Lawrence Fisher, Ph.D.

My primary research activity addresses the social, behavioral, self-management support and care system factors that affect the management of both type 1 and type 2 diabetes among adults through the Behavioral Diabetes Research Group in the Department of Family & Community Medicine at UCSF. In collaboration with a multidisciplinary group of medical, developmental, and methodological specialists in our program, we have been studying how to address behavioral change, weight loss, medication adherence, disease management, and particularly depression and distress among type 1 and type 2 adults. New projects test active interventions in primary care to re-configure panel management, outreach and care delivery to patients with chronic disease. Our studies include longitudinal observational studies and active multi-arm interventions around behavioral change and implementation support for primary care system innovations.

Over the course of these studies I have become impressed with how stress, depressive affect, disease management, and glycemic control operate together over time. These studies will help us learn more about the causal linkages among mood, disease management and glycemic control over time so that treatment programs, primarily in primary care where most patients with diabetes are seen, can be initiated. All of this research adopts a social context perspective for understanding how social systems (the patient’s social context and the primary care system) affect chronic disease management.