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An online positive affect skills intervention reduces depression in adults with type 2 diabetes
Open accessAbstract
Positive affect predicts improved glycemic control and longevity in adults with type 2 diabetes. We tested Developing Affective HeaLth to Improve Adherence (DAHLIA), a self-paced online intervention for type 2 diabetes that teaches positive affect skills such as savoring, gratitude, and acts of kindness. Participants (n = 49) were randomized to the five-week DAHLIA course or an emotion-reporting wait-list control. DAHLIA was understood and accepted by participants and showed good retention (78%). At post-intervention, DAHLIA participants showed a significantly greater decrease in depression than controls (−4.3 vs. +0.6 points on the CES-D, p = 0.05). Secondary analyses found that this effect was considerably stronger in intervention recipients recruited online than those recruited in person. Intervention recipients recruited online also showed significantly increased positive affect, reduced negative affect, and reduced perceived stress. There were no effects on measures of diabetes-specific efficacy or sense of burden, or preliminary measures of health behaviors. This successful feasibility and efficacy trial provides support for a larger trial focusing more specifically on health behavior.
Overview
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Written from the paper’s full text.
TL;DR
A 5-week self-paced online positive affect skills intervention (DAHLIA) reduced depressive symptoms in adults with type 2 diabetes compared with an emotion-reporting waitlist control. Effects were strongest among participants recruited online, with no significant effects on diabetes-specific efficacy, distress, or preliminary health behaviors.
Key findings
- Depression decreased significantly more in the DAHLIA condition than control: −4.3 vs. +0.6 points on the CES-D (β = −.21, p = .05), with intervention scores falling from 16.9 to 12.6.
- Exploratory analyses found the depression effect was considerably stronger for online-recruited participants: a 7.2-point reduction vs. 1.4 points for in-person recruits; adding recruitment type strengthened the condition effect (β = −.34, p = .02).
- Among online recruits, the intervention also significantly reduced perceived stress when recruitment type was included (βcond = −.43, p = .01) and increased retrospective positive affect (βcond = .32, p = .05), with marginal reductions in negative affect.
- No significant intervention effects were found for diabetes self-efficacy, diabetes distress, or health behaviors (all |β| < .19, p > .20); retention was 79% for final questionnaires and 72% met full-completer criteria.
Methods
- Randomized pilot trial: 53 adults with type 2 diabetes recruited in person from UCSF diabetes education classes (n = 28) or online via Craigslist (n = 25); 49 completed the emotion-reporting run-in and were randomized to the 5-week DAHLIA course or an emotion-reporting waitlist control, and 42 completed final questionnaires used in analyses.
- DAHLIA taught 8 positive affect/coping skills (e.g., savoring, gratitude, mindfulness, positive reappraisal, acts of kindness); participants practiced skills daily and completed daily emotion reports.
- Main analysis used regression models predicting Time 2 scores from Time 1 scores and treatment condition; follow-up models added recruitment type and recruitment-by-condition interactions. Outcomes included CES-D depression, PSS perceived stress, DES positive/negative affect, CIDS diabetes self-efficacy, DDS diabetes distress, and daily self-reported health behaviors.
Limitations
- The paper states it was a pilot not powered to detect downstream changes from psychological benefits to health behaviors or health outcomes, and it lacked long-term follow-up.
- The paper states future studies need a more potent control than the emotion-reporting waitlist, and that paid assessments increased per-participant cost and reduced generalizability.
- The paper notes the intervention was less effective in the in-person clinic sample, with a marginally significant suggestion of reduced diabetes self-efficacy in that subset; evident from the text, the small sample and multiple exploratory subgroup analyses make the online-vs-offline findings tentative.
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Claims the paper makes
53 Own result · 28 Not checked yet · 10 Own interpretation · 8 Own method · 1 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Depression scores dropped significantly in the intervention condition compared to control (β = −.21, p = .05).”
- Also stated in: § Abstract · plain
“At post-intervention, DAHLIA participants showed a significantly greater decrease in depression than controls (−4.3 vs. +0.6 points on the CES-D, p =.05).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Primary Outcomes: Depression, Affect, and Perceived Stress
plaindirectn = 49 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The emotion-reporting-only control condition is an appropriate comparator for testing DAHLIA's efficacy.
