Abstract
Early emerging adulthood (ages 18–25) is a time of risk for type 1 diabetes (T1D) when relationships with parents and providers are changing. We examined whether individuals’ high-quality relationships with mothers are associated with greater perceptions of patient-centered communication (PCC) with their doctor and whether PCC is associated with better adherence and glycemic control through diabetes-related self-efficacy. Additionally, we tested whether associations of PCC with self-efficacy and diabetes outcomes are stronger among those who had transferred to adult care. One-year post-high school, 217 individuals with T1D (60% women, 53% in adult care) reported perceptions of maternal relationship quality, PCC, self-efficacy, and adherence. Glycemic control was measured via HbA1c assay kits. Structural equation modeling indicated good model fit and revealed indirect paths linking higher maternal relationship quality to better adherence through higher PCC, and higher PCC to better HbA1c through adherence. Transfer status moderated the link between PCC and self-efficacy, suggesting PCC may be especially important when emerging adults transfer to adult care.
Similar content being viewed by others
References
Aikens, J. E., Bingham, R., & Piette, J. D. (2005). Patient-provider communication and self-care behavior among type 2 diabetes patients. The Diabetes Educator, 31, 681–690. https://doi.org/10.1177/0145721705280829
American Diabetes Association. (2017). Standards of medical care in diabetes. Diabetes Care, 40, S105–S113. https://doi.org/10.2337/dc14-S014
Arnett, J. J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55, 469–480. https://doi.org/10.1037//0003-066X.55.5.469
Arnett, J. J. (2004). Emerging adulthood: The winding road from the late teens through the twenties. New York: Oxford University Press.
Berg, C. A., Butner, J. E., Wiebe, D. J., Lansing, A. H., Osborn, P., King, P. S., et al. (2017). Developmental model of parent-child coordination for self-regulation across childhood and into emerging adulthood: Type 1 diabetes management as an example. Developmental Review, 46, 1–26. https://doi.org/10.1016/j.dr.2017.09.001
Berg, C. A., Queen, T., Butner, J. E., Turner, S. L., Lansing, A. H., Main, A., et al. (2016). Adolescent disclosure to parents and daily management of type 1 diabetes. Journal of Pediatric Psychology. https://doi.org/10.1093/jpepsy/jsw056
Bowen, M. E., Henske, J. A., & Potter, A. (2010). Health care transition in adolescents and young adults with diabetes. Clinical Diabetes, 28, 99–106. https://doi.org/10.2337/diaclin.28.3.99
Browne, M., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136–162). Newbury Park, CA: Sage.
Bryden, K. S., Dunger, D. B., Mayou, R. A., Peveler, R. C., & Neil, H. A. W. (2003). Poor prognosis of young adults with type 1 diabetes. Diabetes Care, 26, 1052–1057. https://doi.org/10.2337/diacare.26.4.1052
Bullock, J. G., Green, D. P., & Ha, S. E. (2010). Yes, but what’s the mechanism? (Don’t expect an easy answer). Journal of Personality and Social Psychology, 98, 550–558. https://doi.org/10.1037/a0018933
Ciechanowski, P., Russo, J., Katon, W., Von Korff, M., Ludman, E., Lin, E., et al. (2004). Influence of patient attachment style on self-care and outcomes in diabetes. Psychosomatic Medicine, 66, 720–728. https://doi.org/10.1097/01.psy.0000138125.59122.23
Clements, M. A., Lind, M., Raman, S., Patton, S. R., Lipska, K. J., Fridlington, A. G., et al. (2014). Age at diagnosis predicts deterioration in glycaemic control among children and adolescents with type 1 diabetes. BMJ Open Diabetes Research and Care, 2, e000039. https://doi.org/10.1136/bmjdrc-2014-000039
Cox, E. D., Smith, M. A., & Brown, R. L. (2007). Evaluating deliberation in pediatric primary care. Pediatrics, 120, e68–e77. https://doi.org/10.1542/peds.2006-2602
Croom, A., Wiebe, D. J., Berg, C. A., Lindsay, R., Donaldson, D., Foster, C., et al. (2010). Adolescent and parent perceptions of patient-centered communication while managing type 1 diabetes. Journal of Pediatric Psychology, 36, 206–215. https://doi.org/10.1093/jpepsy/jsq072
Dabelea, D., Mayer-Davis, E. J., Saydah, S., Imperatore, G., Linder, B., Divers, J., et al. (2014). Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA, 311, 1778–1786. https://doi.org/10.1001/jama.2014.3201
Epstein, S. (1983). Scoring and interpretation of the mother-father-peer scale. Unpublished manuscript. Department of Psychology, University of Massachusetts Amherst, Massachusetts, USA.
