Table 1:
Studies of Parental Involvement, Self-Regulation, and Diabetes Management
| Authors | Sample | Design | Parental Involvement | Regulation of Behavior, Emotion, and Cognition |
Primary Findings |
|---|---|---|---|---|---|
| Anderson et al. (2002) | 104 youth (ages 8-17) with “short-duration” D (.5 to 6 years) and P | Cross-sectional | D responsibility; D-specific family conflict | Adherence Behaviors | P responsibility was [+] associated with adherence to BGM. Conflict was [−] associated with adherence to BGM and [+] with HbA1c. |
| Armstrong, Mackey, & Streisand (2011) | 84 youth (ages 9-11; M = 10.8, SD = .75) | Cross-sectional | Critical or negative (low quality) | Depressive symptoms (A), Self-efficacy (A) Adherence Behaviors |
Critical parenting was [+] associated with depression and [−] to self-efficacy, but not adherence or HbA1c . Depressive symptoms were [−] associated with self-efficacy and adherence, but not HbA1c . Self-efficacy mediated relationship between depressive symptoms and adherence. |
| Berg et al. (2011) | 252 youth with D (ages 10-14, M age=12.5) | Cross-sectional | M and F monitoring; parent-child relationship quality; P behavioral involvement in D management | Self-efficacy (A), Internalizing and externalizing behaviors (A) |
Relationship quality and monitoring related to adherence [+], HbA1c [−], self-efficacy [+], externalizing and internalizing [−]. Relationship quality→self-efficacy→ adherence. |
| Berg et al. (2013) | 180 youth (ages 10.50-15.58; M age = 12.87, SD = 1.53) and M (n=176) and F (n=139) |
Longitudinal (daily assessments across 14 days) | Parental persuasive strategies (e.g., “How much did you remind your child of the things he or she needs to do to manage his or her diabetes?”) | P confidence in adolescent’s ability to manage D | M persuasive strategies [−] associated with next day BG. M persuasive strategies [−] associated with next day confidence for A with high self-efficacy, [+] associated with next day confidence for A with low self-efficacy. |
| Berg et al. (2017) | 236 late adolescents (M age=17.76) | Cross-sectional Daily Diary |
Acceptance, Monitoring, Disclosure (A) | Adherence Behaviors Self-regulation failures |
Disclosure to M but not F associated with better daily adherence and fewer self-regulation failures. |
| Botello-Harbaum et al. (2008) | 69 youth (ages 11-16, M age = 13.3, SD = 1.7) |
Longitudinal (baseline, 12-month follow-up) | Authoritative parenting style (low quality): demandingness, responsiveness; D responsibility; D conflict. | Quality of Life | P responsiveness [+] associated with QOL at baseline and 12 months. D responsibility, D conflict, and demandingness not associated with QOL at either time point. |
| Butler, Skinner, Gelfand, Berg, & Wiebe (2007) | 78 youth (ages 11.58 – 17.42; M age = 14.21) and M | Cross-sectional | M psychological control, firm control, and acceptance | Depressive symptoms, Self-efficacy Adherence Behaviors |
Psychological control was [+] associated with A depression. A report of firm control was associated with A self-efficacy [+] and depressive symptoms [−] among older A. A report of M acceptance was associated with [−] depression and [+] with self-efficacy. M report of acceptance [+] associated with adherence. |
| Chisholm et al. (2011) | 40 youth (ages 2-8, M age = 6.57, SD = 1.63) | Cross-sectional | Quality of communication (combination of cohesion, expressiveness, and conflict); Behavioral control: a) commands, b) assigns responsibility | Internalizing and Externalizing Behaviors | Assign responsibility was associated [−] with % energy intake from sugars (NMES). When NMES consumption >10%, M quality of communication associated [−] to HbA1c. Command statements [+] correlated with externalizing symptoms. Assign responsibility statements [−] correlated with internalizing symptoms. |
