Adherence intervention research in diabetes is limited by poor representation of young, lower income minority children and lack of long term follow-up. It is important to target this patient group because 1) minorities have more glycemic control problems and 2) many risk factors for adolescent glycemic control problems may develop during later childhood. There is also a need for study of family factors related to adherence and glycemic control in this patient population. Adherence interventions for this population should be informed by the child development and clinical literature, and build on existing empirically useful approaches.
The specific aims of the proposed research are: 1) to determine the demographic, psychosocial, and behavioral factors that affect glycemic control of young minority children with diabetes; and 2) to conduct a randomized prospective study of a family-based adherence intervention for this age group aimed at improving glycemic control via improved adherence and psychosocial functioning. The investigators will recruit 100 7 to 10 year old lower income African American and Hispanic children and conduct assessments of pertinent psychosocial, behavioral and metabolic variables using standardized measures. The 1-year intervention program is based on an established parent training and synthesis teaching model as well as a family-based diabetes self-management training program. Follow-up will be obtained 18 months post treatment, allowing a test of the intervention's effectiveness at preventing the problems typically expected in late childhood and early adolescence.
| Davis, C L; Delamater, A M; Shaw, K H et al. (2001) Parenting styles, regimen adherence, and glycemic control in 4- to 10-year-old children with diabetes. J Pediatr Psychol 26:123-9 |
