Diabetes-Specific Family Conflict and Blood Glucose Monitoring in Adolescents With Type 1 Diabetes: Mediational Role of Diabetes Self-Efficacy

Emily P. Sander; Shannon Odell; Korey K. Hood

doi:10.2337/diaspect.23.2.89

Feature Articles

Diabetes-Specific Family Conflict and Blood Glucose Monitoring in Adolescents With Type 1 Diabetes: Mediational Role of Diabetes Self-Efficacy

Emily P. Sander, MA,
Shannon Odell, MA and
Korey K. Hood, PhD

Diabetes Spectrum 2010 Mar; 23(2): 89-94. https://doi.org/10.2337/diaspect.23.2.89

Abstract

Purpose. To determine whether the association between diabetes-specific family conflict and self-monitoring of blood glucose (SMBG) frequency is mediated by diabetes self-efficacy.

Methods. A total of 276 adolescents with type 1 diabetes (aged 15.6 ± 1.4 years; duration of diabetes 6.6 ± 1.8 years; A1C 8.9 ± 1.8%) completed measures of diabetes-specific family conflict and self-efficacy. Sociodemographic, family, and disease characteristics (including SMBG frequency and glycemic control) were obtained at the clinic visit.

Results. Multivariate analyses were used to test the mediational role of self-efficacy. The first model established that family conflict was associated with lower levels of self-efficacy. The second model established that increased family conflict was associated with lower SMBG frequency. In the third model, self-efficacy was added, and the effect of family conflict on SMBG frequency became less significant (P = 0.001 to P = 0.03). The indirect effect of family conflict on SMBG frequency through diabetes self-efficacy was significant (Sobel = 2.10, P = 0.035) and explained 22% of the association between family conflict and SMBG frequency.

Conclusions. Results confirm a partial mediational role of diabetes self-efficacy and suggest that a family environment characterized by conflict may also contain poorer self-efficacy in the adolescent. In these cross-sectional analyses, both variables contributed to less frequent SMBG. Future longitudinal research to confirm these relationships and potential avenues for intervention are discussed.

Footnotes

Korey K. Hood, PhD, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH 45229.
The authors are all based in Cincinnati, Ohio. Emily P. Sander, MA, and Shannon Odell, MA, are advanced practicum students at the Center for Treatment Adherence, Division of Behavioral Medicine and Clinical Psychology, at Cincinnati Children's Hospital Medical Center and doctoral students in the Department of Psychology at Xavier University. Korey K. Hood, PhD, is a staff psychologist at the Center for Treatment Adherence, Division of Behavioral Medicine and Clinical Psychology, at Cincinnati Children's Hospital Medical Center and a research assistant professor in the Department of Pediatrics at the University of Cincinnati College of Medicine.