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Journal of Pediatric Psychology Advance Access published online on March 3, 2005

Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsj004
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Journal of Pediatric Psychology © The Author 2005. Published by Oxford University Press on behalf of the Society of Pediatric Psychology.
Received July 16, 2004
Revised January 14, 2005
Accepted January 19, 2005

Article

The Relation Between Family Factors and Metabolic Control: The Role of Diabetes Adherence

Adam B. Lewin MS1*, Amanda D. Heidgerken PhD2, Gary R. Geffken PhD3, Laura B. Williams MS1, Eric A. Storch PhD4, Kenneth M. Gelfand PhD5, and Janet H. Silverstein MD6

1 Department of Clinical and Health Psychology, University of Florida; Department of Psychiatry University of Florida
2 Department of Psychiatry University of Florida
3 Department of Clinical and Health Psychology, University of Florida; Department of Psychiatry University of Florida; Department of Pediatrics, University of Florida, and
4 Department of Psychiatry, University of Florida; Department of Pediatrics, University of Florida, and
5 Department of Psychology, Mount Washington Pediatric Hospital
6 Department of Pediatrics, University of Florida, and

* To whom correspondence should be addressed.
Adam B. Lewin, E-mail: alewin{at}phhp.ufl.edu


   Abstract

Objectives To examine family factors as predictors of metabolic control in children with type 1 diabetes and determine whether adherence behaviors mediate this relationship. Method Participants were 109 children (ages 8-18) and a parent. Measures of diabetes-specific family functioning and an adherence interview were completed. Glycosylated hemoglobin (HbA1c) was the index of metabolic control. Results Family functioning and adherence were strongly associated with metabolic control. Combined with demographic information, these constructs accounted for 49% of the variance in metabolic control. Age moderated the relation between aspects of family functioning and HbA1c. Path analyses suggest that adherence mediates the relationship between family functioning and metabolic control. Conclusions Family functioning and adherence behaviors are strongly related to a child’s health status. Assessment of diabetes-specific family functioning, in addition to adherence, is an important factor in understanding metabolic control.

Keywords: adherence; family functioning; mediator; metabolic control; type 1 diabetes.
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