Search for a command to run...
Introduction and Objective: Habit theory describes context stability as important for the development of habit automaticity, but its role in insulin habit automaticity and adherence is unknown. The objective of the study was to examine the roles of context and context stability on insulin habit automaticity and adherence in adults with T1D. Methods: Adults with T1D (N = 63) completed a 7-day ecological momentary assessment (EMA) protocol using a time-contingent prompt schedule corresponding to approximate mealtimes (morning, afternoon, and evening). Physical, social, and emotional contexts were assessed at each timepoint. Generalized linear mixed-effects models tested associations between specific contexts with momentary insulin habit automaticity and insulin adherence. Spearman correlations were used to assess the strength of associations of context stability with insulin habit automaticity and insulin adherence. Results: The median age of the sample was 49 years, 58.7% were female, 96.8% were using a pump and CGM, and 76.3% were using automated insulin delivery. Feeling fatigued, stressed, and depressed reduced the likelihood of adherence to insulin but were not associated with automaticity. Those who reported feeling stressed were 56% less likely to adhere to insulin compared to those who reported no stress at all. As the extent of feeling fatigued increased, the likelihood of adherence decreased. More stable emotional contexts were associated with higher insulin habit automaticity scores and with greater insulin adherence. Greater stability in emotional context was also associated with less variability in both insulin habit automaticity and insulin adherence. Social context demonstrated a similar pattern of associations to that of emotional context for adherence but not for automaticity. Conclusion: Negative emotional contexts and emotional context stability appear to be important in insulin adherence and insulin habit automaticity. Disclosure J.Y. Stone: None. M.S. Dietrich: None. L.S. Mayberry: None. K. Clouse: None. S.A. Mulvaney: None. Funding Vanderbilt Institute for Clinical and Translational Research (UL1 TR002243)