Contact Info Lawrence Fisher, Ph.D. FCM Box 0900, MU 330E 500 Parnassus Ave. San Francisco, CA 94143 Tel: (415) 476-5403 Fax: (415) 476-6051 Email: fisher@fcm.ucsf.edu

My primary research activity addresses personal and family relationship factors in the management of type 2 diabetes 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, I have been studying how personal, family, and provider factors influence chronic disease management over time. Our work has highlighted the important contributions of patient gender and ethnicity in the disease management process. In two, NIH-funded, assessment intensive studies we have collected data on approximately 500 European-, Chinese-, African-American, and Latino couples in which one spouse or partner has type2. The results of these studies have been applied to an ADA-funded intervention trial that focused on enhancing spousal collaboration to improve disease management. Over the course of these studies I have become impressed with how the emotional climate of the family affects disease management and glycemic control. Current research focuses on how stress, depressive affect, disease management, and glycemic control operate together over time among patients with type 2 diabetes. One study focuses on these processes on a daily basis, whereas the other follows patients over an 18-month period. These studies will help us learn more about the causal linkages among mood, disease management and glycemic control over time so that treatment programs can be initiated. Furthermore, I am a member of a team of clinical researchers at the University of Colorado Health Sciences Center that is developing and implementing intervention trials to help primary care practitioners re-configure care to improve services to patients with chronic disease, primarily diabetes, using automated telephone and web-based intervention methods. All of this research adopts a social context perspective for understanding how social systems (the family and the primary care system) affect chronic disease management.

Fisher, L., Chesla, C.A., Mullan, J.T., Skaff, M.M., & Kanter, R.A.
(2001).  Contributors to depression in Latino and European-American patients with type 2 diabetes.  Diabetes Care, 24, 1751-1757.

Fisher, L., Chesla, C.A., Skaff, M.M., Mullan, J.T., Kanter, R.A.
(2002).  Depression and anxiety among partners of European-American
and Lationo patients with type 2 diabetes.  Diabetes Care, 25,
1564-1570.

Fisher, L., & Weihs, K.L. (2000). Family relationships:  A key for
improving outcomes in chronic disease.  Journal of Family  Practice,
49, 561-566.

Fisher, L., Chesla, C.A., Skaff, M.A., Gilliss, C., Mullan, J.T.,
Bartz, R.J., Kanter, R.J., & Lutz, C.P. (2000). The
family and disease management in Latino and Euro-American patients
with type 2 diabetes. Diabetes Care, 23, 267-272.

Fisher, L., Chesla, C.A., Skaff, M.A, Gilliss, C., Kanter, R.A.,
Lutz, C.P., & Bartz, R.J. (2000). Diabetes status:  A
typology of disease management for Latino and Euro-American patients
with type 2 diabetes.  Behavioral Medicine, 26, 53-66.

Fisher, L., Gudmundsdottir, M., Gilliss, C., Skaff, M., Mullan, J.,
Kanter, R., & Chesla, C. (2000).  Resolving disease
management problems in Euro-American and Latino couples with type 2
diabetes:  The effects of ethnicity and gender.  Family Process, 39,
403-416.