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Published online January 17, 2008
Diabetes Care 31:678-683, 2008
DOI: 10.2337/dc07-1678
© 2008 by the American Diabetes Association
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Clinical Care/Education/Nutrition/Psychosocial Research
Original Research

Role of Parental Monitoring in Understanding the Benefits of Parental Acceptance on Adolescent Adherence and Metabolic Control of Type 1 Diabetes

Cynthia A. Berg, PHD1, Jorie M. Butler, PHD1, Peter Osborn, MA1, Gary King1, Debra L. Palmer, PHD2, Jonathan Butner, PHD1, Mary Murray, MD3, Rob Lindsay, MD3, David Donaldson, MD3, Carol Foster, MD3, Michael Swinyard, MD4 and Deborah J. Wiebe, PHD5

1 Department of Psychology, University of Utah, Salt Lake City, Utah
2 Department of Psychology, University of Wisconsin–Stevens Point, Stevens Point, Wisconsin
3 Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
4 Office of Mike T. Swinyard, MD, PC, South Jordan, Utah
5 University of Texas Southwestern Medical Center, Dallas, Texas

Address correspondence and reprint requests to Cynthia A. Berg, 380 S. 1530 E., Department of Psychology, University of Utah, Salt Lake City, UT 84112. E-mail: cynthia.berg{at}psych.utah.edu

OBJECTIVE—This study examined 1) whether the benefits of mothers’ and fathers’ accepting relationships with their adolescents regarding diabetes control were due to parental monitoring and 2) how parents together may provide sufficient acceptance and monitoring for diabetes management.

RESEARCH DESIGN AND METHODS—Adolescents aged 10–14 years with type 1 diabetes (n = 185) and their mothers (n = 185) and fathers (n = 145) completed assessments of parental acceptance and monitoring of diabetes tasks. Adolescents completed a modified version of the Self-Care Inventory (1) to measure adherence. A1C scores were used as a marker of glycemic control.

RESULTS—Mediational analyses revealed that the benefits of adolescents’ reports of fathers’ acceptance on A1C and mothers’ and fathers’ acceptance on better adherence were partially mediated by monitoring. Both mothers’ and fathers’ monitoring and fathers’ acceptance had independent effects in predicting adherence. However, only fathers’ monitoring had an independent effect on A1C. The effect of fathers’ monitoring on A1C occurred as fathers were monitoring at a lower level than mothers. Mothers’ and fathers’ reports of their own acceptance and monitoring were not associated with A1C or adherence.

CONCLUSIONS—Results reveal the importance of fathers’ acceptance and monitoring in diabetes management, a role that should be encouraged, despite the little attention it has received.


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