title: Parenting style, parent-youth conflict, and medication adherence in youth with type 2 diabetes participating in an intensive lifestyle change intervention.
abstract: Parenting behaviors and family conflict relate to type 1 diabetes outcomes in youth. Our purpose was to understand these relationships in parents and youth with type 2 diabetes (T2DM). The TODAY (Treatment Options for Type 2 Diabetes in Adolescents and Youth) trial enrolled youth (10-17 years) with T2DM and parent/guardian. For this ancillary study, we enrolled a sample of youth-parent pairs (N = 137) in 1 study arm (metformin plus lifestyle intervention). They completed questionnaires measuring parenting style related to normative (e.g., completing homework) and diabetes self-care (e.g., testing blood glucose) tasks, and parent-youth verbal conflict (baseline, 6, and 12 months). Parenting style was consistent across normative and diabetes tasks, with gradual increases in autonomy perceived by youth. Conversations were generally calm, with greater conflict regarding normative than diabetes tasks at baseline (youth: p < .001, parent: p = .01), 6 months (youth: p = .02, parent: p > .05), and 12 months (youth: p > .05., parent: p = .05). A permissive parenting style toward normative tasks and a less authoritarian style toward diabetes tasks, at baseline, predicted better medication adherence (8-12 months) (normative: adjusted R2 = 0.48, p < .001; diabetes: adjusted R2 = 0.47, p < .001). Parent-youth conflict did not predict medication adherence. Youth with T2DM who perceive more autonomy (less parental control) in day-to-day and diabetes tasks are more likely to adhere to medication regimens. It may be valuable to assess youth perceptions of parenting style and help parents understand youths' needs for autonomy.
authors.affiliation: Department of Psychiatry & Behavioral Sciences, SUNY Upstate Medical University.
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Saletsky
authors.affiliation: Department of Psychiatry & Behavioral Sciences, SUNY Upstate Medical University.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Trief
authors.affiliation: Department of Pediatrics, Baylor College of Medicine.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Anderson
authors.affiliation: Department of Public Health and Preventive Medicine, SUNY Upstate Medical University.
authors.forename: Paula
authors.initials: P
authors.lastname: Rosenbaum
authors.affiliation: Department of Medicine, SUNY Upstate Medical University.
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Weinstock
mesh_terms: D000293:Adolescent; D002648:Child; D003142:Communication; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D006801:Humans; D055118:Medication Adherence / Q000523:psychology*; D010287:Parent-Child Relations; D040242:Risk Reduction Behavior; D012648:Self Care / Q000379:methods* / Q000523:psychology; D011795:Surveys and Questionnaires