Spouses Use of Social Control To Improve Diabetic Patients' Dietary Adherence

Mary Ann Parris Stephens, Karen S. Rook, Melissa M. Franks, Cynthia Khan, Masumi Iida

Research output: Contribution to journalArticlepeer-review

83 Scopus citations


We investigated two types of negative and positive social control strategies, warning and encouragement, used by spouses to urge patients with type II diabetes to improve adherence to the diabetic diet. Warning refers to things a spouse may say or do to caution the patient about the consequences of eating a poor diet, and encouragement refers to things a spouse may say or do to promote healthier food choices by the patient. Our dyadic design (n = 109 couples) assessed spouses' use of warning and encouragement (reported by spouses and by patients), as well as patients' reports of dietary adherence. Spouses being actively involved in patients' dietary choices was the largest category of open-ended descriptors of both warning and encouragement. Both spousal warning and encouragement were associated with patients' adherence to the recommended diabetic diet, with warning associated with poorer adherence and encouragement associated with better adherence. Moreover, it was the spouses' perceptions of their own influence attempts, and not patients' reports, that were consequential for patients' adherence. Patients' dietary behavior, and ultimately disease management, appears to be best served when the spouse uses more positively toned and less coercive influence attempts.

Original languageEnglish (US)
Pages (from-to)199-208
Number of pages10
JournalFamilies, Systems and Health
Issue number3
StatePublished - Sep 2010
Externally publishedYes


  • Adherence
  • Dietary choices
  • Marriage
  • Social control
  • Type II diabetes

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


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