Table 1.
Characteristics of Well-Being Intervention Studies with Control/Comparison Groups
| Authors | Sample Size | Sample Characteristics | Intervention Description | Psychological Outcomes (significant in bold) | Effect Size | Physical Health Outcomes (significant in bold) | Effect Size |
|---|---|---|---|---|---|---|---|
| PP Interventions | |||||||
| Cohn et al., (2014) | 49 | Adults with T2D 51% female Median age 54 | Online, 60-day, self-paced intervention to enhance positive emotion or adaptive coping Control group: Reported emotions daily on website |
Depression Perceived stress Positive affect Negative affect Confidence in DM self-care Diabetes-related distress |
β=−.21 β=−.13 |β|<.15 |β|<.15 |β|<.09 |β|<.09 |
Medication adherence Glucose testing adherence Physical activity |
|β|<.19 |β|<.19 |β|<.19 |
| Jaser et al., (2014) | 39 | Adolescent (age 13-17) outpatients with T1D Intervention group: 60% female Mean age 15.3 (SD=1.4) Control group: 42.1% female Mean age 15.0 (1.6) |
Positive affect intervention delivered in one in-person visit and bi-weekly phone calls over 8 weeks Control group: Education (biweekly mailed materials) |
Positive affect | NR | Self-reported average daily glucose | NR |
| Nowlan et al. (2016) | 81 | Australian older adults (age 60+) with T2D 40% female Mean age 71.7 (7.4) | Positive Reappraisal program delivered in one 50-minute in-person session Comparison group: Cognitive Restructuring Control group: supportive counseling |
Positive reappraisal Positive emotion Negative emotion Anxiety Depression |
ηp2=.16 ηp2=.09 NR NR NR |
||
| Mindfulness-Based Interventions | |||||||
| Haenen et al. (2016) | 139 | Outpatients with low levels of emotional wellbeing with T1D or T2D Intervention Group: 53% female Mean age 56 (13) Control Group: 46% female Mean age 57 (13) |
Mindfulness-based Cognitive Therapy delivered in weekly groups for 8 weeks with one booster session 3 months later Control group: wait list |
Mood Anger Fatigue Vigor Mindfulness |
ηp2=.07 ηp2=.10 ηp2=.09 ηp2=.04 −.07 |
HRQoL | NR |
| Jung et al. (2015) | 56 | Male and female outpatients with T2D from South Korean hospital (no demographic info) | Korean Mindfulness-Based Stress Reduction program delivered in twice weekly groups for 8 weeks Comparison groups: walking exercise and patient education groups delivered weekly |
Diabetes-related Stress Psychologica l Response to Stress |
NR NR |
Cortisol Level Vascular Inflammation Blood Glucose Level |
(All NR) |
| Miller et al. (2014) | 52 | Individuals with T2D Intervention Group: 63% female Mean age 53.9 (8.2) Comparison Group: 64% female Mean age 54.0 (7.0) |
Mindfulness Eating for Diabetes (MB-EAT-D) program delivered in groups for 3 months with follow-ups 1 and 3 months post-intervention Control group: educational/goal-setting program |
Depression Mindfulness Self-Efficacy Related to Diabetes Nutrition Self-Efficacy in Controlling Overeating Cognitive Control of eating Disinhibition of Control Anxiety Quality of Life Susceptibility to Nonphysical Hunger |
(All NR) |
Weight Outcome Expectations for Making Health Food Choices Food Intake Nutrition Knowledge Diabetes Meal Planning Glycemic Control |
(All NR) |
| Rungreangkul kij et al. (2011) | 64 | Individuals with T2D 93.8% female overall Intervention Group: Mean age 50.0 (10.6) Control Group: Mean age 47.0 (9.5) |
Buddhist Mindfulness delivered in weekly groups for six weeks; one follow-up at six months Control group: TAU |
Depression | d=1.74 | ||
| Schroevers et al. (2015) | 24 | Individuals with T1D or T2D 42% female Intervention Group: Mean age 54.9 (10.3) Control Group: Mean age 55.9 (8.2) |
Individual Mindfulness-Based Cognitive Therapy (I-MBCT) delivered in individual sessions for 8 weeks with a follow-up at 3 months Control group: waitlist |
Depression Diabetes-related Distress Attention Regulation Mindfulness: Act with Awareness Mindfulness: Accept Without Judgment |
d=1.23 d=1.08 d=.93 d=.63 NR |
||
| Friis et al. (2016) | 63 | Outpatients with T1D or T2D 68% female Mean age 44.4 (15.6) |
Mindful Self-Compassion Group delivered in group sessions for 8 weeks; three-month follow-up Control group: Waiting List/TAU |
Self-Compassion Depression Diabetes-specific Distress | ηp2=.21 ηp2=.19 ηp2=.29 |
HBA1C (at 3 mos) | ηp2=.15 |
