Family and youth factors associated with health beliefs and health outcomes in youth with type 1 diabetes.
OBJECTIVE
To examine the association of family organization with metabolic control in adolescents with type 1 diabetes through the mechanisms of family self-efficacy for diabetes and disease management.


METHODS
Data from the baseline assessment of a longitudinal RCT were used, wherein 257 adolescent-parent dyads (adolescents aged 11-14) each completed the family organization subscale of the Family Environment Scale, the self-efficacy for Diabetes Self-Management Scale, the Diabetes Behavior Rating Scale, and 2 24-hr diabetes interviews.


RESULTS
Structural equation modeling showed greater family organization was associated indirectly with better disease management behaviors via greater family self-efficacy (β = .38, p < .001). Greater self-efficacy was indirectly associated with better metabolic control via better disease management both concurrently (β = -.37, p < .001) and prospectively (β = -.26, p < .001). The full model indicates more family organization is indirectly associated with better metabolic control concurrently and prospectively through greater self-efficacy and better disease management (β = -.13, p < .001).


CONCLUSIONS
Understanding the mechanisms by which family organization is associated with metabolic control provides insight into possible avenues of prevention/intervention for better diabetes management.
Children’s National Medical Center, USA. w.herge@umiami.edu
Whitney M
WM
Herge
Randi
R
Streisand
Rusan
R
Chen
Clarissa
C
Holmes
Anil
A
Kumar
Eleanor Race
ER
Mackey
D000293:Adolescent; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology* / Q000628:therapy; D019468:Disease Management; D005190:Family / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy; D012944:Social Support