| Davis et al. (2001) | 55 youth (ages 4-10; M age = 7.5, SD = 1.9) and a P |
Cross-sectional | Parenting style: a) warmth, b) restrictiveness, c) amount of control, d) physical punishment | Adherence Behaviors | Warmth alone was [+] associated with better adherence. No P measures were associated with HbA1c. |
| Drew et al. (2010) | 252 youth with D (ages 10-14; M age = 12.5) | Cross-sectional | Relationship quality | Extreme peer orientation (i.e., prioritizing peers over D management) Adherence Behaviors |
Relationship quality related to adherence [+], HbA1c [−], and extreme peer orientation [−]. Relationship quality →peer orientation→adherence, HbA1c. |
| Ellis et al. (2007) | 103 youth (ages 12-18; M = 14.8, SD = 1.7) |
Cross-sectional | Affective support for D; D and general monitoring | Adherence Behaviors | Monitoring (latent factor) was [+] associated with adherence, and indirectly [−] associated with HbA1c. |
| Hanna et al. (2011) | 118 late adolescents (range age 17-19) | Longitudinal | D Responsibility | Self-efficacy Worry about hypoglycaemia |
Greater youth D responsibility associated (+) with self-efficacy for those living independently, but (−) for those not living independently. |
| Hansen, Weissbrod, Schwartz, & Taylor (2012) | Parents (82 M and 43 F) of youth withD (ages 7-14) | Cross-sectional | P frequency and helpfulness of support for D management | Adherence Behaviors | F helpfulness associated with adherence [+]. |
| Helgeson et al. (2014a) | 112 youth with type 1 diabetes (M age=12) followed for 6 years | Longitudinal | P support and control | Adherence Behaviors Depressive Symptoms |
P control associated with lower depressive symptoms among those with type 1 diabetes. |
| Helgeson et al. (2014b) | 117 youth with type 1 diabetes and 122 without (M age=18.15 years) | Longitudinal | P support and control | Adherence Behaviors | P support associated with positive changes in adherence; parent control related to increases in depressive symptoms. Friend support buffered the negative effects of parent control on adherence |
| Helgeson, Reynolds, Siminerio, Escobar, Becker (2008) | 132 youth ages 10.73 – 14.21; M = 12.10) and a P | Longitudinal, across 3 time points (some cross-sectional results also reported) | D responsibility: a) % parent responsibility, b) % child responsibility, c) % shared responsibility | Depression, anxiety, anger, social competence, global self-worth, D self-efficacy | Shared responsibility (P-report) [+] associated with adherence. Shared responsibility (A-report) associated with HbA1c [−], self-efficacy [+], depressive symptoms [−], anger [−]. P responsibility (A-report) [+] associated with adherence. Child responsibility (A-report) associated with HbA1c [+], global self-worth [−], self-efficacy [−], and anger [+]. |
| Helgeson, Siminerio, Escobar, & Becker (2009) | 132 youth (ages 10.73-14.21; M = 12.10) | Longitudinal, across 4 time points, some cross-sectional findings reported | General relationship quality between P and A; P D-specific support | Depressive symptoms | Relationship quality [−] associated with HbA1c for girls only (Cross-Sectional). Depressive symptoms associated with HbA1c over time [+], but this association dissipated over time. |
| Helgeson, Snyder, Seltman, Escobar, Becker, & Siminerio (2009) | 132 youth (ages 10.73-14.21; M = 12.10) | Longitudinal across 5 years | Quality of parent relationship with M and F and emotional and instrumental support, friend support and conflict | Depressive symptoms, global self-worth | Deteriorating metabolic control trajectory associated [+] peer conflict and [+] poorer well-being. |
