title: The Impact of Frequency and Tone of Parent-Youth Communication on Type 1 Diabetes Management.
abstract: BACKGROUND
  The purpose of this study is to assess the impact of frequency and tone of parent-youth communication on glycemic control as measured by the Family Communication Inventory (FCI). Adolescence provides a unique set of diabetes management challenges, including suboptimal glycemic control. Continued parental involvement in diabetes management is associated with improved HbA1c outcomes; however, diabetes-related conflict within the family can have adverse effects. Although it is clear that communication plays an important role in diabetes outcomes, the specific impact of frequency and tone of such communication is largely understudied.
  
  
  METHODS
  A total of 110 youths with type 1 diabetes and their parents completed questionnaires assessing diabetes-related adherence, family conflict, and family communication (i.e., frequency and tone) during a routine clinic visit. Routine testing of HbA1c was performed.
  
  
  RESULTS
  Youth- and parent-reported frequency of communication were unrelated to HbA1c. Instead, greater discrepancies between parents and children on reported frequency of communication (most commonly parents reporting frequent and youth reporting less frequent communication) corresponded with poorer glycemic control and increased family conflict. More positive tone of communication as rated by youth was associated with lower HbA1c.
  
  
  CONCLUSIONS
  Diabetes-related communication is more complex than conveyed simply by how often children and their parents communicate. Tone of communication and discrepancies in a family's perception of the frequency of communication were better than frequency as predictors of glycemic control. The FCI appears to capture the frequency and tone of diabetes-related communication, though larger-scale studies are warranted to inform future use of this scale.
authors.affiliation: Department of Pediatrics, University of Virginia Health System, Charlottesville, VA, USA. deboer@virginia.edu.
authors.forename: Mark D
authors.initials: MD
authors.lastname: DeBoer
authors.affiliation: Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA.
authors.forename: Rupa
authors.initials: R
authors.lastname: Valdez
authors.affiliation: Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Chernavvsky
authors.affiliation: Department of Pediatrics, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Grover
authors.affiliation: Department of Pediatrics, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Burt Solorzano
authors.affiliation: Department of Pediatrics, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Kirabo
authors.initials: K
authors.lastname: Herbert
authors.affiliation: Department of Systems and Information Engineering, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Patek
keywords: Adolescent; Communication; Diabetes mellitus; Family conflict; Parents; Surveys and questionnaires