Predicting Health Resilience in Pediatric Type 1 Diabetes: A Test of the Resilience Model Framework

J Pediatr Psychol. 2015 Oct;40(9):956-67. doi: 10.1093/jpepsy/jsv061. Epub 2015 Jul 7.

Abstract

Objectives: This research examined whether individual and family-level factors during the transition from late childhood to early adolescence protected individuals from an increased risk of poor glycemic control across time, which is a predictor of future diabetes-related complications (i.e., health resilience).

Methods: This longitudinal, multisite study included 239 patients with type 1 diabetes and their caregivers. Glycemic control was based on hemoglobin A1c. Individual and family-level factors included: demographic variables, youth behavioral regulation, adherence (frequency of blood glucose monitoring), diabetes self-management, level of parental support for diabetes autonomy, level of youth mastery and responsibility for diabetes management, and diabetes-related family conflict.

Results: Longitudinal mixed-effects logistic regression indicated that testing blood glucose more frequently, better self-management, and less diabetes-related family conflict were indicators of health resilience.

Conclusions: Multiple individual and family-level factors predicted risk for future health complications. Future research should develop interventions targeting specific individual and family-level factors to sustain glycemic control within recommended targets, which reduces the risk of developing future health complications during the transition to adolescence and adulthood.

Keywords: diabetes; health promotion and prevention; longitudinal research; resilience.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Blood Glucose / analysis
  • Caregivers
  • Child
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / psychology*
  • Family Conflict
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Longitudinal Studies
  • Male
  • Models, Psychological*
  • Resilience, Psychological*
  • Self Care

Substances

  • Blood Glucose
  • Glycated Hemoglobin A