| Herzer, Vesco, Ingerski, Dolan, & Hood (2011) | 147 youth (ages 13-18; M age = 15.5, SD = 1.4 |
Longitudinal, across 3 time points | D-specific family conflict | Anxiety, Depressive symptoms | Conflict at baseline [+] associated with HbA1c at 9 months, Conflict →anxiety→HbA1c. |
| Hilliard et al. (2011) | 136 youth (ages 9-12; M = 10.5, SD = .9) | Cross-sectional | F “involvement (frequency and helpfulness of D- supportive behaviors) | Adherence Behaviors | F involvement [−] associated with HbA1c, but not with adherence. |
| Hilliard et al. (2012) | 257 youth (ages 11-14; M age = 12.8, SD = 1.2), P |
Cross-sectional | D monitoring, D-specific conflict, general family conflict | Adherence Behaviors | Monitoring [+] and conflict [−] associated with adherence, and (indirectly) with HbA1c . |
| Hilliard, Holmes et al. (2013) | 257 youth (ages 11-14, M age=12.8) | Cross-sectional | D monitoring and conflict | Adherence Behaviors | Conflict (+) and monitoring (−) independently associated with HbA1 through adherence behaviors. |
| Hilliard, Wu et al. (2013) | 150 youth (ages 13-18; M = 15.5, SD = 1.4) | Cross-sectional | D-specific family conflict | Depressive symptoms, Negative Affect (NA) related to BGM | Identified 3 trajectories of HbA1c, one trajectory representing those meeting their HbA1c treatment target, and others with HbA1c values exceeding recommended levels. Higher family conflict, depressive symptoms, and NA associated [−] to BGM and predicted poorer HbA1c trajectories. |
| Hilliard et al., (2014) | 136 families (M age=10.5) | Longitudinal | F involvement from M and F report. | Adherence Behaviors | Lower adherence was associated with increasing F involvement across time and higher F involvement associated with slower declines in adherence over time. |
| Hood, et al. (2007) | 202 youth (ages 8.2 – 18.7; M = 13.3, SD = 2.4, and P |
Cross-sectional | D family conflict | Negative affect (NA) responses to BGM results (A, P) | Conflict [+] associated with HbA1c. Conflict (A-report) associated with youth NA around BGM [+]. |
| Hsin, La Greca, Valenzuela, Moine, & Delamater (2010) | 111 youth (ages 10-17; M = 13.33, SD = 2.82) and a primary caregiver |
Cross-sectional | D responsibility, D “support” (i.e., frequency of supportive behavior x helpfulness of behavior) | Adherence Behaviors | Family support [+] associated with adherence. |
| Ingerski, Anderson, Dolan, & Hood (2010) | 147 youth (ages 13-18; M age = 15.5, SD = 1.4) |
Longitudinal | D responsibility, D conflict | Depressive symptoms, anxiety BGM frequency |
BGM frequency associated with P responsibility [+], D conflict [−]. P-reported child trait anxiety was [−] associated with BGM. Conflict [+] associated with HbA1c. |
| Iskander et al. (2015) | 217 youth (9-11 years) | Longitudinal | P negative and positive communication in interactions. | Adherence Behaviors | M positive communication predicted (+) adherence 3 years later. Changes in communication did not predict changes in HbA1c or adherence. |
| Jaser & Grey (2010) | 30 youth (ages 10-16; M = 12.6, SD = 1.6) and M | Cross-sectional | Ratings of a) hostility, b) parental influence, c) sensitive/child-centered, d) positive reinforcement during P-A interactions. | Depressive Symptoms | HbA1c associated with child-centered parenting [−], positive reinforcement [−], hostility [+], and parental influence [+]. M hostility associated with A depressive symptoms [+] and HbA1c [+]. Parental influence associated with child depression [+]. |
| King et al. (2012) | 252 youth (ages 10-14, M = 12.49, SD = 1.52) |
Longitudinal | M and F acceptance (relationship quality), D monitoring, and frequency of help | Behavioral self-control Externalizing Behaviors |
Better trajectories of HbA1c over time were associated with F monitoring [+], F frequency of help, behavioral self-control [+], extreme peer orientation [−], and externalizing behavior [−]. |
