Association of Family Structure and Glycemic Control in Adolescents with Type 1 Diabetes: Risk and Protective Factors

<p>Youth with type 1 diabetes (T1D) from single-parent families are more likely to be in poorer glycemic control (HbA1c). Demographic trends indicate more households are composed of unmarried adults and fewer youths. Family density, or a youth: adult ratio, may be a more salient factor than single-parent status in the association with glycemic control. Data from 257 adolescents aged 11-14 years (M = 12.84) at two different sites were collected as part of a randomized control trial of a treatment intervention designed to increase parent involvement and prevent deterioration of adolescent diabetes disease care. Single-parent status was determined by parental report of a sole caregiving adult in a youth’s household. A family density ratio was calculated via parental report of the number of youths to adults in a home. A youth: adult ratio greater than two was considered “high family density” (Liaw & Brooks-Gun, 1994). Diabetes-related risk and protective factors of parental monitoring, youth adherence to disease care behaviors, parental stress, and diabetes-related conflict were measured using parent and youth report questionnaires. Glycemic control was determined via a DCA2000 analyzer with results abstracted from medical chart review. Consistent with the literature, single-parent status was correlated with higher HbA1c (r = .19, p = .01) or poorer glycemic control. Similarly, higher family density also was related to higher HbA1c (r = .32, p < .001). An overall multiple regression model including family structure constructs (single-parent status and density), socioeconomic status, and ethnicity accounted for 18% of the variance in glycemic control. However, family density, β = .22, and SES, β = -.29, were the only significant correlates of glycemic control in the model when considered simultaneously with single-parent status and ethnicity. Although single-parent families have youths in poorer metabolic control, higher family density appears to be a more potent correlate of youth glycemic control perhaps because it might be a more sensitive indicator of available parental time and resources. Family density is significantly related to poorer adherence and greater diabetes-related conflict. Further, poorer adherence and more diabetes-related conflict partially explained the relation between high family density and poorer glycemic control. Family density appears to be an important family structure factor for adolescents with T1D and the identification of risk factors for poorer glycemic control has both clinical and research implications.</p>

Name thesis:degree_name

Master of Science

Level thesis:degree_level

Thesis

Discipline thesis:degree_discipline

Psychology

Year dc:date.available

2013

Author dc:creator

• Caccavale, Laura Jean

Contributors dc:contributor

• Clarissa Holmes

• Type 1 Diabetes
• Adolescents
• Family Structure
• Psychology
• Social and Behavioral Sciences

Statement dc:rights

• © The Author

Identifier

https://scholarscompass.vcu.edu/etd/562

OAI identifier oai:identifier

oai:scholarscompass.vcu.edu:etd-1561