Erickson, S. J., Gerstle, M., & Feldstein, S. W. (2005). Brief interventions and motivational interviewing with children, adolescents and their parents in pediatric health care settings. Archives of Pediatric Adolescence Medicine, 159 SRC, 1173–1180. https://doi.org/10.1001/archpedi.159.12.1173
Goethals, E. R., Oris, L., Soenens, B., Berg, C. A., Prikken, S., Van Broeck, N., et al. (2017). Parenting and treatment adherence in type 1 diabetes throughout adolescence and emerging adulthood. Journal of Pediatric Psychology. https://doi.org/10.1093/jpepsy/jsx053
Hanna, K. M., Weaver, M. T., Stump, T. E., Dimeglio, L. A., Miller, A. R., Crowder, S., et al. (2013). Initial findings: Primary diabetes care responsibility among emerging adults with type 1 diabetes post high school and move out of parental home. Child: Care, Health and Development, 39, 61–68. https://doi.org/10.1111/j.1365-2214.2011.01320.x
Hare, A. L., Marston, E. G., & Allen, J. P. (2011). Maternal acceptance and adolescents’ emotional communication: A longitudinal study. Journal of Youth and Adolescence, 40, 744–751.
Helgeson, V. S., Vaughn, A. K., Seltman, H., Orchard, T., Becker, D., & Libman, I. (2018a). Relation of parent knowledge to glycemic control among emerging adults with type 1 diabetes: A mediational model. Journal of Behavioral Medicine, 41, 186–194. https://doi.org/10.1007/s10865-017-9886-3
Helgeson, V. S., Vaughn, A. K., Seltman, H., Orchard, T., Libman, I., & Becker, D. (2018b). Trajectories of glycemic control over adolescence and emerging adulthood: An 11-year longitudinal study of youth with type 1 diabetes. Journal of Pediatric Psychology, 43, 8–18. https://doi.org/10.1093/jpepsy/jsx083
Hu, L., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods, 3, 424–453. https://doi.org/10.1037//1082-989x.3.4.424
Iannotti, R. J., Schneider, S., Nansel, T. R., Haynie, D. L., Plotnick, L. P., Clark, L. M., et al. (2006). Self-efficacy, outcome expectations, and diabetes self-management in adolescents with type 1 diabetes. Journal of Developmental and Behavioral Pediatrics, 27, 98–105. https://doi.org/10.1097/00004703-200604000-00003
Institute of Medicine (U.S.). (2001). Crossing the quality chasm: A new health system for the 21st century. Washington DC: National Academy Press.
