Skip to main content
Top
Published in: Diabetes Therapy 3/2017

Open Access 01-06-2017 | Original Research

The Impact of Frequency and Tone of Parent–Youth Communication on Type 1 Diabetes Management

Authors: Mark D. DeBoer, Rupa Valdez, Daniel R. Chernavvsky, Monica Grover, Christine Burt Solorzano, Kirabo Herbert, Stephen Patek

Published in: Diabetes Therapy | Issue 3/2017

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference Gerstl EM, Rabl W, Rosenbauer J, et al. Metabolic control as reflectet by HbA1c in children, adolescents and young adults with type-1 diabetes mellitus: combined longitudinal analysis including 27,035 patients from 207 centers in Germany and Austria during the last decade. Eur J Pediatr. 2008;167:447–53.CrossRefPubMed Gerstl EM, Rabl W, Rosenbauer J, et al. Metabolic control as reflectet by HbA1c in children, adolescents and young adults with type-1 diabetes mellitus: combined longitudinal analysis including 27,035 patients from 207 centers in Germany and Austria during the last decade. Eur J Pediatr. 2008;167:447–53.CrossRefPubMed
2.
go back to reference Hanna KM, Juarez B, Lenss SS, Guthrie D. Parent-adolescent communication and support for diabetes management as reported by adolescents with type 1 diabetes. Issues Compr Pediatr Nurs. 2003;26:145–58.CrossRefPubMed Hanna KM, Juarez B, Lenss SS, Guthrie D. Parent-adolescent communication and support for diabetes management as reported by adolescents with type 1 diabetes. Issues Compr Pediatr Nurs. 2003;26:145–58.CrossRefPubMed
3.
go back to reference Wysocki T, Meinhold P, Cox DJ, Clarke WL. Survey of diabetes professionals regarding developmental changes in diabetes self-care. Diabetes Care. 1990;13:65–8.CrossRefPubMed Wysocki T, Meinhold P, Cox DJ, Clarke WL. Survey of diabetes professionals regarding developmental changes in diabetes self-care. Diabetes Care. 1990;13:65–8.CrossRefPubMed
4.
go back to reference Sawyer SM, Aroni RA. Self-management in adolescents with chronic illness. What does it mean and how can it be achieved? Med J Aust. 2005;183:405–9.PubMed Sawyer SM, Aroni RA. Self-management in adolescents with chronic illness. What does it mean and how can it be achieved? Med J Aust. 2005;183:405–9.PubMed
5.
go back to reference Guilfoyle SM, Crimmins NA, Hood KK. Blood glucose monitoring and glycemic control in adolescents with type 1 diabetes: meter downloads versus self-report. Pediatr Diabetes. 2011;12:560–6.PubMed Guilfoyle SM, Crimmins NA, Hood KK. Blood glucose monitoring and glycemic control in adolescents with type 1 diabetes: meter downloads versus self-report. Pediatr Diabetes. 2011;12:560–6.PubMed
6.
go back to reference Campbell M, Schatz D, Chen V, et al. A contrast between children and adolescents with excellent and poor control: the T1D exchange clinic registry experience. Pediatr Diabetes. 2014;15:110–7. Campbell M, Schatz D, Chen V, et al. A contrast between children and adolescents with excellent and poor control: the T1D exchange clinic registry experience. Pediatr Diabetes. 2014;15:110–7.
7.
go back to reference Hilliard ME, Wu YP, Rausch J, Dolan LM, Hood KK. Predictors of deteriorations in diabetes management and control in adolescents with type 1 diabetes. J Adolesc Health. 2013;52:28–34.CrossRefPubMed Hilliard ME, Wu YP, Rausch J, Dolan LM, Hood KK. Predictors of deteriorations in diabetes management and control in adolescents with type 1 diabetes. J Adolesc Health. 2013;52:28–34.CrossRefPubMed
8.
