For Scientists Research Information Alumni Connection

Katie Weinger, Ed.D., R.N.

Dr. Weinger is an Investigator in the Section on Behavioral and Mental Health and an Assistant Professor of Psychiatry at Harvard Medical School. She directs Joslin Diabetes Center’s Office of Research Fellow Affairs as well as the Joslin Clinic’s Center for Excellence in Diabetes Education. She also serves as Vice Chair of the Joslin Diabetes Center Committee on Human Subjects. Dr. Weinger received her nursing degree from Boston College and her doctoral degree in Human Development and Psychology from Harvard University. She completed postdoctoral fellowships in Psychiatry at Harvard Medical School and at the Harvard Institute of Nursing Research at the Harvard School of Public Health. She received the Priscilla White Fellowship, a Harvard Medical School Center of Excellence in Women’s Health Research Grant as well as several grants funded by the National Institutes of Health.

Helping people with diabetes live long and healthy lives requires more than information. In addition to understanding the disease and its medical treatment, patients must learn to self-manage their diabetes through physical activity and diet. Dr. Weinger approaches the issue from two perspectives: (1) investigating barriers to effective patient self-management and (2) determining ways in which diabetes educators can adapt and incorporate psychological techniques to improve patient adherence and outcomes.

Dr. Weinger has identified several factors that interfere with effective patient self-management: inaccurate perceptions of recommendations, misunderstanding of how to implement advice, ineffective coping styles, diabetes-related emotional distress, use of insulin for weight control and negative attitudes about treatment. 

The Diabetes Education Study, of which Dr. Weinger is Principal Investigator, compares experimental group education incorporating psychological techniques with standard group and individual patient education. All programs are taught by a nurse and a nutritionist. The study evaluates whether psychological techniques adapted to educators’ practice patterns are useful in helping patients with poor glycemic control improve their self-management skills and health.

With other Joslin colleagues, Dr. Weinger is also studying additional psychological and educational interventions to help adults and young adolescents manage their diabetes more safely and effectively. Subjects under investigation include behavioral risks of automobile collisions and mishaps caused by low blood-glucose levels, barriers to successful insulin pump use, attitudes toward insulin as well as the impact of its use and misuse on a patient’s health and weight. In addition, Dr. Weinger is developing and evaluating educational tools to help young adolescent patients improve problem-solving ability and recognize symptoms of hypoglycemia early enough to prevent it. These tools include the book “Choose Your Own Adventure” and a related “Symptom Experiment Workbook.”

Due to the limited time most patients have to attend educational sessions and the limited education benefits of most insurance policies, Dr. Weinger is planning to study ways to maximize the effect of diabetes education, especially through age-specific reinforcement of learned behaviors using audiotapes, videotapes and Internet programs.

Dr. Weinger also directs the Joslin Office of Research Fellow Affairs, which oversees the approximately 150 research fellows who work at Joslin each year in clinical research and basic science. The office introduces new fellows from all over the world to Joslin and Harvard Medical School, and also provides a foundation in general research skills, such as grant writing, statistics and writing for publication. Dr. Weinger works closely with Joslin’s Office of Sponsored Research and with Human Resources on this program. Dr. Weinger also sponsors the annual Joslin Research Poster Day, at which researchers and fellows present posters on abstracts previously presented at national diabetes conferences. This activity provides fellows, clinicians and established researchers an opportunity to discuss research findings and their potential clinical relevance, and to develop collaborations with other researchers in related fields.

Selected References
Smaldone A, Ganda O, McMurrich S, Hannagan K, Lin S, Caballero AE, Weinger K.  Should group education appointments be separated by type of diabetes? Diabetes Care 2006, in press.

Weinger K, Butler HA, Welch GW, La Greca AM.  Measuring diabetes self-care: a psychometric analysis of the Self-Care Inventory-Revised with adults. Diabetes Care 28:1346-1352, 2005.

Weinger K, McMurrich SJ, Yi JP, Lin S, Rodriguez M. Psychological characteristics of frequent short-notice cancellers of diabetes medical and education appointments.  Diabetes Care 28:1791-1793, 2005.

Weinger K. Group interventions: emerging applications for diabetes care: preface. Diabetes Spectrum 16:86-87, 2003.

Welch G, Weinger K, Anderson B, Polonsky WH. Responsiveness of the Problem Areas in Diabetes (PAID) questionnaire. Diabet Med 20:69-72, 2003.

Weinger K, O’Donnell K, Ritholz MD. Adolescent views of diabetes-related parent conflict and support: a focus group analysis. J Adolesc Health 29:330-336, 2001.

Weinger K, Jacobson AM. Psychosocial and quality of life correlates of glycemic control during intensive treatment of type 1 diabetes. Patient Educ Couns 42:123-131, 2001.

Weinger