The Division of Type 1 Diabetes Responsibility Between Mothers and Adolescents in Latinx and Non-Latinx White Dyads

• In Event: Poster Session 04
  In Poster Session: PS 04 Topic - Health, Growth, Injury

Abstract

Adolescence is a pivotal time for individuals with type 1 diabetes because diabetes management typically begins to decline during this period (Wiebe et al., 2016). Diagnoses of type 1 diabetes for Latinx youths in the U.S. have been increasing each year (Mayer-Davis et al., 2017) and literature is mixed regarding whether Latinx youth have worse diabetes management compared with other ethnic groups (Nicholl et al., 2019). Parental involvement in diabetes care can mitigate these declines. Specifically, collaboration between adolescents and family members is associated with better diabetes management (Wiebe et al., 2016). However, these studies were conducted with primarily Non-Latinx White (NLW) individuals. Shared responsibility for diabetes management may be particularly important in this population, as previous studies have found high levels of collaboration and familism with Latinx individuals (Alcalá et al., 2018; Knight et al., 2010).

We examined associations between diabetes responsibility and adolescent health in a sample of Latinx and NLW adolescents with type 1 diabetes and their mothers (N=118, adolescent age 10-15 years, 68% Latinx). We hypothesized that Latinx families would be more likely to share diabetes responsibility and less likely to report adolescent responsibility. We also hypothesized that shared responsibility would be associated with better health (lower glycemic control and higher adherence to diabetes regimens) while parent and adolescent responsibility alone would not.
Diabetes responsibility was measured using the Diabetes Family Responsibility Questionnaire (Anderson et al., 1990). Diabetes adherence was measured using parent and adolescent scores from Self-Care Inventory (Lewin et al., 2009). Glycemic control was measured using HbA1c values from the adolescent’s medical records; lower values indicate better glycemic control. Adolescent sex, age, insulin pump status, years since diagnosis, and socioeconomic status (SES) were controlled for in the analyses.
Latinx mothers reported more shared and less adolescent responsibility than NLW mothers after controlling for sex, age and SES (see Figure 1). Adolescent reports of diabetes responsibility were unrelated to ethnicity.

Adolescent-reported adolescent responsibility was associated with lower adolescent and parent-reported adherence (r = -.19 p = .045; r = -.24, p = .011). Adolescent-reported shared responsibility was associated with higher mother-reported adherence (r = .23 p = .017) while mother-reported shared responsibility was associated with higher adolescent and mother-reported adherence (r = .19 p = .046; r = .26, p = .005) After controlling for sex, age insulin pump status, years since diagnosis, and SES, mother-reported parent responsibility was associated with lower mother-reported adherence (β = -.34, p = .002), while mother-reported shared responsibility was associated with higher mother-reported adherence (β = .24, p = .018). The relationship between shared responsibility and adherence was only significant for the Latinx families (see Figure 2).

Consistent with hypotheses, findings indicate a positive association between adolescent health and shared responsibility, and a negative association between adolescent health and individual responsibility. In addition, results indicate that Latinx families are more likely to share diabetes responsibility than NLW families. Future investigations can focus on why Latinx families divide diabetes responsibility differently than NLW families.

Authors

• Abigail Bolter, University of California Merced
  Presenting Author

• Alexandra Main, University of California, Merced
  Non-Presenting Author

• Deborah Wiebe, University of California, Merced
  Non-Presenting Author

• Jennifer Raymond, Children's Hospital Los Angeles
  Non-Presenting Author

• Linda Cameron, University of California, Merced
  Non-Presenting Author