Parental Strategies for Adolescent Diabetes Management in Latino and Caucasian Youth
Adolescence is a particularly challenging and important time for type 1 diabetes management. Parental involvement during this time has been associated with more effective diabetes management in adolescence and throughout adulthood, but research on adolescent diabetes management has primarily focused on Caucasian samples. The purpose of this study was to explore the parental strategies that Caucasian and Latina mothers employ when helping their adolescent deal with diabetes management problems, and to begin to illuminate the strategies that are associated with adolescent outcomes (i.e. metabolic control, adherence, and depressive symptoms) across ethnic groups. Participants were Caucasian and Latina mothers and their adolescents with type 1 diabetes (N=118 dyads; 48% Latino; 54% female adolescents; 10 to 15 years old; illness duration > 1 year; 25% on insulin pump). Qualitative data consisted of maternal and adolescent narrative responses to the open-ended question, “What do you (does your mother) do when diabetes management is not going well?” Quantitative data included maternal and adolescent report of adherence, teen report of depressive symptoms and metabolic control. Sociodemographic information was collected by maternal report. Qualitative analysis revealed 11 parental strategies that mothers employ when dealing with daily diabetes related problems. Across the full sample, take charge was the most commonly reported strategy by both mothers and teens, followed by negative emotional reaction and collaboration (by teen report) and collaboration and parental monitoring (by mother report). Across ethnic groups, take charge was commonly endorsed by all reporters. Caucasian families were more likely to report collaboration and general emotional support, while Latino families were more likely to report parental monitoring. Exploratory analyses of correlation differences across ethnic groups suggested parental strategies functioned differently for Caucasian and Latino families. Caucasian and Latino families differed on the frequency of parental strategies reported, as well as on associations between strategies and outcomes (i.e. glycemic control, adherence, and depressive symptoms). The mixed methods approach identified important parental strategies that enrich our understanding of how parents manage diabetes and illuminate interesting ethnic differences that should be further considered in the context of clinical intervention and future research.
Diabetes Mellitus, Type 1, Mother-Child Relations, Disease Management
University of Texas Southwestern Medical Center
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