A 3-year prospective study of parent-child communication in early adolescents with type 1 diabetes: relationship to adherence and glycemic control.
OBJECTIVE
To examine changes in parent-child communication patterns and their relation to glycemic control and treatment adherence using observational data in a 3-year prospective multisite study of youth with type 1 diabetes aged 9-11 years at baseline and their families (n = 217).


METHODS
Adolescents and caregivers participated in a diabetes problem-solving discussion. Families were rated on negative and positive communication and interactions using the Interaction Behavior Code.


RESULTS
Maternal and paternal negative communication decreased over time, whereas adolescent and maternal positive communication and positive reciprocity increased. Baseline preadolescent youth and maternal positive communication predicted adherence 3 years later. Changes in family communication did not predict changes in glycemic control or adherence.


CONCLUSIONS
During the transition to adolescence, family communication changed in unexpected and positive ways. Additionally, the relationship of baseline family communication to subsequent adherence suggests the need to assess family communication concerning diabetes-related management during preadolescence.
Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine Jeannette.Iskander@cchmc.org.
Jeannette M
JM
Iskander
Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine.
Jennifer M
JM
Rohan
Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine.
Jennifer Shroff
JS
Pendley
Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine.
Alan
A
Delamater
Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine.
Dennis
D
Drotar
D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003142:Communication; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D055809:Illness Behavior; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D010287:Parent-Child Relations; D011446:Prospective Studies
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin
glycemic control; observational data; parent–adolescent communication; treatment adherence; type 1 diabetes