- Also stated in: § Abstract · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Exploratory analysis found that this effect did not appear for the subset of positive affect CES-D items (β = .05, p = .71), but only the negative items (β = −.25, p = .03).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Primary Outcomes: Depression, Affect, and Perceived Stress
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Scores in the intervention condition dropped by 4.3 points, from a mean of 16.9 – above the threshold for probable clinical depression – to 12.6, well below the threshold.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Primary Outcomes: Depression, Affect, and Perceived Stress
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The intervention did not have a significant effect on PSS scores (β = −.13, p = .31).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Primary Outcomes: Depression, Affect, and Perceived Stress
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The emotion-reporting-only control condition is an appropriate comparator for testing DAHLIA's efficacy.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was no significant effect of condition for positive or negative affect, using either measure (|β| < .15, p > .20).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Primary Outcomes: Depression, Affect, and Perceived Stress
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The emotion-reporting-only control condition is an appropriate comparator for testing DAHLIA's efficacy.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The effect of the intervention was considerably stronger among participants recruited over the Internet compared to participants recruited in-person.”
- Also stated in: § Limitations of the current study · hedged
“The intervention appears to have been effective in a sample recruited online, but less so in a sample recruited in-person from a diabetes clinic.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Discussion > Online vs. offline recruitment
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Limitations of the current study · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Baseline depression strongly predicted increases over time in negative affect (β =.74, p = .02) and, marginally, perceived stress (β =.52, p = .06) but did not predict positive affect (β −.13, p = .51).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There are no obvious demographic differences that might explain these differential effects.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Discussion > Online vs. offline recruitment
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Unexpectedly, we found that the intervention’s effects were on the negative, rather than the positive, CES-D items; there were also clearer effects on negative affect than on positive affect.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Discussion
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The magnitude of the interaction between treatment group and recruitment method was effectively unchanged for positive affect (β changed from −.35 to −.43, new p = .09) or negative affect (β changed from .46 to .41, new p = .15).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 25
- It may state two separate claims as one. 25
- The quote only partly states this claim. 1
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Control participants visited significantly more frequently than intervention participants (5.8 vs. 4.5 visits / week; F = 4.28, p = .05, η2 = .10)”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Website Use
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Neither the diabetes self-efficacy scale nor the diabetes distress scale showed any intervention effect (|β| < .09, p > .20).”
- Also stated in: § Abstract · plain
“There were no effects on measures of diabetes-specific efficacy or sense of burden, or preliminary measures of health behaviors.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Diabetes-Specific Psychological Measures
plainn = 49- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The emotion-reporting-only control condition is an appropriate comparator for testing DAHLIA's efficacy.
- Also stated in: § Abstract · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The retrospective and averaged daily measures were strongly correlated with each other for both PA and NA and at both timepoints (rs ranging from .61 to .85, p < .001).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Primary Outcomes: Depression, Affect, and Perceived Stress
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants who dropped out generally cited time constraints; none raised issues with the content of the intervention.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Discussion > Feasibility and acceptability
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The interaction between treatment group and recruitment method was substantially reduced for perceived stress (β changed from .62 to .37, new p = .19).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Adding recruitment group did not change these results (|β| < .13, p > .20), with the exception of a marginal interaction between condition and recruitment group for the CIDS (β = .−.45, p = .08).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For positive affect, they improved according to the retrospective measure but not the averaged daily measures.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Discussion > Online vs. offline recruitment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Glucose testing was highly dichotomized, with nearly all participants scoring either 0 (never tested twice or more in a day) or 1 (tested twice or more every day; 88% scored 0 or 1 at baseline and 80% at post-intervention).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Health Behaviors
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“DAHLIA was understood and accepted by participants and showed good retention (78%).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Abstract
plainn = 49- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During post-study interviews, participants expressed that they understood the intervention content and found it sensitive and useful.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Discussion > Feasibility and acceptability
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Condition assignment was not related to either completing the final measures or reaching the full completer criterion (χ2 < .13, p> .72).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When recruitment type was added, a significant effect of condition emerged for retrospective PA (βcond = .32, p = .05); a marginal interaction indicated that the intervention increased PA only for intervention participants recruited online (βinteraction = −.35, p = .10).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Rests on an assumption: The emotion-reporting-only control condition is an appropriate comparator for testing DAHLIA's efficacy.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For NA, the retrospective measure had a similar pattern of marginal effects (βcond = −.35, p = .08; βinteraction = .46, p = .10), indicating that the intervention reduced NA for participants recruited online but not offline. The averaged daily measure showed the same pattern, though the interaction fell short of significance (βcond = −.32, p = .09; βinteraction = .38, p = .13; see Figure 3).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The emotion-reporting-only control condition is an appropriate comparator for testing DAHLIA's efficacy.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When recruitment type was added, a significant effect of condition emerged for retrospective PA (βcond = .32, p = .05); a marginal interaction indicated that the intervention increased PA only for intervention participants recruited online (βinteraction = −.35, p = .10).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Frequency of visits was not affected by recruitment method and there was no interaction between recruitment method and condition. (F < .78, p > .38).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Visit frequency was slightly higher in the emotion-reporting control condition, possibly due to the lower time requirement for control visits.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Discussion > Feasibility and acceptability
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In fact there was some suggestion of reduced diabetes self-efficacy among intervention participants recruited in person, though this was a marginally significant finding and may have occurred by chance.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Discussion > Limitations of the current study
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Recruitment method did not predict likelihood of reaching randomization (χ2 = .85, p = .36).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, participants recruited online were significantly more likely to complete the final measures (92% vs. 68%, χ2 = 4.68, p = .03) and to be full completers (88% vs. 57%, χ2 = 6.20, p = .01).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Scores dropped significantly for participants in the intervention who were recruited online, but not those recruited offline (see Figure 2).”