go back to reference Olinder AL, Kernell A, Smide B. Missed bolus doses: devastating for metabolic control in CSII-treated adolescents with type 1 diabetes. Pediatr Diabetes. 2009;10:142–8.CrossRefPubMed Olinder AL, Kernell A, Smide B. Missed bolus doses: devastating for metabolic control in CSII-treated adolescents with type 1 diabetes. Pediatr Diabetes. 2009;10:142–8.CrossRefPubMed
9.
go back to reference VanderWel BW, Messer LH, Horton LA, et al. Missed insulin boluses for snacks in youth with type 1 diabetes. Diabetes Care. 2010;33:507–8.CrossRefPubMed VanderWel BW, Messer LH, Horton LA, et al. Missed insulin boluses for snacks in youth with type 1 diabetes. Diabetes Care. 2010;33:507–8.CrossRefPubMed
10.
go back to reference Laffel LMB, Vangsness L, Connell A, Goebel-Fabbri A, Butler D, Anderson BJ. Impact of ambulatory, family-focused teamwork intervention on glycemic control in youth with type 1 diabetes. J Pediatr. 2003;142:409–16.CrossRefPubMed Laffel LMB, Vangsness L, Connell A, Goebel-Fabbri A, Butler D, Anderson BJ. Impact of ambulatory, family-focused teamwork intervention on glycemic control in youth with type 1 diabetes. J Pediatr. 2003;142:409–16.CrossRefPubMed
11.
go back to reference Anderson BJ, Vangsness L, Connell A, Butler D, Goebel-Fabbri A, Laffel LM. Family conflict, adherence, and glycaemic control in youth with short duration type 1 diabetes. Diabet Med. 2002;19:635–42.CrossRefPubMed Anderson BJ, Vangsness L, Connell A, Butler D, Goebel-Fabbri A, Laffel LM. Family conflict, adherence, and glycaemic control in youth with short duration type 1 diabetes. Diabet Med. 2002;19:635–42.CrossRefPubMed
12.
go back to reference Vesco AT, Anderson BJ, Laffel LM, Dolan LM, Ingerski LM, Hood KK. Responsibility sharing between adolescents with type 1 diabetes and their caregivers: importance of adolescent perceptions on diabetes management and control. J Pediatr Psychol. 2010;35:1168–77.CrossRefPubMedPubMedCentral Vesco AT, Anderson BJ, Laffel LM, Dolan LM, Ingerski LM, Hood KK. Responsibility sharing between adolescents with type 1 diabetes and their caregivers: importance of adolescent perceptions on diabetes management and control. J Pediatr Psychol. 2010;35:1168–77.CrossRefPubMedPubMedCentral
13.
go back to reference Ellis DA, Podolski CL, Frey M, Naar-King S, Wang B, Moltz K. The role of parental monitoring in adolescent health outcomes: impact on regimen adherence in youth with type 1 diabetes. J Pediatr Psychol. 2007;32:907–17.CrossRefPubMed Ellis DA, Podolski CL, Frey M, Naar-King S, Wang B, Moltz K. The role of parental monitoring in adolescent health outcomes: impact on regimen adherence in youth with type 1 diabetes. J Pediatr Psychol. 2007;32:907–17.CrossRefPubMed
14.
go back to reference Wysocki T, Taylor A, Hough BS, Linscheid TR, Yeates KO, Naglieri JA. Deviation from developmentally appropriate self-care autonomy. Association with diabetes outcomes. Diabetes Care. 1996;19:119–25.CrossRefPubMed Wysocki T, Taylor A, Hough BS, Linscheid TR, Yeates KO, Naglieri JA. Deviation from developmentally appropriate self-care autonomy. Association with diabetes outcomes. Diabetes Care. 1996;19:119–25.CrossRefPubMed
15.
go back to reference Berg CA, King PS, Butler JM, Pham P, Palmer D, Wiebe DJ. Parental involvement and adolescents’ diabetes management: the mediating role of self-efficacy and externalizing and internalizing behaviors. J Pediatr Psychol. 2011;36:329–39.CrossRefPubMed Berg CA, King PS, Butler JM, Pham P, Palmer D, Wiebe DJ. Parental involvement and adolescents’ diabetes management: the mediating role of self-efficacy and externalizing and internalizing behaviors. J Pediatr Psychol. 2011;36:329–39.CrossRefPubMed
16.
