title: A model of parental distress and factors that mediate its link with parental monitoring of youth diabetes care, adherence, and glycemic control.
abstract: Parental monitoring of adolescents' diabetes self-care is associated with better adherence and glycemic control (A1c). A number of parent-level factors are associated with higher levels of parental monitoring, including lower levels of parental distress (depressive symptoms, stress, anxiety), as well as higher levels of parental self-efficacy for diabetes management and authoritative parenting. Often studied in isolation, these factors may be best considered simultaneously as they are interrelated and are associated with parental monitoring and youth adherence.
  
  
  
  Structural equation modeling with a cross-sectional sample of 257 parent/youth (aged 11-14) dyads: (a) examined a broad model of parental factors (i.e., parental distress, parental diabetes self-efficacy, authoritative parenting), and (b) assessed their relation to parental monitoring, youth adherence, and A1c. Post hoc analyses of variance (ANOVAs) evaluated clinical implications of daily parental monitoring.
  
  
  
  Parental distress was not related directly to parental monitoring. Instead less distress related indirectly to more monitoring via higher parental self-efficacy and more authoritative parenting which, in turn, related to better adherence and A1c. Higher parental self-efficacy also related directly to better youth adherence and then to better A1c. Clinically, more parental monitoring related to more daily blood glucose checks and to better A1c (8.48% vs. 9.17%).
  
  
  
  A broad model of parent-level factors revealed more parental distress was linked only indirectly to less monitoring via lower parental self-efficacy and less authoritative parenting. Behaviorally, more parental monitoring related to better adherence and to clinically better A1c in adolescents. Further study of parent-level factors that relate to parental distress and monitoring of adherence appears warranted. (PsycINFO Database Record
authors: Department of Psychology, Virginia Commonwealth University.
authors: Elizabeth M
authors: EM
authors: Robinson
authors: Department of Psychology, Eastern Michigan University.
authors: Patrick
authors: P
authors: Weaver
authors: Center For New Designs In Learning and Scholarship, Georgetown University.
authors: Rusan
authors: R
authors: Chen
authors: Department of Psychiatry and Behavioral Sciences, Division of Behavioral Medicine and Clinical Psychology, Children's National Medical Center.
authors: Randi
authors: R
authors: Streisand
authors: Department of Pediatrics, Virginia Commonwealth University.
authors: Clarissa S
authors: CS
authors: Holmes
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D010290:Parents / Q000523:psychology*; D012648:Self Care / Q000523:psychology; D020377:Self Efficacy
chemical_list: D001786:Blood Glucose