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Parenting style, parent-youth conflict, and medication adherence in youth with type 2 diabetes participating in an intensive lifestyle change intervention.

ABSTRACT: Parenting behaviors and family conflict relate to type 1 diabetes outcomes in youth. Our purpose was to understand these relationships in parents and youth with type 2 diabetes (T2DM). The TODAY (Treatment Options for Type 2 Diabetes in Adolescents and Youth) trial enrolled youth (10-17 years) with T2DM and parent/guardian. For this ancillary study, we enrolled a sample of youth-parent pairs (N = 137) in 1 study arm (metformin plus lifestyle intervention). They completed questionnaires measuring parenting style related to normative (e.g., completing homework) and diabetes self-care (e.g., testing blood glucose) tasks, and parent-youth verbal conflict (baseline, 6, and 12 months). Parenting style was consistent across normative and diabetes tasks, with gradual increases in autonomy perceived by youth. Conversations were generally calm, with greater conflict regarding normative than diabetes tasks at baseline (youth: p < .001, parent: p = .01), 6 months (youth: p = .02, parent: p > .05), and 12 months (youth: p > .05., parent: p = .05). A permissive parenting style toward normative tasks and a less authoritarian style toward diabetes tasks, at baseline, predicted better medication adherence (8-12 months) (normative: adjusted R2 = 0.48, p < .001; diabetes: adjusted R2 = 0.47, p < .001). Parent-youth conflict did not predict medication adherence. Youth with T2DM who perceive more autonomy (less parental control) in day-to-day and diabetes tasks are more likely to adhere to medication regimens. It may be valuable to assess youth perceptions of parenting style and help parents understand youths' needs for autonomy.

SUBMITTER: Saletsky RD

PROVIDER: S-EPMC4069236 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature

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Parenting style, parent-youth conflict, and medication adherence in youth with type 2 diabetes participating in an intensive lifestyle change intervention.

Saletsky Ronald D RD Trief Paula M PM Anderson Barbara J BJ Rosenbaum Paula P Weinstock Ruth S RS

Families, systems & health : the journal of collaborative family healthcare 20140217 2

Parenting behaviors and family conflict relate to type 1 diabetes outcomes in youth. Our purpose was to understand these relationships in parents and youth with type 2 diabetes (T2DM). The TODAY (Treatment Options for Type 2 Diabetes in Adolescents and Youth) trial enrolled youth (10-17 years) with T2DM and parent/guardian. For this ancillary study, we enrolled a sample of youth-parent pairs (N = 137) in 1 study arm (metformin plus lifestyle intervention). They completed questionnaires measuring ...[more]

PMID: 24548045

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Project description:Objective: Attention-deficit/hyperactivity disorder (ADHD) is a common neurobiological disorder for which effective and safe medication is recommended as first-line treatment. However, many parents and teachers do not believe that ADHD is a disorder or do not accept medication treatment in China. Treatment is often short term or intermittent. Our study aimed to investigate the clinical effect of employing a 4-week, session-based training for both parents and teachers in improving medication adherence for primary school children with ADHD. Methods: From January 2018 to December 2018, a total of 5,118 primary school children were screened. Among 211 children diagnosed with ADHD, 116 were assigned to the intervention group and 95 to the control group. This study provided systematic training for parents and teachers in the intervention group. The training consisted of education about the disorder and ADHD behavioral intervention for both parents and teachers as well as classroom management techniques for just the teachers. A cluster randomized controlled trial (RCT) was conducted to investigate the effect of this training at 6 months follow-up. The study determined medication adherence using a questionnaire and scoring with a rating scale at baseline and at the 6 month follow-up endpoint. The questionnaire was self-report. Results: The study population had a relatively low rate of attention deficit hyperactivity disorder (4.1%) compared to the generally accepted prevalence. After the training, more parents and teachers believed that ADHD is a neurobiological disorder and that medication is the first line treatment. At 6 months follow-up, the Medication Adherence Report Scale (MARS) score for the intervention group was 22.8 ± 0.75 and 16.5 ± 1.63 for the control group (t = 5.217, P < 0.01). Based on parents' reports and medical records, 82 children (70.69%) were continuously taking medication for 6 months in the intervention group, while only 35 children (36.84%) were doing so in the control group. In the intervention group, the mean SNAP-IV score was 1.98 ± 0.42 at baseline but 0.99 ± 0.31 at 6-month follow-up. In the control group, the mean SNAP-IV score was 1.89 ± 0.47 at baseline but 1.37 ± 0.42 at 6-months follow-up (F = 2.67, P = 0.009). Factors influencing medication adherence for children with ADHD were parent's beliefs, teacher's beliefs, socioeconomic status, adverse effect, insurance coverage, gender, and trust of the medical system. Conclusions: Our findings indicate that comprehensive training programs improve the understanding of ADHD and medication adherence for both children's parents and teachers, providing a promising approach for improving clinical efficacy for children with ADHD.

Dataset Information

Parenting style, parent-youth conflict, and medication adherence in youth with type 2 diabetes participating in an intensive lifestyle change intervention.

Publications

Parenting style, parent-youth conflict, and medication adherence in youth with type 2 diabetes participating in an intensive lifestyle change intervention.

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