title: Disentangling the roles of parental monitoring and family conflict in adolescents' management of type 1 diabetes.
abstract: OBJECTIVE
  Less parental monitoring of adolescents' diabetes self-care and more family conflict are each associated with poorer diabetes outcomes. However, little is known about how these two family factors relate with one another in the context of self-care and glycemic control. Diabetes self-care was evaluated as a mediator of the associations among parental monitoring, family conflict, and glycemic control in early adolescents with type 1 diabetes.
  
  
  METHODS
  Adolescent-parent dyads (n = 257) reported on the frequency of parental monitoring, family conflict, and diabetes self-care. Hemoglobin A1c was abstracted from medical charts. Structural equation modeling was used for mediation analysis.
  
  
  RESULTS
  A mediation model linking parental involvement and family conflict with A1c through diabetes self-care fit the data well. Monitoring and conflict were inversely correlated (β = -0.23, p < .05) and each demonstrated indirect associations with A1c (standardized indirect effects -0.13 and 0.07, respectively) through their direct associations with self-care (β = 0.39, p < .001 and β = -0.19, p < .05, respectively). Conflict also was positively associated with higher A1c (β = 0.31, p < .01).
  
  
  CONCLUSIONS
  Elevated family conflict and less parental monitoring are risk factors for poorer glycemic control, and diabetes self-care is one mediator linking these variables. Interventions to promote parental monitoring of diabetes management during early adolescence may benefit from emphasizing strategies to prevent or reduce family conflict.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Children's National Medical Center.
authors.forename: Marisa E
authors.identifier: 0000-0002-8813-629X
authors.initials: ME
authors.lastname: Hilliard
authors.affiliation: Department of Psychology, Virginia Commonwealth University.
authors.forename: Clarissa S
authors.initials: CS
authors.lastname: Holmes
authors.affiliation: Center for New Designs in Learning and Scholarship, Georgetown University.
authors.forename: Rusan
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Psychology, Virginia Commonwealth University.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Maher
authors.affiliation: Department of Psychology, Virginia Commonwealth University.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Robinson
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Division of Behavioral Medicine and Clinical Psychology, Children's National Medical Center.
authors.forename: Randi
authors.initials: R
authors.lastname: Streisand
mesh_terms: D000293:Adolescent; D015190:Blood Glucose Self-Monitoring / Q000523:psychology; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D019468:Disease Management; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D006943:Hyperglycemia; D008297:Male; D016487:Parenting / Q000523:psychology*; D012307:Risk Factors; D012648:Self Care / Q000523:psychology*
chemical_list: D006442:Glycated Hemoglobin