Insulin-dependent diabetes mellitus (IDDM) is one of the most prevalent and serious health problems in youth. Even with careful treatment, IDDM can lead to serious cardiovascular and other major organ system complications. Treatment has focused primarily on adherence to a complex and difficult treatment regimen. Although many researchers have found that metabolic control and adherence are related to several psychosocial variables, causal relations have rarely been demonstrated and comprehensive causal models have not been developed. In a cross-sectional study, we used structural equation modeling to develop a preliminary causal model of the linkages among several important psychosocial variables and adherence and metabolic control in youth with IDDM. The major aim of the present proposal is to further develop and empirically test our preliminary causal model in a four-year longitudinal design, and to increase the amount of variance that is predicted by the model by including pertinent psychosocial variables that were not assessed in the preliminary study.
The second aim of the proposal is to identify environmental factors that relate to poor health in a group of children (i.e., black females) who are at high risk for future cardiovascular and other major organ system complications.
The third aim i s to develop preliminary psychosocial intervention strategies for youth who are at high risk for poor control and future complications. These interventions will be based on the causal models developed during the first four years of the project. We plan to test the efficacy of these intervention strategies in future controlled comparative outcome studies.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
7R29DK041969-04
Application #
3463983
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1989-05-01
Project End
1994-07-31
Budget Start
1992-08-01
Budget End
1993-07-31
Support Year
4
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Medical University of South Carolina
Department
Type
Schools of Medicine
DUNS #
183710748
City
Charleston
State
SC
Country
United States
Zip Code
29425
Hanson, C L; De Guire, M J; Schinkel, A M et al. (1996) Self-care behaviors in insulin-dependent diabetes: evaluative tools and their associations with glycemic control. J Pediatr Psychol 21:467-82
Hanson, C L; De Guire, M J; Schinkel, A M et al. (1995) Empirical validation for a family-centered model of care. Diabetes Care 18:1347-56
Hanson, C L; Henggeler, S W; Harris, M A et al. (1992) Contributions of sibling relations to the adaptation of youths with insulin-dependent diabetes mellitus. J Consult Clin Psychol 60:104-12
Hanson, C L; De Guire, M J; Schinkel, A M et al. (1992) Comparing social learning and family systems correlates of adaptation in youths with IDDM. J Pediatr Psychol 17:555-72
Hanson, C L; Rodrigue, J R; Henggeler, S W et al. (1990) The perceived self-competence of adolescents with insulin-dependent diabetes mellitus: deficit or strength? J Pediatr Psychol 15:605-18
Hanson, C L; Rodrigue, J R; Burghen, G A et al. (1990) Peptic ulcer disease in youths with insulin-dependent diabetes mellitus: a prospective study. J Pediatr Psychol 15:595-604
Hanson, C L; Henggeler, S W; Harris, M A et al. (1989) Family system variables and the health status of adolescents with insulin-dependent diabetes mellitus. Health Psychol 8:239-53
Hanson, C L; Cigrang, J A; Harris, M A et al. (1989) Coping styles in youths with insulin-dependent diabetes mellitus. J Consult Clin Psychol 57:644-51