CDE Behavioral Strategies 4 — Questions and Answers
Question 1: Social support is recognized as a key behavioral determinant in diabetes management. Which type of social support involves practical assistance, such as a family member driving a patient to appointments?
- Emotional support
- Informational support
- Instrumental support (Correct answer)
- Appraisal support
Correct answer: Instrumental support
Instrumental support refers to tangible, practical help that facilitates the patient's ability to carry out health behaviors.
Question 2: A patient with type 1 diabetes reports deliberately skipping insulin doses to lose weight. This behavior is most accurately described as:
- Medication non-adherence due to cost
- Diabulimia, a form of disordered eating in diabetes (Correct answer)
- An intentional insulin reduction protocol
- A symptom of insulin resistance
Correct answer: Diabulimia, a form of disordered eating in diabetes
Diabulimia is a serious eating disorder specific to diabetes where insulin is restricted for weight control, requiring specialized behavioral and medical intervention.
Question 3: Problem-solving training in diabetes education typically follows which sequence?
- Define problem → generate solutions → evaluate options → implement and review (Correct answer)
- Implement solution → evaluate problem → generate options → review outcomes
- Generate solutions → define problem → review → evaluate options
- Evaluate options → implement → define problem → generate solutions
Correct answer: Define problem → generate solutions → evaluate options → implement and review
Structured problem-solving follows a logical sequence: clearly define the problem, brainstorm solutions, evaluate them, then act and assess results.
Question 4: Which behavior change technique uses predetermined rewards to reinforce desired diabetes self-management behaviors?
- Motivational interviewing
- Contingency management (Correct answer)
- Cognitive behavioral therapy
- Acceptance and commitment therapy
Correct answer: Contingency management
Contingency management applies behavioral reinforcement principles by linking specific rewards to the performance of target health behaviors.
Question 5: A patient reports that stress from work causes blood glucose spikes and leads to emotional eating. The MOST appropriate initial behavioral intervention is:
- Adjust insulin dosing to account for stress-related hyperglycemia
- Identify the stress-eating cycle and teach coping strategies to interrupt it (Correct answer)
- Recommend a structured meal plan with no flexibility
- Refer the patient to occupational therapy
Correct answer: Identify the stress-eating cycle and teach coping strategies to interrupt it
Helping the patient recognize the stress-glucose-eating cycle and introducing alternative coping behaviors directly addresses the behavioral root cause.
Question 6: Peer support in diabetes education is effective primarily because it:
- Replaces the need for professional diabetes education
- Provides lived-experience modeling and reduces feelings of isolation (Correct answer)
- Offers medically supervised group therapy
- Guarantees improved glycemic outcomes
Correct answer: Provides lived-experience modeling and reduces feelings of isolation
Peers with shared experiences normalize the challenges of living with diabetes and serve as credible role models, which Social Cognitive Theory identifies as vicarious learning.
Question 7: Which concept from Self-Determination Theory is most closely associated with a patient choosing to manage their diabetes because they find personal meaning in staying healthy?
- External regulation
- Introjected regulation
- Identified regulation
- Integrated regulation (Correct answer)
Correct answer: Integrated regulation
Integrated regulation occurs when health behaviors are fully assimilated into the patient's identity and values, representing the highest form of autonomous motivation.
CDE Behavioral Strategies 4
Social support is recognized as a key behavioral determinant in diabetes management.
Which type of social support involves practical assistance, such as a family member driving a patient to appointments?