- Also stated in: § Abstract · plain
“Intervention recipients recruited online also showed significantly increased positive affect, reduced negative affect, and reduced perceived stress.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The emotion-reporting-only control condition is an appropriate comparator for testing DAHLIA's efficacy.
- Also stated in: § Abstract · plain
None of the sources cited for this claim have been checked yet.
In the paper
“In observational studies, positive affect is associated with an increased likelihood of physical activity[4,5,6,7] and healthy eating[5,8], as well as a lower likelihood of tobacco use [9,10].”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Abstract
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“In observational studies, positive affect is associated with an increased likelihood of physical activity[4,5,6,7] and healthy eating[5,8], as well as a lower likelihood of tobacco use [9,10].”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Depression is common in people with type 2 diabetes[21] and is associated with poorer glycemic control, increased symptoms and complications, poorer adherence to exercise and diet recommendations[22], and elevated risk of mortality, over and above the elevations in risk associated with diabetes itself[23].”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Positive Affect and Depression
What the sources say
- Not checked yetcites [22] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Depression is common in people with type 2 diabetes[21] and is associated with poorer glycemic control, increased symptoms and complications, poorer adherence to exercise and diet recommendations[22], and elevated risk of mortality, over and above the elevations in risk associated with diabetes itself[23].”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Positive Affect and Depression
What the sources say
- Not checked yetcites [21] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“In observational studies, positive affect is associated with an increased likelihood of physical activity[4,5,6,7] and healthy eating[5,8], as well as a lower likelihood of tobacco use [9,10].”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Research on individuals newly diagnosed with HIV indicates that positive affect prospectively predicts greater liklihood of engagement in care and better medication adherence [11].”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Abstract
What the sources say
- Not checked yetcites [11] source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The most successful of these interventions have a variety of components and interactive elements to encourage engagement (including Beating the Blues, which is approved for use by the British National Institute for Health and Clinical Excellence [35,36,37,38,39,40].)”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Positive Affect and Depression
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A meta-analysis of 25 programs targeting constructs such as gratitude, happiness, and optimism found a medium effect size for relief of depression symptoms (median r = .26), with stronger effects for currently-depressed participants[24].”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Positive Affect and Depression
What the sources say
- Not checked yetcites [24] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Depressive Symptoms were measured using the CES-D[69], a measure of clinical and subclinical depressive symptomatology.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Method > Measures
What the sources say
- Not checked yetcites [69] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Those who completed four emotion reports within the first 7 days were randomized to begin the intervention or to the control condition in which participants continued for 60 days of emotion reporting only1.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Method > Procedure
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Diabetes self efficacy was measured using a version of the Confidence in Diabetes Self-Care scale (CIDS;[73]) adapted for type 2 diabetes.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Method > Measures
What the sources say
- Not checked yetcites [73] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The focus on pleasurable and rewarding activities of positive psychology interventions resembles the approach of Behavioral Activation (BA) therapies, which have also shown substantial effectiveness at treating depression [25].”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Positive Affect and Depression
What the sources say
- Not checked yetcites [25] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Intervention and control groups did not differ on age (F = 2.59, p = .11), gender (χ2 = .66, p = .42), or any racial category (χ2 < .1.63, p > .20).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In a meta-analysis, Pal and colleagues[30] found that online diabetes self-management interventions have a small, but statistically significant, effects on HbA1c, diet, and lipids, but do not consistently improve depression symptoms.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Positive Affect and Depression
What the sources say
- Not checked yetcites [30] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Positive and Negative Affect were measured with the Differential Emotions Scale (DES; [72]).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Method > Measures
What the sources say
- Not checked yetcites [72] Van’t Hof E., 2009, CNS Spectrums source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Diabetes-related distress was measured using the Diabetes Distress Scale (DDS; [74]).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Method > Measures
What the sources say
- Not checked yetcites [74] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Online interventions for diabetes self-management and depression are feasible and have shown some efficacy [28]|[29] at improving symptoms of depression and some health outcomes.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Positive Affect and Depression