| King et al. (2013) | 252 youth (ages 10-14, M = 12.49, SD = 1.52) and 252 M and 188 F | Longitudinal |
M and F relationship quality, D monitoring, and behavioral involvement |
D Self-efficacy Adherence Behaviors |
M and F D monitoring and acceptance at baseline associated with less declines in adherence. Declines in M and F monitoring and acceptance predict declines in adherence. Tests of mediation indicated declines in M acceptance → less increase in self-efficacy → greater declines in adherence (A-report). Also, declines in maternal acceptance → less increase in self-efficacy → greater declines in adherence (A and M reports) |
| La Greca & Bearman (2002) | 74 youth (ages 11-18; M = 14.2, SD = 2.3) | Cross-sectional | D-specific support (frequency x helpfulness) | Adherence Behaviors | D-specific family support (frequency x helpfulness) was [+] associated with adherence, after controlling for family cohesion. |
| La Greca, Follansbee, & Skyler, 1990 | 40 youth w/ D (ages 7-17; M “Preadolescents” = 9.5; M “Adolescents” = 13.0) and M |
Cross-sectional | Transfer of responsibility from P to A Knowledge (Monitoring) of Diabetes |
Adherence Behaviors | Earlier transfer of responsibility [+] associated with HbA1c. M knowledge of D [+] associated with adherence of younger A. |
| Law et al. (2013) | 203 youth (M age=14.5 years) | Cross-sectional | Discrepancies in D responsibility | Perceived Consequences Dietary Self-efficacy |
HbA1c (+) associated with disagreements about responsibility and (−) with self-efficacy. |
| Lewandowski & Drotar (2007) | 51 youth (ages 13-18; M = 14.67, SD = 1.24) and M | Cross-sectional | M-A D conflict | Adherence Behaviors (A and M) | D conflict was [−] associated with adherence. |
| Luyckx et al. (2013) | 109 youth (M age=13.17 at baseline) | Longitudinal | P conflict | Internalizing and externalizing behaviors Adherence Behaviors |
Conflict with M and F associated with (−) adherence through (+) externalizing behaviors. |
| Main et al. (2014) | 118 youth (M age=12.74) | Cross-sectional | P acceptance and conflict | Depressive Symptoms Adherence Behaviors |
M and F acceptance associated (+) with adherence and conflict (−) with adherence and M conflict (+) with depressive symptoms. Conflict and adherence stronger associations among Caucasian rather than Latinos. |
| Main et al. (2015) | 247 late adolescents (M age=17.76) | Cross sectional | P monitoring, acceptance, disclosure, secrecy. | Externalizing Behaviors Adherence Behaviors |
M and F acceptance, monitoring, disclosure, (+) associated with adherence (−) to externalizing behaviors; secrecy associated (−) to adherence and (+) to externalizing behaviors. Externalizing behaviors (−) associated with adherence. |
| Miller & Drotar (2007) | 63 youth with D (ages 11-17, M = 13.3) and P | Cross-sectional | P-A communication and conflict | Adherence Behaviors | Parent-adolescent communication [+] associated with adherence. |
| Monaghan et al. (2015) | 134 children (ages=1 to 6) | Cross-sectional | P mealtime behaviors | Child’s problematic mealtime behaviors | More child problematic mealtime behaviors (+) associated with HbA1c. |
| Nansel, T., Rovner, A. J., Hayne, D., Iannottie, R. J., Simons-Morton, B., Wysocki, T., Anderson, B., Weissberg-Benchell, & Laffel, L. (2009) | 122 youth (M age=12) | Cross-sectional | Collaboration Parent Responsiveness and Demandingness, D Responsibility |
Adherence Quality of Life |
Collaboration was [+] associated with responsiveness, adherence, and quality of life. |
| Oris et al. (2015) | 228 youth (M age=13.9 years) | Longitudinal | P support | Internalizing Symptoms |