go back to reference Cameron FJ, Skinner TC, de Beaufort CE, et al. Are family factors universally related to metabolic outcomes in adolescents with type 1 diabetes? Diabet Med. 2008;25:463–8.CrossRefPubMed Cameron FJ, Skinner TC, de Beaufort CE, et al. Are family factors universally related to metabolic outcomes in adolescents with type 1 diabetes? Diabet Med. 2008;25:463–8.CrossRefPubMed
17.
go back to reference Lewin AB, Heidgerken AD, Geffken GR, et al. The relation between family factors and metabolic control: the role of diabetes adherence. J Pediatr Psychol. 2006;31:174–83.CrossRefPubMed Lewin AB, Heidgerken AD, Geffken GR, et al. The relation between family factors and metabolic control: the role of diabetes adherence. J Pediatr Psychol. 2006;31:174–83.CrossRefPubMed
18.
go back to reference Drotar D, Ittenbach R, Rohan JM, Gupta R, Pendley JS, Delamater A. Diabetes management and glycemic control in youth with type 1 diabetes: test of a predictive model. J Behav Med. 2013;36:234–45.CrossRefPubMed Drotar D, Ittenbach R, Rohan JM, Gupta R, Pendley JS, Delamater A. Diabetes management and glycemic control in youth with type 1 diabetes: test of a predictive model. J Behav Med. 2013;36:234–45.CrossRefPubMed
20.
go back to reference Miller-Johnson S, Emery RE, Marvin RS, Clarke W, Lovinger R, Martin M. Parent-child relationships and the management of insulin-dependent diabetes mellitus. J Consult Clin Psychol. 1994;62:603–10.PubMed Miller-Johnson S, Emery RE, Marvin RS, Clarke W, Lovinger R, Martin M. Parent-child relationships and the management of insulin-dependent diabetes mellitus. J Consult Clin Psychol. 1994;62:603–10.PubMed
21.
go back to reference Geffken GR, Lehmkuhl H, Walker KN, et al. Family functioning processes and diabetic ketoacidosis in youths with type I diabetes. Rehabil Psychol. 2008;53:231–7.CrossRef Geffken GR, Lehmkuhl H, Walker KN, et al. Family functioning processes and diabetic ketoacidosis in youths with type I diabetes. Rehabil Psychol. 2008;53:231–7.CrossRef
22.
go back to reference Duke DC, Geffken GR, Lewin AB, Williams LB, Storch EA, Silverstein JH. Glycemic control in youth with type 1 diabetes: family predictors and mediators. J Pediatr Psychol. 2008;33:719–27.CrossRefPubMed Duke DC, Geffken GR, Lewin AB, Williams LB, Storch EA, Silverstein JH. Glycemic control in youth with type 1 diabetes: family predictors and mediators. J Pediatr Psychol. 2008;33:719–27.CrossRefPubMed
23.
go back to reference Martin MT, Miller-Jonson S, Kitzmann KM, Emery RE. Parent-child relationships and insulin-dependent diabetes mellitus: observational ratings of clinically relevant dimensions. J Fam Psychol. 1998;12:102–11.CrossRef Martin MT, Miller-Jonson S, Kitzmann KM, Emery RE. Parent-child relationships and insulin-dependent diabetes mellitus: observational ratings of clinically relevant dimensions. J Fam Psychol. 1998;12:102–11.CrossRef
24.
go back to reference Laffel LM, Connell A, Vangsness L, Goebel-Fabbri A, Mansfield A, Anderson BJ. General quality of life in youth with type 1 diabetes: relationship to patient management and diabetes-specific family conflict. Diabetes Care. 2003;26:3067–73.CrossRefPubMed Laffel LM, Connell A, Vangsness L, Goebel-Fabbri A, Mansfield A, Anderson BJ. General quality of life in youth with type 1 diabetes: relationship to patient management and diabetes-specific family conflict. Diabetes Care. 2003;26:3067–73.CrossRefPubMed
25.
