Family Functioning and Adherence in Youth With Type 1 Diabetes: A Latent Growth Model of Glycemic Control |
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| Authors: | Kristen M. Grabill Gary R. Geffken Danny Duke Adam Lewin Laura Williams Eric Storch |
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| Affiliation: | 1. Lifespan , Providence, RI;2. Department of Psychiatry , University of Florida , Gainesville, FL;3. Child Development and Rehabilitation Center, Oregon Health &4. Science University , Portland, OR;5. Rothman Center for Neuropsychiatry, Department of Pediatrics , University of South Florida School of Medicine , St. Petersburg, FL;6. Rare Diseases Clinical Research Network, University of South Florida School of Medicine , St. Petersburg, FL;7. Department of Pediatrics , University of South Florida School of Medicine , St. Petersburg, FL |
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| Abstract: | The objective of this research is to determine the direct impact of family variables on initial status of a glycosylated hemoglobin A1c test (HbA1c) and HbA1c rate of change, and to determine the indirect effects of family variables on HbA1c through adherence. Study participants were 224 children and their parents who completed baseline measures of diabetes-specific family functioning and separate parent- and child-structured adherence interviews. HbA1c assays were performed at baseline, Year 1, and Year 2. Latent growth curve modeling indicated that, together, disagreement about responsibility for diabetes regimen, critical parenting, parental guidance, and parental warmth predicted initial status of HbA1c through adherence. Individually, critical parenting indirectly predicted initial status of HbA1c. Family variables did not directly predict initial status or rate of change in HbA1c, and did not indirectly predict rate of change in HbA1c over 2 years. Risk for high HbA1c remains elevated over time for children reporting critical parents, but their trajectory does not indicate compounding risk over time. |
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