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Of the 53 participants recruited, 49 (92%) completed the initial emotion reporting run-in and were randomized (see Figure 1 for the CONSORT flow diagram).”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Completion Rates
plainn = 53- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Thirty-eight participants (72% of the original sample) met this criterion.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Completion Rates
plainn = 8- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Several meta-analyses of internet and computerized interventions, both self-help and clinician-assisted[31,32,33,34], found that internet interventions can reduce symptoms of depression, including among those who might otherwise lack access to treatment.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Positive Affect and Depression
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Psychological interventions that specifically target depression in samples of people with type 2 diabetes have shown some efficacy (e.g.[26]) but tend to be time intensive for both the patient and the provider, expensive to deliver, and difficult to disseminate in home or other non-clinic settings [27].”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Positive Affect and Depression
What the sources say
- Not checked yetcites [27] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Perceived Stress was measured with the Perceived Stress Scale (PSS; [70,71]). The PSS is a widely-used measure of psychological stress designed for community samples.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Method > Measures
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Forty-two participants (25 intervention and 17 control; 79% of the original sample) completed the final questionnaires. This is the sample used in the analyses reported below.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Completion Rates
plainn = 2- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The pre-post change in CIDS score for intervention-offline participants was marginally significant on its own (t(10) = 1.92, p = .08), tentatively suggesting that the intervention may have led to reduced diabetes self-efficacy for this subset of participants.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Rests on an assumption: The emotion-reporting-only control condition is an appropriate comparator for testing DAHLIA's efficacy.
In the paper
“This adds to the growing evidence that interventions based on positive emotions are accessible and effective even for individuals already experiencing depression[75], rather than being restricted to those who are doing well.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Discussion
What the sources say
- Not checked yetcites [75] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, this study did not include follow-up assessments that would allow us to assess long-term intervention effects.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Discussion > Limitations of the current study
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We have demonstrated that individuals with type 2 diabetes find our online positive emotion skills intervention engaging and feasible to complete.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Discussion > Conclusion
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This pilot study provides initial evidence that an online positive emotions intervention can be delivered in an effective, understandable, and sensitive manner to adults with type 2 diabetes, with strong participant engagement and adherence.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Discussion > Limitations of the current study
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
The emotion-reporting-only control condition is an appropriate comparator for testing DAHLIA's efficacy.
“control condition in which participants continued for 60 days of emotion reporting only1”
The authors state this as an assumption.
Mindfulness exercises may help participants recognize and appreciate positive events even under chronic stress.
“Mindfulness exercises are continued throughout the intervention because we believe they may also help participants recognize and appreciate positive events, even in the context of chronic stress.”
The paper relies on this without support.
The intervention is low cost.
“Because of the low cost of this intervention, and because individuals typically do not receive interventions of this type (i.e., there is no comparable treatment-as-usual), any degree of efficacy is of potential value.”
The paper relies on this without support.
People with type 2 diabetes typically do not receive interventions of this type, so there is no comparable treatment-as-usual.
“Because of the low cost of this intervention, and because individuals typically do not receive interventions of this type (i.e., there is no comparable treatment-as-usual), any degree of efficacy is of potential value.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“In the 1 prior study 20 of a positive psychology-based intervention in patients with type 2 diabetes, the intervention was associated with improvements in psychological outcomes but not health behavior adherence compared to waitlist control.”
From Feasibility and acceptability of a positive psychological intervention for patients with type 2 diabetes (2016) · cites this paper as [20]
The cited source says what the claim attributes to it.
In the citing paper
“Despite these appealing features, there has been minimal use of positive psychology interventions in this population. 20”
From Feasibility and acceptability of a positive psychological intervention for patients with type 2 diabetes (2016) · cites this paper as [20]
The cited source says what the claim attributes to it.
