title: High health satisfaction among emerging adults with diabetes: Factors predicting resilience.
abstract: This study was conducted to identify factors contributing to health satisfaction outcomes among emerging adults (ages 18-25) with diabetes.
  
  
  
  SEARCH for Diabetes in Youth study participants whose diabetes was prevalent in 2001 and were ≥18 years of age when they completed a 2008-2009 follow-up survey (n = 340) were included. We developed a health resilience model (HRM) to identify potentially modifiable factors (anticipatory guidance, social support, physical activity, quality of life) associated with health outcomes (satisfaction with health care, overall personal health, self-report of hemoglobin A1c [HbA1c]). Proportional odds logistic regression models were used to examine relationships between modifiable factors and health outcomes while adjusting for predetermined characteristics; linear regression models were used for reported HbA1c. Comparison of participants who reported HbA1c versus nonreporters was conducted.
  
  
  
  A majority (70%) of participants rated satisfaction with health care ≥7 out of 10, and most (71%) rated overall health as good, very good, or excellent. Satisfaction with health care was independent of change in provider between the ages of 17 and 24. After controlling for predetermined characteristics, we found that the odds of increased satisfaction with health care and overall personal health were 1.3 and 1.2 greater, respectively, when participants discussed additional diabetes-related anticipatory guidance topics with a provider and 1.3 and 2.1, respectively, for each 10-unit change in quality of life score. Relationship between HbA1c level and modifiable factors was not significant; however, participants reporting HbA1c had higher ratings of health care and overall health versus nonreporters.
  
  
  
  HRM describes relationships between modifiable factors and patient-reported outcomes of satisfaction with health care and overall personal health among a cohort of ethnically and racially diverse emerging adults with longstanding diabetes, over half of whom experienced a change in provider. HRM may discern candidate areas for intervention, such as effective anticipatory guidance that can impact satisfaction with health care and overall health, to promote positive health outcomes. (PsycINFO Database Record
authors.affiliation: Division of Endocrinology.
authors.forename: Sarah D
authors.identifier: 0000-0001-7019-278X
authors.initials: SD
authors.lastname: Corathers
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Children's Hospital Medical Center.
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Kichler
authors.affiliation: Department of Bio-statistical Sciences, Wake Forest School of Medicine.
authors.forename: Nora F
authors.initials: NF
authors.lastname: Fino
authors.affiliation: Department of Bio-statistical Sciences, Wake Forest School of Medicine.
authors.forename: Wei
authors.initials: W
authors.lastname: Lang
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California.
authors.forename: Jean M
authors.initials: JM
authors.lastname: Lawrence
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Raymond
authors.affiliation: Department of Pediatrics, University of Washington School of Medicine.
authors.forename: Joyce P
authors.initials: JP
authors.lastname: Yi-Frazier
authors.affiliation: Department of Epidemiology, Colorado School of Public Health.
authors.forename: Dana
authors.initials: D
authors.lastname: Dabelea
authors.affiliation: Department of Epidemiology and Biostatistics.
authors.forename: Angela D
authors.initials: AD
authors.lastname: Liese
authors.affiliation: Division of Diabetes Translation, Centers for Disease Control and Prevention.
authors.forename: Sharon H
authors.initials: SH
authors.lastname: Saydah
authors.affiliation: Division of Pulmonary Medicine.
authors.forename: Michael
authors.initials: M
authors.lastname: Seid
authors.affiliation: Division of Endocrinology.
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Dolan
mesh_terms: D000293:Adolescent; D000328:Adult; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior; D006801:Humans; D008297:Male; D010549:Personal Satisfaction; D011237:Predictive Value of Tests; D011788:Quality of Life / Q000523:psychology; D055500:Resilience, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin