Developmental Expectations and Adolescent Type 1 Diabetes Management in Latino and Caucasian Families
Sundaram, Saranya Easwar
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BACKGROUND: Transfer of responsibility for diabetes management is important across adolescence. It may contribute to poorer adherence and family conflict if unmatched to adolescent development. Research has primarily studied Caucasian samples, which may have different expectations for autonomy compared to Latino samples. This study examined developmental expectations for independence in both general and diabetes-related tasks in age- and sex-matched samples of Caucasian and Latino youth with type 1 diabetes. SUBJECTS: Participants included 118 10- to 15-year-old Caucasian and Latino adolescents with type 1 diabetes [M (SD) = 13.24 (1.69) years; 54% female] and their mothers. METHOD: Participants independently completed questionnaires measuring expectations for independence, diabetes responsibility and conflict, and adherence to diabetes management. In addition, adolescents completed an inventory measuring depressive symptoms, and HbA1c levels were obtained through medical records. RESULTS: Mothers and adolescents held different expectations for the age at which adolescents should make independent decisions about general and diabetes-related activities. In the overall sample, adolescents expected independence at younger ages for prudential activities, but at older ages for diabetes activities than did parents. These mother-adolescent differences occurred in different domains across ethnicity; Caucasians displayed mother-adolescent differences in expectations for diabetes activities, while Latinos displayed differing expectations for prudential activities. In the overall sample, expectations were associated with mother-reported conflict, but were minimally correlated with parental diabetes responsibility. Younger age expectations for prudential items were associated with poorer diabetes outcomes, but age expectations for personal and diabetes items were generally unrelated to diabetes outcomes. In contrast to expectations, associations of developmental expectations with diabetes responsibility, conflict, and outcomes were similar across Caucasian and Latino youth. DISCUSSION: Findings support that there were differing age expectations between parents and adolescents in prudential and diabetes-related activities. Different factors may influence how these expectations were associated with parental responsibility, conflict, and diabetes outcomes.