Meg C Nicholl1, Jessica M Valenzuela2, Keith Lit3, Christian DeLucia2, Amanda M Shoulberg4, Jennifer M Rohan5, Jennifer Shroff Pendley6, Lawrence Dolan4,7, Alan M Delamater8. 1. Department of Pediatrics, Kennedy Krieger Institute/Johns Hopkins School of Medicine, Baltimore, MD, USA. 2. Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL, USA. 3. Department of Psychology, Jackson Health System, Miami, FL, USA. 4. Division of Behavioral Medicine and Clinical Psychology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. 5. Division of Hematology and Oncology, Children's Hospital of Richmond at VCU, Richmond, VA, USA. 6. Division of Behavioral Health, Nemours Alfred I. duPont Hospital for Children, Wilmington, DE, USA. 7. Division of Endocrinology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. 8. Department of Pediatrics, University of Miami, Miller School of Medicine, Miami, FL, USA.
Abstract
OBJECTIVE: Ethnic minority youth with type 1 diabetes (T1D) often have poorer glycemic control and lower rates of adherence compared to White Non-Hispanic (WNH) youth. Variables such as family conflict, autonomy support, and youth regimen responsibility have been shown to change over adolescence and impact diabetes management. However, these factors have been investigated in predominantly White samples. Few studies have examined potential differences in these variables and their trajectories for Hispanic youth over early adolescence. METHODS: Youth with T1D (178 WNH and 33 Hispanic youth participants), as well as their maternal caregivers (174 WNH and 32 Hispanic maternal caregivers), completed measures of diabetes-specific autonomy support, diabetes-related family conflict, regimen responsibility, and blood glucose monitoring frequency at 4 timepoints over a 3-year period. RESULTS: At baseline, Hispanic youth had significantly poorer glycemic control, more family conflict, and fewer blood glucose checks on average compared to WNH youth. Similar to WNH youth, Hispanic youth have increasing independence for regimen tasks and decreasing parent autonomy support during this developmental period. However, while Hispanic youth had worsening diabetes management during early adolescence (as did WNH youth), Hispanic parents reported a more gradual change in youth's diabetes management over early adolescence. CONCLUSIONS: This study presents an important contribution to the existing literature on youth with T1D. Findings suggest potential strengths and targets for Hispanic youth navigating diabetes management during the adolescent period. It is important to continue to investigate the trajectories of ethnic minority youth with diabetes.
OBJECTIVE: Ethnic minority youth with type 1 diabetes (T1D) often have poorer glycemic control and lower rates of adherence compared to White Non-Hispanic (WNH) youth. Variables such as family conflict, autonomy support, and youth regimen responsibility have been shown to change over adolescence and impact diabetes management. However, these factors have been investigated in predominantly White samples. Few studies have examined potential differences in these variables and their trajectories for Hispanic youth over early adolescence. METHODS: Youth with T1D (178 WNH and 33 Hispanic youth participants), as well as their maternal caregivers (174 WNH and 32 Hispanic maternal caregivers), completed measures of diabetes-specific autonomy support, diabetes-related family conflict, regimen responsibility, and blood glucose monitoring frequency at 4 timepoints over a 3-year period. RESULTS: At baseline, Hispanic youth had significantly poorer glycemic control, more family conflict, and fewer blood glucose checks on average compared to WNH youth. Similar to WNH youth, Hispanic youth have increasing independence for regimen tasks and decreasing parent autonomy support during this developmental period. However, while Hispanic youth had worsening diabetes management during early adolescence (as did WNH youth), Hispanic parents reported a more gradual change in youth's diabetes management over early adolescence. CONCLUSIONS: This study presents an important contribution to the existing literature on youth with T1D. Findings suggest potential strengths and targets for Hispanic youth navigating diabetes management during the adolescent period. It is important to continue to investigate the trajectories of ethnic minority youth with diabetes.
Authors: A M Delamater; K H Shaw; E B Applegate; I A Pratt; M Eidson; G X Lancelotta; L Gonzalez-Mendoza; S Richton Journal: Diabetes Care Date: 1999-05 Impact factor: 19.112
Authors: M A Harris; T Wysocki; M Sadler; K Wilkinson; L M Harvey; L M Buckloh; N Mauras; N H White Journal: Diabetes Care Date: 2000-09 Impact factor: 19.112
Authors: Adam B Lewin; Amanda D Heidgerken; Gary R Geffken; Laura B Williams; Eric A Storch; Kenneth M Gelfand; Janet H Silverstein Journal: J Pediatr Psychol Date: 2005-03-03