, PTSD) and within-day time spent doing physical activities; Aim 2) Use EMA to examine
within-person social contextual factors (social support, social interactions) and daily time spent doing physical
activities; Exploratory ...

## Key facts

- **NIH application ID:** 10413728
- **Project number:** 1IK2RX003634-01A2
- **Recipient organization:** VA SAN DIEGO HEALTHCARE SYSTEM
- **Principal Investigator:** Jennalee S Wooldridge
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-04-01 → 2027-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10413728

## Citation

> US National Institutes of Health, RePORTER application 10413728, Real-World Assessment of Daily Functioning in Veterans with Type 2 Diabetes (1IK2RX003634-01A2). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10413728. Licensed CC0.

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