Kelly, C. S., Berg, C. A., Ramsey, M. A., Baker, A. C., Murray, M., Swinyard, M., et al. (2018). The role of social relationships in health care transition readiness in emerging adults with type 1 diabetes. Children’s Health Care, 47, 308–325. https://doi.org/10.1080/02739615.2017.1354294
King, P. S., Berg, C. A., Butner, J. E., Butler, J. M., & Wiebe, D. J. (2014). Longitudinal trajectories of parental involvement in type 1 diabetes and adolescents’ adherence. Health Psychology, 33, 424–432. https://doi.org/10.1037/a0032804
Lyons, S. K., Becker, D. J., & Helgeson, V. S. (2014). Transfer from pediatric to adult health care: effects on diabetes outcomes. Pediatric Diabetes, 15, 10–17. https://doi.org/10.1111/pedi.12106
Michie, S., Miles, J., & Weinman, J. (2003). Patient-centredness in chronic illness: What is it and does it matter? Patient Education and Counseling, 51, 197–206. https://doi.org/10.1016/S0738-3991(02)00194-5
Miller, K. M., Foster, N. C., Beck, R. W., Bergenstal, R. M., DuBose, S. N., DiMeglio, L. A., et al. (2015). Current state of type 1 diabetes treatment in the U.S.: Updated data from the T1D exchange clinic registry. Diabetes Care, 38, 971–978. https://doi.org/10.2337/dc15-0078
Monaghan, M., Helgeson, V. S., & Wiebe, D. J. (2015). Type 1 diabetes in young adulthood. Current Diabetes Reviews, 11, 239–250. https://doi.org/10.2174/1573399811666150421114957
Monaghan, M., Hilliard, M., Sweenie, R., & Riekert, K. (2013). Transition readiness in adolescents and emerging adults with diabetes: The role of patient-provider communication. Current Diabetes Reports, 13, 1–15. https://doi.org/10.3174/ajnr.A1650.Side
Muthén, L., & Muthén, B. (2012). Mplus user’s guide (7th ed.). Los Angeles: Muthén & Muthén.
Ng, J. Y. Y., Ntoumanis, N., Thogersen-Ntoumani, C., Deci, E. L., Ryan, R. M., Duda, J. L., et al. (2012). Self-determination theory applied to health contexts: A meta-analysis. Perspectives on Psychological Science, 7, 325–340. https://doi.org/10.1177/1745691612447309
Palmer, D. L., Osborn, P., King, P. S., Berg, C. A., Butler, J., Butner, J., et al. (2010). The structure of parental involvement and relations to disease management for youth with type 1 diabetes. Journal of Pediatric Psychology, 36, 596–605.
Peters, A. L., & Laffel, L. (2011). Diabetes care for emerging adults: Recommendations for transition from pediatric to adult diabetes care systems. Diabetes Care, 34, 2477–2485. https://doi.org/10.2337/dc11-1723
Ryan, R., & Deci, E. (2000). Self-determination theory and the facilitation of intrinsic motivation. American Psychologist, 55, 68–78. https://doi.org/10.1037/0003-066X.55.1.68
Schwandt, A., Hermann, J. M., Rosenbauer, J., Boettcher, C., Dunstheimer, D., Grulich-Henn, J., et al. (2017). Longitudinal trajectories of metaboliccontrol from childhood to young adulthood in type 1 diabetes from a large German/austrian registry: A group-based modeling approach. Diabetes Care, 40, 309–316. https://doi.org/10.2337/dc16-1625
Sheehan, A. M., While, A. E., & Coyne, I. (2015). The experiences and impact of transition from child to adult healthcare services for young people with Type 1 diabetes: A systematic review. Diabetic Medicine, 32, 440–458. https://doi.org/10.1111/dme.12639
US Medical Licensing Examination (USMLE). (2012). 2012 Step 2 CS content description and information for examinees testing for USMLE. Phi.
