I am submitting this application to further the research plan and specific aims of my K23. In my K23, I am conducting a randomized controlled trial (RCT) of an enhanced parent-child diabetes education/counseling program to promote metabolic control/behavioral adherence among children with type 1 diabetes. In the intervention arm, families receive patient education and brief counseling regarding parents staying involved in their child's diabetes care. Preliminary data suggest that this is a salient component of the intervention and the information and skills taught resonate well with our parent subjects. However, clinical information has come to light underscoring the challenges some parents are experiencing with diabetes involvement. These challenges include overuse of ineffective parenting behaviors (e.g., coercion, poor supervision, rejection, harsh/inconsistent punishment), underuse of effective parenting behaviors (e.g., modeling of predictable and mature behavior, communicating clear expectations, limit setting, praise/reward), and the presence of psychological stress related to their child's diabetes. This information has raised questions regarding normal variations in parenting behavior and how these variations might be associated with their child's diabetes control. It has also raised questions about how parent psychological stress might be associated with their child's diabetes control. Thus, this application focuses on addressing the social and behavioral roles that parents play in managing their child's type 1 diabetes. Specifically, I am seeking to deepen my understanding of the interrelationships among parenting style (e.g., responsiveness and demandingness), pediatric parenting stress (i.e., stress associated with caring for a child with diabetes), and diabetes control (i.e., metabolic control and behavioral adherence). I will do this first (Phase I) by conducting a cross-sectional, descriptive investigation of these and other related factors in a clinical sample of N=120 parents of children ages 8-11 years with type 1 diabetes. Next, I will develop and pilot test a parenting adjunct to the ongoing RCT with N=10 parents (Phase II). This work will be conducted as an independent but related study to my K23 utilizing a different/not active pool of subjects. The institutional resources available to me at Children's National Medical Center and my established, productive working relationships with my Mentors all contribute to the feasibility of accomplishing these aims in a timely manner. The results of this R03 will ultimately be interpreted in light of the ongoing RCT's results. They will be used to guide and inform the development of a family management program which will subsequently be tested in an effectiveness trial (R01) to promote diabetes control among affected youth.
| Guion, Kimberly; Mrug, Sylvie (2012) The role of parental and adolescent attributions in adjustment of adolescents with chronic illness. J Clin Psychol Med Settings 19:262-9 |
| Monaghan, Maureen; Horn, Ivor B; Alvarez, Vanessa et al. (2012) Authoritative parenting, parenting stress, and self-care in pre-adolescents with type 1 diabetes. J Clin Psychol Med Settings 19:255-61 |
