title: Children's roles in parents' diabetes self-management.
abstract: BACKGROUND
  Family support is important in diabetes self-management. However, children as providers of support have received little attention. This study examines the role of children in their parents' diabetes self-management, diet, and exercise.
  
  
  METHODS
  This research used community-based participatory research principles. Researchers conducted semi-structured parallel interviews of 24 Latino and African-American adults with diabetes and with a child (aged 10-17 years) in their home (2004-2006). Interviews were transcribed, coded, and analyzed for themes (2004-2007).
  
  
  RESULTS
  Adults and children perceived that children play many roles related to adults' diabetes self-management. Parents described children as monitoring parents' dietary intake and reminding them what they should not be eating. Some children helped with shopping and meal preparation. Families described children reminding parents to exercise and exercising with their parents. Children reminded parents about medications and assisted with tasks such as checking blood sugar. Parents and children perceived that children played a role in tempting parents to stray from their diabetes diet, because children's diets included food that parents desired but tried to avoid.
  
  
  CONCLUSIONS
  Children and parents perceived that children have many roles in both supporting and undermining adults' diabetes self-management. There is more to learn about the bi-directional relationships between adults and children in this setting, and the most beneficial roles children can play. Healthcare providers should encourage family lifestyle changes, strengthen social support for families, and direct children toward roles that are beneficial for both parent and child without placing an unreasonable level of responsibility on the child.
authors.affiliation: Department of Internal Medicine,Division of General Medicine, University of Iowa, VA Medical Center, 601 Highway 6 West, Iowa City, IA 52246, USA. Helena-laroche@uiowa.edu
authors.forename: Helena H
authors.initials: HH
authors.lastname: Laroche
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Davis
authors.forename: Jane
authors.initials: J
authors.lastname: Forman
authors.forename: Gloria
authors.initials: G
authors.lastname: Palmisano
authors.forename: Heather Schacht
authors.initials: HS
authors.lastname: Reisinger
authors.forename: Cheryl
authors.initials: C
authors.lastname: Tannas
authors.forename: Michael
authors.initials: M
authors.lastname: Spencer
authors.forename: Michele
authors.initials: M
authors.lastname: Heisler
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D002648:Child; D003625:Data Collection; D003920:Diabetes Mellitus / Q000523:psychology / Q000628:therapy*; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006630:Hispanic or Latino; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D012648:Self Care / Q000379:methods*; D012944:Social Support; D014481:United States / Q000453:epidemiology