| Gainey et al. (2016) | 23 | Outpatients with T2D 82.6% female Intervention Group: Mean age 58 (3) Control Group: Mean age 63 (2) |
Buddhism-Based Walking: Meditation Exercise delivered in-person for 12 (with thrice-weekly walks) Comparison group: Traditional Walking Group |
Blood Pressure Arterial Stiffness HbA1C Cortisol Flow-Mediated Dilation Ankle Brachial Index Fasting Blood Glucose Body Mass Index Maximal Oxygen Consumption Muscle Strength Insulin Lipid Profile |
(All NR) | ||
| Hartmann et al. (2012) | 110 | Outpatients with T2D Intervention Group:32.5% female Mean age 58.7 (7.4) Control Group: 19.3% female Mean age 59.3 (7.8) |
Mindfulness-Based Stress Reduction delivered in group sessions for 8 weeks with one booster session 6 months later; follow-ups annually for 5 years Control group: TAU |
Depression Stress Mental Health Status (outcomes significant only at 1 year follow-up) |
d=.71-.79 d=.48-.64 d=.54-.65 |
Blood Pressure Diastolic Systolic Albuminuria Physical Health Status HBA1C (outcomes significant only at 1 year follow-up) |
d=.68-.78 d=.39-.42 d=.40-.44 d=.19-.23 d=.37-.47 |
| Teixeira (2010) | 20 | Individuals with T2D and painful diabetic neuropathy 75% female Mean age 74.6 (10.8) | Mindfulness meditation instruction/practice delivered in one in-person class and four weeks of at-home practice with an audio CD Control group: Nutrition education |
Sleep Quality Neuropathic Pain Neuropathy-specific Quality of Life |
r=.53 ηp2=.001-.16 ηp2=.05 |
||
| Tovote et al. (2014) | 94 | Outpatients with T1D or T2D and depressive symptoms 49% female Mean age 53.1 (11.8) |
Mindfulness-Based Cognitive Therapy (MCBT) delivered in individual sessions over 8 weeks with daily homework Comparison group: CBT Control group: Waitlist |
Depression Diabetes-related Distress Anxiety Well-being *Significant differences were found for MBCT group compared to the control; no differences found between MBCT and CBT groups |
d=.80-1.17 d=.52 d=.98 d=.92 |
HBA1C | NR |
| Tovote et al. (2017) | 91 | Outpatients with either T1D or T2D and depressive symptoms 50% female Mean age 53.2 (11.9) |
MCBT delivered in individual sessions over 8 weeks with daily homework Comparison group:CBT |
Depression (moderated by education level) | NR | ||
| van Son et al. (2013) | 139 | Outpatients (T1D or T2D) with low levels of emotional wellbeing MBCT Group: 53% female Mean age 56 (13) Control Group: 46% female Mean age 57 (13) |
MCBT delivered in in-person group sessions for 8 weeks with one booster session 3 months post-intervention Control group: Waitlist |
Perceived Stress Anxiety Depression Mental HRQoL Fatigue Diabetes-Specific Distress |
d=.70 d=.44-.82 d=.59-.71 d=.55 d=.58 d=.21 |
Physical HRQoL HBA1C |
d=.40 d=.14 |
| Wagner et al. (2015) | 107 | Hispanic/Latino outpatients with T2D Mindfulness group: 74% female Mean age 60.0 (11.2) Control group: 72% female Mean age 60.8 (12.1) |
Mindfulness meditation and stress management in-person weekly group intervention for 8 weeks Control group: Diabetes education |
In-Session Positive Affect In-Session Negative Affect Treatment Satisfaction Therapeutic Cohesion |
NR NR NR NR |
Diabetes Knowledge | NR |
| Wagner et al. (2016) | 107 | Same as above | Same as above |
Depression Anxiety Diabetes distress |
R2=.086 R2=.077 R2=.000 |
Self-Reported Health Status HBA1C Cortisol Diabetes Self-Care | R2=.048 R2=.015 R2=.012 R2=.000 |
| Sasikumar & Latheef (2017) | 40 | Individuals from India with T2D for ≥1 year MBSR group: 60.0% female Control group: 61.1% female 38.9% in the 45-49 age group (mean not reported) |
MBSR delivered in group format plus daily practice for 8 weeks Control group: Waitlist |
Stress Depression Mindfulness | (All NR) | ||
| ACT Interventions | |||||||
| Gregg et al. (2007) | 73 | Outpatients with T2D ACT Group: 48.8% Female Mean age 51.9 Control Group: 57.9% Female Mean age 49.8 |
ACT and education workshop delivered in a 7-hour group session, with a 3-month follow-up Control group: Education only |
ACT processes Satisfaction with Treatment |
d=.78 NR |
Diabetes Self Management-Adherence Diabetic Control HBA1C Understanding of Diabetes |
d=.68 d=.61 d=.35 d=.30 |
| Shayeghian et al. (2016) | 100 | Outpatients with T2D ACT Group: 66% Female Mean age 55.2 (8.3) Control Group: 54% Female Mean age 55.7 (9.0) |