go back to reference Weissberg-Benchell J, Nansel T, Holmbeck G, et al. Study SCotFMoD: generic and diabetes-specific parent-child behaviors and quality of life among youth with type 1 diabetes. J Pediatr Psychol. 2009;34:977–88.CrossRefPubMedPubMedCentral Weissberg-Benchell J, Nansel T, Holmbeck G, et al. Study SCotFMoD: generic and diabetes-specific parent-child behaviors and quality of life among youth with type 1 diabetes. J Pediatr Psychol. 2009;34:977–88.CrossRefPubMedPubMedCentral
26.
go back to reference Anderson BJ, Holmbeck G, Iannotti RJ, et al. Dyadic measures of the parent-child relationship during the transition to adolescence and glycemic control in children with type 1 diabetes. Fam Syst Health. 2009;27:141–52.CrossRefPubMedPubMedCentral Anderson BJ, Holmbeck G, Iannotti RJ, et al. Dyadic measures of the parent-child relationship during the transition to adolescence and glycemic control in children with type 1 diabetes. Fam Syst Health. 2009;27:141–52.CrossRefPubMedPubMedCentral
27.
go back to reference American Diabetes Association. (11) Children and adolescents. Diabetes Care. 2015;38(Suppl):S70–6.CrossRef American Diabetes Association. (11) Children and adolescents. Diabetes Care. 2015;38(Suppl):S70–6.CrossRef
28.
go back to reference Lewin AB, LaGreca AM, Geffken GR, et al. Validity and reliability of an adolescent and parent rating scale of type 1 diabetes adherence behaviors: the Self-Care Inventory (SCI). J Pediatr Psychol. 2009;34:999–1007.CrossRefPubMedPubMedCentral Lewin AB, LaGreca AM, Geffken GR, et al. Validity and reliability of an adolescent and parent rating scale of type 1 diabetes adherence behaviors: the Self-Care Inventory (SCI). J Pediatr Psychol. 2009;34:999–1007.CrossRefPubMedPubMedCentral
29.
go back to reference Hilliard ME, Guilfoyle SM, Dolan LM, Hood KK. Prediction of adolescents’ glycemic control 1 year after diabetes-specific family conflict: the mediating role of blood glucose monitoring adherence. Arch Pediatr Adolesc Med. 2011;165:624–9.CrossRefPubMedPubMedCentral Hilliard ME, Guilfoyle SM, Dolan LM, Hood KK. Prediction of adolescents’ glycemic control 1 year after diabetes-specific family conflict: the mediating role of blood glucose monitoring adherence. Arch Pediatr Adolesc Med. 2011;165:624–9.CrossRefPubMedPubMedCentral
30.
go back to reference Wysocki T, Harris MA, Buckloh LM, et al. Randomized trial of behavioral family systems therapy for diabetes: maintenance of effects on diabetes outcomes in adolescents. Diabetes Care. 2007;30:555–60.CrossRefPubMed Wysocki T, Harris MA, Buckloh LM, et al. Randomized trial of behavioral family systems therapy for diabetes: maintenance of effects on diabetes outcomes in adolescents. Diabetes Care. 2007;30:555–60.CrossRefPubMed
31.
go back to reference Weinger K, O’Donnell KA, Ritholz MD. Adolescent views of diabetes-related parent conflict and support: a focus group analysis. J Adolesc Health. 2001;29:330–6.CrossRefPubMedPubMedCentral Weinger K, O’Donnell KA, Ritholz MD. Adolescent views of diabetes-related parent conflict and support: a focus group analysis. J Adolesc Health. 2001;29:330–6.CrossRefPubMedPubMedCentral
32.
go back to reference Seiffge-Krenke I. “Come on, say something, dad!”: communication and coping in fathers of diabetic adolescents. J Pediatr Psychol. 2002;27:439–50.CrossRefPubMed Seiffge-Krenke I. “Come on, say something, dad!”: communication and coping in fathers of diabetic adolescents. J Pediatr Psychol. 2002;27:439–50.CrossRefPubMed
33.
