Wendy N Gray1, Lawrence M Dolan, Korey K Hood. 1. Center for the Promotion of Treatment Adherence and Self-Management, Division of Behavioral Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Abstract
BACKGROUND: This longitudinal study examined whether diabetes-specific family conflict and glycemic control were impacted/explained by negative affective responses to blood glucose checks (Negative BGM Affect). METHOD: Adolescents (N=150, ages 13-18 years) with type 1 diabetes, and their caregivers, completed measures of Negative BGM Affect, diabetes-specific family conflict, and glycemic control (i.e., hemoglobin A1c) at baseline, 6-, and 12-months. RESULTS: Caregiver Negative BGM Affect predicted higher A1c values at 12 months. Diabetes-specific family conflict mediated and explained 39% of the Negative BGM Affect-A1c relationship. Conflict around direct management tasks mediated the caregiver Negative BGM Affect-A1c relationship for adolescents (30.6% of variance). The impact of Negative BGM Affect on diabetes-specific family conflict is more pervasive for caregivers (direct and indirect diabetes management tasks) than adolescents (direct diabetes management tasks only). CONCLUSIONS: Caregiver Negative BGM Affect is an important contributor to A1c via diabetes-specific family conflict. Identifying and intervening with families who endorse high levels of Negative BGM Affect may prevent diabetes-specific family conflict, thereby minimizing the impact of family conflict on glycemic control. Brief clinic-based interventions to address Negative BGM Affect can be incorporated into clinical practice to prevent long-term negative impact on glycemic control.
BACKGROUND: This longitudinal study examined whether diabetes-specific family conflict and glycemic control were impacted/explained by negative affective responses to blood glucose checks (Negative BGM Affect). METHOD: Adolescents (N=150, ages 13-18 years) with type 1 diabetes, and their caregivers, completed measures of Negative BGM Affect, diabetes-specific family conflict, and glycemic control (i.e., hemoglobin A1c) at baseline, 6-, and 12-months. RESULTS: Caregiver Negative BGM Affect predicted higher A1c values at 12 months. Diabetes-specific family conflict mediated and explained 39% of the Negative BGM Affect-A1c relationship. Conflict around direct management tasks mediated the caregiver Negative BGM Affect-A1c relationship for adolescents (30.6% of variance). The impact of Negative BGM Affect on diabetes-specific family conflict is more pervasive for caregivers (direct and indirect diabetes management tasks) than adolescents (direct diabetes management tasks only). CONCLUSIONS: Caregiver Negative BGM Affect is an important contributor to A1c via diabetes-specific family conflict. Identifying and intervening with families who endorse high levels of Negative BGM Affect may prevent diabetes-specific family conflict, thereby minimizing the impact of family conflict on glycemic control. Brief clinic-based interventions to address Negative BGM Affect can be incorporated into clinical practice to prevent long-term negative impact on glycemic control.
Authors: Kimberly L Savin; Emily R Hamburger; Alexandra D Monzon; Niral J Patel; Katia M Perez; Jadienne H Lord; Sarah S Jaser Journal: J Fam Psychol Date: 2018-02
Authors: Rosanna Fiallo-Scharer; Mari Palta; Betty A Chewning; Tim Wysocki; Tosha B Wetterneck; Elizabeth D Cox Journal: Contemp Clin Trials Date: 2017-04-24 Impact factor: 2.226