ACT and education workshop delivered in 10 group sessions with a 3-month follow-up Control group: Education only |
ACT processes | ηp2=.44 | HBA1C Diabetes Self Management-Adherence | ηp2=.25 ηp2=.22 |
| Moazzezi et al. (2015) | 32 | Adolescents (ages 7-15) with T1D or T2D ACT Group: 25% Female Mean age 11.4 (2.6) Control Group: 43.75% Female Mean age 9.7 (2.4) |
ACT workshop delivered in 10 group sessions Control group: TAU |
Total Perceived Stress Negative Perceived Stress Positive Perceived Stress | (All NR) | Special Health Self-Efficacy | NR |
| Moghanloo et al. (2015) | 34 | Adolescents (ages 7-15) with T1D or T2D ACT Group: 52.94% Female Mean age 10.4 (2.9) Control Group: 47.06% Female Mean age 10.6 (3.2) |
ACT workshop delivered in 10 group sessions Control group: TAU |
Depressive Symptoms Feeling of Guilt Psychologic al Well-Being | (All NR) | ||
| Whitehead et al. (2017) | 106 | Individuals with uncontrolled T2D ACT Group: 41% Female Mean age 53.8 (8.7) ACT + Education: 56% Female Mean age 56.1 (6.9) Control Group: 42% Female Mean age 56.4 (7.0) |
ACT and Education workshop delivered in a 6.5 hour group session with 3-month and 6-month follow-up Comparison group: Education Only Control group: TAU |
Acceptance of Diabetes Understanding Diabetes Satisfaction with Diabetes Management Anxiety Depression |
(All NR) | HBA1C (significant only between education and control groups) Understanding Diabetes Diabetes-related Self-Management |
(All NR) |
| Resilience Interventions | |||||||
| Steinhardt et al. (2015) | 65 | African American adults with T2D 72% female Mean age 62 (10.3) |
Resilience-based diabetes self-management education program delivered in 8 weekly in-person groups plus 2 bi-weekly support group sessions Control group: Groups without resilience component |
Positive meaning Positive adaptation to stress Coping Positive affect Negative affect Quality of life Perceived stress Depression |
d=.61 d=.24 d=.21 d=.42 d=.29 d=−.30 d=−.45 d=−.11 |
DM knowledge Fasting blood glucose HDL cholesterol LDL cholesterol Physical activity Blood glucose self-monitoring BMI HBA1C Triglycerides Systolic blood pressure Diastolic blood pressure |
d=.75 d=−.59 d=.84 d=−.47 d=.40 d=.50 d=−.15 d=−.27 d=.45 d=−.35 d=−.18 |
| Bradshaw et al. (2007)* | 67 | 65% female Intervention Group: Mean age 60.8 (10.9) Control Group: Mean age 57.5 (11.0) Adult outpatients with T2D referred for DM education |
Resilience intervention delivered in in-person groups twice a week for 5 weeks Control group: TAU |
Resiliency(at 6 mos.) Self-efficacy Locus of control Social support Purpose in life | ηp2=.156 NR NR NR NR |
Barriers to physical activity (at 3 mos.) HBA1C Waist circumference Compliance with DM self-management Blood glucose management Physical activity Healthy diet |
ηp2=.141 NR NR NR NR NR NR |
| Rosenberg et al. (2015) | 30 | Adolescent or young adults (age 15-25) with T1D diagnosed ≥6 months ago or cancer diagnosed ≥2 weeks ago Diabetes Group: 67% female Mean age 15.1 (11.3) Cancer Comparison Group: 58% female Mean age 16.2 (2.8) |
Promoting Resilience in Stress Management program delivered in 2 individual sessions Comparison group: Same intervention |
Resilience | d=.15 | ||
| Other Well-Being Interventions | |||||||
| Yalcin et al. (2008) | 36 | Turkish adults (age 40-60) with T2D 50% female Intervention Group: Mean age=54.3 (7.3) Control Group: Mean age=51.2 (5.8) |
Emotional Intelligence intervention delivered in 12 weekly group sessions Control group: Wait List |
Emotional Intelligence Well-being Quality of life | z=5.129 z=4.514 z=4.568 |
Physical functional status | z=2.595 |
| Voseckova et al. (2017) | 46 | Older adults (age 65-70) with T2D in Czech Republic 61% female Mean age 69 (14) |
Humanistic psychotherapy intervention focused on strengthening self-concept and perceived self-efficacy delivered in 8 monthly in-person groups Control group: TAU |
Subjective feelings and states Hardiness | NR NR |
Fasting blood glucose HBA1C | NR NR |
Note. HRQoL=Health-Related Quality of Life. NR=Not reported in article. d=Cohen’s d. ηp2=partial eta squared. R2=R squared. TAU=treatment as usual. (β=beta. z=z score comparing post-test scores in intervention versus control group.
*
Description of results is presented at item level and is unclear regarding effect sizes for larger constructs in most cases