Future directions for research on pediatric chronic disease management: lessons from diabetes.

Discussed conceptual and methodological issues related to research on the management of pediatric chronic disease, focusing on diabetes. The quality of studies in this area has improved, but several problems remain. Recommendations include greater use of theory in planning studies; population-based samples; more sophisticated definitions of adherence; longitudinal designs; and analyses that control for demographic, developmental, and medical variables. Most needed are prevention and intervention studies that modify (rather than simply describe) contextual, behavioral, and psychological variables hypothesized to facilitate or impede adherence and adjustment. The questions asked and designs employed should match the state of knowledge regarding the conceptual issue(s) being studied. It is often not possible for a given study to incorporate all of the recommendations above, but it is hoped that more research studies will move toward these goals, and thereby enhance the contribution of pediatric psychology to chronic disease management.