P support associated (−) internalizing symptoms and HbA1c. HbA1c and depressive symptoms especially high when low P support is combined with low friend support. |
| Ott et al. (2000) | 161 youth with D (ages 11-18, M = 13.97) | Cross sectional | P supportive and non-supportive behaviors | Self-efficacy for D management | Non-supportive behaviors→[−] Self-efficacy and [+] A non-adherence to BGM. |
| Palmer et al. (2004) | 127 youth with D (ages 10-15; M = 12.85) | Cross-sectional | M involvement in D care | Autonomy | HbA1c higher when parental involvement was low among adolescents with low autonomy. |
| Palmer et al. (2009) | 185 adolescents with D (ages 10-14, M=12.52), and 185 M and 145 F | Cross-sectional | P involvement in D care | Self-efficacy | P involvement [−] associated with self-efficacy. HbA1c higher when parental involvement was low among adolescents with low self-efficacy. |
| Patton, Piazza-Waggoner, Modi, Dolan, & Powers (2009) | 35 families of Youth with D (M = 5.6 years) | Cross sectional | Family functioning during mealtimes: Task Accomplishment and Behavioral Control | Affect management | Children’s dietary adherence [−] correlated with task accomplishment and behavioral control. Affect management [+] correlated with percentage of above-normal blood glucose levels. |
| Robinson et al. (2016) | 257 youth (ages 11-14) | Cross-sectional | Authoritative parenting, monitoring | Adherence Behaviors | More authoritative parenting and more monitoring were associated (+) with adherence. |
| Ronan et al. (2014) | 239 youth (ages 9-11) | Longitudinal | Family conflict | Executive Functioning, Adherence, Blood glucose monitoring | Higher family conflict and lower frequency of blood glucose monitoring associated with groups at elevated and high risk for poor HbA1c. |
| Skinner, et al. (2000) | 52 youth with D (ages 12-18; M = 15.2) | Longitudinal | General and D -specific family support | “Personal model” of D care | Family support [+] associated with adherence. Beliefs about effectiveness of D treatment regimens was [+] associated with dietary self-care. |
| Sweenie et al. (2014) | 86 youth (M =10.8 years) | Cross-sectional | Critical parenting | Child behavior problems | Critical parenting associated (+) with behavior problems and with HbA1c |
| Vesco et al. (2010) | 261 adolescents (13-18 years) | Cross-sectional | D responsibility | BGM frequency | Greater parental responsibility associated with higher BGM frequency |
| Weissberg-Benchell et al. (2009) | 121 youth with D (M age=12.1) | Cross-sectional | P responsiveness and demandingness, conflict, collaboration, positive and negative communication observed interactions | Quality of Life | Conflict and negative communication associated [−] quality of life, collaboration [+] associated with quality of life |
| Wiebe et al (2005) | 127 youth with D (ages 10-15 years) | Cross-sectional | M involvement in D | Adherence Behaviors |
M uninvolvement was [−] associated with adherence. Collaboration was associated with adherence [+] and HbA1c [−]. Collaboration and HbA1c was partially mediated by adherence. Control was [−] associated with adherence only among older youth. |
| Wiebe et al. (2014) | 252 youth, M, and F (M = 12.49 at baseline) | Longitudinal | P involvement | Adherence Behaviors Self-Efficacy |
Longitudinal declines in parental involvement especially linked to declines in adherence when adolescents did not report growth in self-efficacy. |
| Wysocki et al. (2009) | 309 youth (age range 9-14.5 years) | Cross-sectional | M and F collaborative involvement | Depressive Symptoms Self-Efficacy |
Depressive symptoms and self-efficacy poor when both primary and secondary caregiver were low in collaboration. |
A=Adolescent, BGM=blood glucose monitoring D=Diabetes, F=Father, M=Mother, P=Parent