In the citing paper
“However, that single prior study 20 was delivered by Internet and was substantially shorter (5 weeks) than our intervention.”
From Feasibility and acceptability of a positive psychological intervention for patients with type 2 diabetes (2016) · cites this paper as [20]
The cited source says what the claim attributes to it.
In the citing paper
“Several such programs, either alone or combined with motivational interviewing, have focused on the promotion of physical activity in patients with cardiac disease or cardiac risk conditions in randomized studies, with a majority, 203-207 but not all, 208 of such studies finding positive psychology-based interventions to be associated with greater improvements in physical activity compared”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [208]
In the citing paper
“Interventions that explicitly target positive emotion show promise for improving health outcomes in a number of chronic illnesses, including diabetes [16,17], heart disease [18,19], hypertension [20,21], depression [22,23], and HIV [24].”
In the citing paper
“However, to our knowledge, PP interventions have not been formally tested in T2D.”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [54]
In the citing paper
“Furthermore, a small randomized trial (N = 43) of an online positive affect skills intervention led to improvements in depressive symptoms in T2D patients [54].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [54]
In the citing paper
“Regarding direct effects of PP on activity, the established benefits of PP on mood, resilience, well-being, and optimism (pathway B1) [41, 54, 124, 125] are associated with increased physical activity (pathway B2) [48, 88, 123, 131, 132].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [54]
In the citing paper
“These consisted of four PP articles [41–44], 18 mindfulness-based articles [45–62], six ACT articles [38, 63–67], four resilience-based articles [68–71], and single studies targeting emotional intelligence [72] and positive self-concept [73]”
From Well-being interventions for individuals with diabetes: A systematic review (2019) · cites this paper as [41]
In the citing paper
“Otherwise, depression was measured in three of four PP studies. Among the two controlled studies, depression significantly changed in only one that examined the efficacy of an online, self-paced PP intervention [41].”
From Well-being interventions for individuals with diabetes: A systematic review (2019) · cites this paper as [41]
In the citing paper
“Third, overlapping intervention components across intervention categories limited our ability to compare these categories to one another (e.g., one PP intervention included a mindfulness component [41]).”
From Well-being interventions for individuals with diabetes: A systematic review (2019) · cites this paper as [41]
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Consistentt(10) = 1.92reported p = .08 · recomputed p = .084
“t(10) = 1.92, p = .08”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Most participants had perfect medication adherence on all days (19/24 or 76% at T1 and 21/24 or 84% at T2)”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Health Behaviors
Reported 84 · recomputed 87.5
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Most participants had perfect medication adherence on all days (19/24 or 76% at T1 and 21/24 or 84% at T2)”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Health Behaviors
Reported 76 · recomputed 79.166667
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Method > Measures
“On a 4-point scale”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Method > Measures
“(0 = “Rarely or none of the time – less than 1 day”; 4 = “All of the time – 5–7 days”)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Discussion > Online vs. offline recruitment
“Online recruits in the intervention condition also showed significant reductions in negative affect and perceived life stress relative to online controls.”
§ An online positive affect skills intervention reduces depression in adults with type 2 diabetes > Results > Exploratory Analyses
“For NA, the retrospective measure had a similar pattern of marginal effects (βcond = −.35, p = .08; βinteraction = .46, p = .10), indicating that the intervention reduced NA for participants recruited online but not offline.”
Citations
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Metadata
- Authors
- Cohn, M. A., Pietrucha, M. E., Saslow, L. R., Hult, J. R., & Moskowitz, J. T.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Cohn, Michael A.
- Venue
- The Journal of Positive Psychology
- Publisher
- Informa UK Limited
- Published
- 2014-06-10
- Volume
- 9
- Issue
- 6
- Pages
- 523-534
- ISSN
- 1743-9760 (ISSN-L)
- 1743-9779
- PMC
- PMC4157680
- OpenAlex
- W2061783093
- Semantic Scholar
- 1aff0866fbdbfe3818195e2d942041b1f336b7a8
- Cited by
- 188
- References
- 86
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 10 · 2023: 20 · 2022: 13 · 2021: 47 · 2020: 15 · 2019: 15 · 2018: 22 · 2017: 16 · 2016: 6 · 2015: 5
- FWCI
- 7.24
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Positive Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K24MH093225)
- National Center for Research Resources (UL1RR024131)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- type 2 diabetes, depression, positive affect, online intervention, savoring, gratitude, acts of kindness, dahlias, perceived stress, glycemic control, health behavior, feasibility
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