Van Dam, H., Van Der Horst, F., Van Den Borne, B., Ryckman, R., & Crebolder, H. (2003). Provider-patient interaction in diabetes care: Effects on patient self-care and outcomes—A systematic review. Patient Education and Counseling, 51, 17–28. https://doi.org/10.1016/S0738-3991(02)00122-2
Van Staa, A., Van Der Stege, H. A., Jedeloo, S., Moll, H. A., & Hilberink, S. R. (2011). Readiness to transfer to adult care of adolescents with chronic conditions: exploration of associated factors. Journal of Adolescent Health, 48, 295–302. https://doi.org/10.1016/j.jadohealth.2010.07.009
Weissberg-Benchell, J., & Shapiro, J. B. (2017). A review of interventions aimed at facilitating successful transition planning and transfer to adult care among youth with chronic illness. Pediatric Annals, 46, e182–e187. https://doi.org/10.3928/19382359-20170421-01
Weissberg-Benchell, J., Wolpert, H., & Anderson, B. J. (2007). Transitioning from pediatric to adult care: A new approach to the post-adolescent young person with type 1 diabetes. Diabetes Care, 30, 2441–2446. https://doi.org/10.2337/dc07-1249
Wiebe, D. J., Baker, A. C., & Marino, J. A. (in press). Medical systems and patient provider relationships. In A. M. Delamater & D. G. Marrero (Eds.), Behavioral diabetes: Ecological perspectives. New York, NY: Springer.
Wiebe, D. J., Chow, C. M., Palmer, D. L., Butner, J. E., Butler, J. M., Osborn, P., et al. (2014). Developmental processes associated with longitudinal declines in parental responsibility and adherence to type 1 diabetes management across adolescence. Journal of Pediatric Psychology, 39, 532–541. https://doi.org/10.1093/jpepsy/jsu006
Wiebe, D. J., Helgeson, V., & Berg, C. A. (2016). The social context of managing diabetes across the life span. American Psychologist, 71, 526–538. https://doi.org/10.1037/a0040355
Williams, G., McGregor, H., Zeldman, A., Freedman, Z., & Deci, E. (2004). Testing a self-determination theory process model for promoting glycemic control through diabetes self-management. Health Psychology, 23, 58–66. https://doi.org/10.1037/0278-6133.23.1.58
Williams, G. C., Freedman, Z. R., & Deci, E. L. (1998). Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care, 21, 1644–1651. https://doi.org/10.2337/diacare.21.10.1644
Williams, G. C., McGregor, H., Zeldman, A., Freedman, Z. R., Deci, E. L., & Elder, D. (2005). Promoting glycemic control through diabetes self-management: Evaluating a patient activation intervention. Patient Education and Counseling, 56, 28–34. https://doi.org/10.1016/j.pec.2003.11.008
Williams, G. C., Patrick, H., Niemiec, C. P., Williams, L. K., Divine, G., Lafata, J. E., et al. (2009). Reducing the health risks of diabetes: how self-determination theory may help improve medication adherence and quality of life. The Diabetes Educator, 35, 484–492.
Williams, G. C., & Zeldman, A. (2002). Patient-centered diabetes self-management education. Current Diabetes Reports, 2, 145–152.
Wong, J. C., Dolan, L. M., Yang, T. T., & Hood, K. K. (2014). Insulin pump use and glycemic control in adolescents with type 1 diabetes: Predictors of change in method of insulin delivery across two years. Pediatric Diabetes, 16, 592–599. https://doi.org/10.1111/pedi.12221
Acknowledgements
We thank Jessica Marino for help with manuscript preparation and Perrin White for helpful comments on the manuscript.
Funding
Deborah J. Wiebe and Cynthia A. Berg received grant support from the National Institute of Diabetes and Digestive and Kidney Diseases (Grant Number R01DK092939)
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Ashley C. Baker, Deborah J. Wiebe, Caitlin S. Kelly, Ascher Munion, Jonathan E. Butner, Michael T. Swinyard, Mary Murray and Cynthia A. Berg declare they have no conflict of interest.
Human and animal rights and Informed consent
All reported studies with human subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines). Informed consent was obtained from all individual participants included in these studies.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Baker, A.C., Wiebe, D.J., Kelly, C.S. et al. Structural model of patient-centered communication and diabetes management in early emerging adults at the transfer to adult care. J Behav Med 42, 831–841 (2019). https://doi.org/10.1007/s10865-019-00012-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10865-019-00012-9