Predictors of youth diabetes care behaviors and metabolic control: a structural equation modeling approach.
OBJECTIVE
To empirically test a biopsychosocial model of predictors of youth diabetes care behaviors and metabolic control.


METHODS
A cross-sectional multisite study of youths (N = 222) with T1D (mean age = 12.6) used structural equation modeling to examine interrelations among predictors, with follow-up analyses of covariance (ANCOVAs).


RESULTS
Youths' memory skills related to diabetes knowledge which, along with self-efficacy and age, was associated with greater youth responsibility that in turn predicted poorer self-care behaviors. Less frequent/briefer exercise and less frequent blood glucose monitoring/eating were found; the latter directly related to poorer metabolic control. Behavior problems also were associated directly with poorer metabolic control. A parsimonious model found memory directly related to blood glucose testing.


CONCLUSIONS
Continued parental supervision of adolescents, along with monitoring diabetes knowledge and efficacy, may help optimize transfer of diabetes care from parents to youths. Behavior problems warrant immediate attention because of their direct and adverse relation to metabolic control.
Holmes
Clarissa S
CS
Department of Psychology, Virginia Commonwealth University, Richmond, 23284-2018, USA. cholmes@richmond.edu
Chen
Rusan
R
Streisand
Randi
R
Marschall
Donna E
DE
Souter
Sari
S
Swift
Erika E
EE
Peterson
Catherine C
CC
D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000517:prevention & control*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011584:Psychology / Q000706:statistics & numerical data*; D012648:Self Care / Q000706:statistics & numerical data*; D020377:Self Efficacy