title: A follow-up study of adherence and glycemic control among Hong Kong youths with diabetes.
abstract: OBJECTIVE
  To extend longitudinally an earlier study of the pathway from symptoms of emotional distress (ED) through self-efficacy (SE) and adherence to glycemic control (GC) in youths with diabetes, and to examine the contribution of different specific adherence behaviors to changes in GC.
  
  
  METHODS
  Fifty-six Hong Kong youths with diabetes received a follow-up evaluation 12-24 months after initial participation. ED, SE, self-reported adherence to medical regimen (SRA), and GC were assessed at both evaluations.
  
  
  RESULTS
  The pathway from ED to SE to SRA to GC was replicated. Participants' SRA to regular checks on blood glucose levels, and taking steps to maintain levels in the recommended range, explained significant variance in changes in GC.
  
  
  CONCLUSIONS
  The model offers strategies to enhance health care in youths with diabetes. Findings support the importance of adherence to the medical regimen but emphasize the complexity of the relationship between adherence behaviors and GC. Self-regulatory behaviors, rather than compliance with fixed instructions, appear to have the most impact on GC.
authors.affiliation: Psychiatry, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390-8589, USA. Sunita.Stewart@UTSouthwestern.edu
authors.forename: Sunita M
authors.initials: SM
authors.lastname: Stewart
authors.forename: Peter W H
authors.initials: PW
authors.lastname: Lee
authors.forename: David
authors.initials: D
authors.lastname: Waller
authors.forename: Carroll W
authors.initials: CW
authors.lastname: Hughes
authors.forename: Louis C K
authors.initials: LC
authors.lastname: Low
authors.forename: Betsy D
authors.initials: BD
authors.lastname: Kennard
authors.forename: Anna
authors.initials: A
authors.lastname: Cheng
authors.forename: Kwai-Fun
authors.initials: KF
authors.lastname: Huen
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D010349:Patient Compliance; D020377:Self Efficacy
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin