title: Diabetes conflict outstrips the positive impact of self-efficacy on youth adherence and glycemic control in type 1 diabetes.
abstract: OBJECTIVE
  To examine whether self-efficacy buffers the deleterious consequences of diabetes-specific family conflict on self-monitoring blood glucose (SMBG) and glycated hemoglobin (HbA1c) in youth with type 1 diabetes mellitus (T1DM).
  
  
  METHODS
  A total of 129 youth with T1DM (aged 10-16 years) completed measures of diabetes-specific family conflict and self-efficacy for diabetes management, and their blood glucose meter data and HbA1c were extracted from the electronic medical record. We preformed moderation analyses to examine whether self-efficacy moderated the association that diabetes-specific family conflict had with SMBG and HbA1c. We used simple slopes analyses to probe significant interactions.
  
  
  RESULTS
  Our results indicated that self-efficacy moderated the association that diabetes-specific family conflict had with SMBG and HbA1c. The pattern of these findings showed that high self-efficacy buffered the negative impact of diabetes conflict on HbA1c. However, benefits of high self-efficacy for more frequent SMBG was only apparent in the context of low diabetes-specific family conflict.
  
  
  CONCLUSIONS
  Study findings highlight the interactive relationship between diabetes-specific family conflict and self-efficacy in relation to SMBG and glycemic control. These findings suggest that family functioning and youth's self-efficacy are promising intervention targets for families having trouble with SMBG and HbA1c.
authors.affiliation: Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Noser
authors.affiliation: Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Huffhines
authors.affiliation: Division of Endocrinology & Diabetes, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Clements
authors.affiliation: Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Susana R
authors.initials: SR
authors.lastname: Patton
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D015190:Blood Glucose Self-Monitoring / Q000009:adverse effects / Q000523:psychology; D002648:Child; D002652:Child Behavior; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology / Q000628:therapy*; D057286:Electronic Health Records; D054541:Family Conflict / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000517:prevention & control*; D008297:Male; D015146:Midwestern United States; D010349:Patient Compliance / Q000523:psychology; D010353:Patient Education as Topic; D020377:Self Efficacy; D000073278:Self-Management / Q000193:education / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: adolescents; family; hemoglobin A1c; self-management; type 1 diabetes mellitus