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Marriage can enhance health for individuals with a chronic disease, yet spouses may also undermine disease management. The current study investigated spousal undermining of dietary regimen in 129 patients with type 2 diabetes mellitus. A total of 40 patients reported that their spouses tempted them with forbidden foods, and 15 reported that their spouses conveyed disregard for their diabetic diet. Spousal tempting was associated with worse dietary adherence, and spousal disregard with worse nondietary adherence. Spousal undermining is relatively rare but is associated with patients' disease management and warrants further investigation to better understand how spouses influence partners' day-to-day management of chronic diseases.

Spouses often seek to influence the health behaviors of chronically ill partners, but little research has examined whether spouses find such involvement to be burdensome. The current study examined this question in a sample of 191 nondiabetic spouses whose partners had type 2 diabetes. Results revealed that spouses who attempted to exert more control over their partners' dietary behavior experienced greater burden, particularly when their partners exhibited poor dietary adherence and reacted negatively to spouses' involvement. The findings contribute to a sparse body of knowledge on how spouses are affected by efforts to influence their chronically ill partners' disease management.

The current study focused on 296 adult daughter caregivers who were simultaneously providing care to an impaired parent, mothers to children living at home, wives, and employees. How mastery (perceived competence and control) in each of these 4 roles was related to well-being was examined. Women experienced higher levels of mastery in the employee role than in any other role. After controlling for household income and dispositional optimism, only employee mastery contributed unique variance to physical health, but mastery in each of the 4 roles contributed unique variance to either depression or life satisfaction. Results also suggest that women's satisfaction with life was related to an accumulation of mastery across roles. The study expands previous research by revealing that mastery in women's additional roles can supplement the benefits of mastery stemming from parent care.

The relationship between program planning and evaluation can be viewed as bidirectional; that is, evaluation methods, procedures, instruments, and criteria not only are determined by, but also influence, program goals and activities. Within the human services context, several factors or sources of reactivity between evaluation and program planning can be identified. These involve (a) quantification of goals and activities, (b) preferences by different audiences for various kinds of evaluation data, (c) values and evaluation criteria, and (d) evaluation requirements and resource availability. Effects of these reactive features are discussed and illustrated with examples drawn from mental health evaluation and accountability practices. It is argued that for evaluation to be a credible and useful practice, evaluators should plan their efforts and assess their own effectiveness within the larger context of human service systems.