Effects of Socio-Demographic Factors on Parental Monitoring, and Regimen Adherence Among Adolescents with Type 1 Diabetes: A Moderation Analysis

Abstract

Parental monitoring of adolescent diabetes care is an important predictor of adolescent regimen adherence. To date, no studies have investigated whether socio-demographic factors are associated with low levels of parental monitoring or differences in parental monitoring styles, and their moderating effects in families of adolescents with type 1 diabetes. The purpose of this cross-sectional study was to determine whether youth and family socio-demographic factors moderated the relationship between monitoring and youth regimen adherence (i.e., mean frequency of blood glucose testing [BGT]). Data were collected from 267 adolescents with type 1 diabetes and their parents. Hierarchical multiple regression analyses were employed. Socio-demographic factors accounted for 17.1% of the variance in adherence. After parental monitoring scales were entered, R2 in all eight equations increased and R2 change score in six of eight equations were significant. All models were significant after the interaction terms were entered. In the adolescent report models, parent age and family structure were both independently associated with adherence and also moderated the association between adolescent-report parental monitoring and adherence to diabetes care, in particular, adolescent report of parental direct observation/presence during diabetes care. In the parent report models, income was moderated the association between parent-report youth disclosure and adherence. Research should focus on identifying additional modifiable factors that place families at risk for low levels of parental monitoring of diabetes care. Future clinical research is needed to help identify risk factors for low levels of parental monitoring and develop interventions to promote optimal parenting skills that can support youth diabetes care.

Factors Associated with Adherence to Self-Monitoring of Blood Glucose Among Young People with Type 1 Diabetes in China: A Cross-Sectional Study

“…54 In addition, young people with T1DM from two-parent families had better adherence to SMBG. The result was in agreement with findings obtained from young people with T1DM in the U.S. 55 The possible reason was that these young people had more resources, which may have contributed to better diabetes management including SMBG. 56 Moreover, they gain support from both parents in terms of motivation for self-care, thus showing improved adherence to SMBG.…”

Adherence and Glycemic Control in Adolescents with Type 1 Diabetes: The Moderating Role of Age, Gender, and Family Support

“…The literature has shown how negative family environments and its interactions were associated with poor adherence and glycemic control in adolescents Lewin et al, 2006). The quality of the family environment such as cohesive, structured, supportive, and parental supervision were related to adolescents' adherence and glycemic control, and the decline in family interactions and supervision was associated with worst diabetes outcomes (Zhang et al, 2016;Cohen et al, 2004).…”

Individual and Family Management in Portuguese Adolescents with Type 1 Diabetes: a Path Analysis

“…Family support and parental coping are some of the social factors that characterize the process dimension of Grey and colleague's framework [8]. The quality of family support has been associated with adherence, metabolic control, and quality of life [21][22][23]. In turn, when adolescents perceived family involvement as supportive, warm, caring, and cohesive, they felt more protected and safer, which positively influenced their quality of life [24,25] and contributed to a better adaptation to T1D [26].…”