go back to reference Wiebe DJ, Berg CA, Korbel C, et al. Children’s appraisals of maternal involvement in coping with diabetes: enhancing our understanding of adherence, metabolic control, and quality of life across adolescence. J Pediatr Psychol. 2005;30:167–78.CrossRefPubMed Wiebe DJ, Berg CA, Korbel C, et al. Children’s appraisals of maternal involvement in coping with diabetes: enhancing our understanding of adherence, metabolic control, and quality of life across adolescence. J Pediatr Psychol. 2005;30:167–78.CrossRefPubMed
34.
go back to reference Berg CA, Butler JM, Osborn P, et al. Role of parental monitoring in understanding the benefits of parental acceptance on adolescent adherence and metabolic control of type 1 diabetes. Diabetes Care. 2008;31:678–83.CrossRefPubMed Berg CA, Butler JM, Osborn P, et al. Role of parental monitoring in understanding the benefits of parental acceptance on adolescent adherence and metabolic control of type 1 diabetes. Diabetes Care. 2008;31:678–83.CrossRefPubMed
35.
go back to reference Wysocki T, Harris MA, Buckloh LM, et al. Randomized, controlled trial of behavioral family systems therapy for diabetes: maintenance and generalization of effects on parent-adolescent communication. Behav Ther. 2008;39:33–46.CrossRefPubMed Wysocki T, Harris MA, Buckloh LM, et al. Randomized, controlled trial of behavioral family systems therapy for diabetes: maintenance and generalization of effects on parent-adolescent communication. Behav Ther. 2008;39:33–46.CrossRefPubMed
36.
go back to reference Iskander JM, Rohan JM, Pendley JS, Delamater A, Drotar D. A 3-year prospective study of parent-child communication in early adolescents with type 1 diabetes: relationship to adherence and glycemic control. J Pediatr Psychol. 2015;40:109–20.CrossRefPubMed Iskander JM, Rohan JM, Pendley JS, Delamater A, Drotar D. A 3-year prospective study of parent-child communication in early adolescents with type 1 diabetes: relationship to adherence and glycemic control. J Pediatr Psychol. 2015;40:109–20.CrossRefPubMed
37.
go back to reference Ellis DA, Templin TN, Podolski CL, Frey MA, Naar-King S, Moltz K. The parental monitoring of diabetes care scale: development, reliability and validity of a scale to evaluate parental supervision of adolescent illness management. J Adolesc Health. 2008;42:146–53.CrossRefPubMed Ellis DA, Templin TN, Podolski CL, Frey MA, Naar-King S, Moltz K. The parental monitoring of diabetes care scale: development, reliability and validity of a scale to evaluate parental supervision of adolescent illness management. J Adolesc Health. 2008;42:146–53.CrossRefPubMed
38.
go back to reference Palmer DL, Osborn P, King PS, et al. The structure of parental involvement and relations to disease management for youth with type 1 diabetes. J Pediatr Psychol. 2011;36:596–605.CrossRefPubMed Palmer DL, Osborn P, King PS, et al. The structure of parental involvement and relations to disease management for youth with type 1 diabetes. J Pediatr Psychol. 2011;36:596–605.CrossRefPubMed
Metadata
Title
The Impact of Frequency and Tone of Parent–Youth Communication on Type 1 Diabetes Management
Authors
Mark D. DeBoer
Rupa Valdez
Daniel R. Chernavvsky
Monica Grover
Christine Burt Solorzano
Kirabo Herbert
Stephen Patek
Publication date
01-06-2017
Publisher
Springer Healthcare
Published in
Diabetes Therapy / Issue 3/2017
Print ISSN: 1869-6953
Electronic ISSN: 1869-6961
DOI
https://doi.org/10.1007/s13300-017-0259-2

Other articles of this Issue 3/2017

Diabetes Therapy 3/2017 Go to the issue