Parent and adolescent distribution of responsibility for diabetes self-care: links to health outcomes.
OBJECTIVE
To examine the relation of adolescent and parent responsibility distribution for diabetes self-care to psychological and physical health.


METHODS
We interviewed children (mean age 12 years) annually for 3 years and asked parents to complete a questionnaire. Both reported how diabetes self-care was distributed in the family. Amount of responsibility held by the child only, the parent only, and shared between child and parent was calculated. Psychological distress, competence, and diabetes outcomes were assessed at each wave.


RESULTS
In both cross-sectional and longitudinal (lagged) analyses, multilevel modeling showed that shared responsibility was consistently associated with better psychological health, good self-care behavior, and good metabolic control, whereas child and parent responsibility were not. In some cases, links of shared responsibility to health outcomes were stronger among older adolescents.


CONCLUSIONS
These findings highlight the importance of shared responsibility for diabetes self-care through early to middle adolescence.
Helgeson
Vicki S
VS
Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA. vh2e@andrew.cmu.edu
Reynolds
Kerry A
KA
Siminerio
Linda
L
Escobar
Oscar
O
Becker
Dorothy
D
D000293:Adolescent; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D055809:Illness Behavior; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems / Q000523:psychology; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy; D013315:Stress, Psychological / Q000150:complications; D011795:Surveys and Questionnaires
D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human