Parenting and Type 1 Diabetes

育儿与 1 型糖尿病

• 批准号: 6961301
• 负责人: RANDI STREISAND
• 金额: $ 8.3万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-01 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6961301
• 关键词: behavior test; behavioral /social science research tag; caregivers; child psychology; clinical research; counseling; data collection methodology /evaluation; diabetes education; disease /disorder prevention /control; focus groups; health care; human subject; insulin dependent diabetes mellitus; middle childhood (6-11); parent offspring interaction; paternal behavior; patient care management; psychological adaptation; psychological stressor; self care; social psychology; statistics /biometry; therapy compliance

DESCRIPTION (provided by applicant): I am submitting this application to further the research plan and specific aims of my K23. In my K23, I am conducting a randomized controlled trial (RCT) of an enhanced parent-child diabetes education/counseling program to promote metabolic control/behavioral adherence among children with type 1 diabetes. In the intervention arm, families receive patient education and brief counseling regarding parents staying involved in their child's diabetes care. Preliminary data suggest that this is a salient component of the intervention and the information and skills taught resonate well with our parent subjects. However, clinical information has come to light underscoring the challenges some parents are experiencing with diabetes involvement. These challenges include overuse of ineffective parenting behaviors (e.g., coercion, poor supervision, rejection, harsh/inconsistent punishment), underuse of effective parenting behaviors (e.g., modeling of predictable and mature behavior, communicating clear expectations, limit setting, praise/reward), and the presence of psychological stress related to their child's diabetes. This information has raised questions regarding normal variations in parenting behavior and how these variations might be associated with their child's diabetes control. It has also raised questions about how parent psychological stress might be associated with their child's diabetes control. Thus, this application focuses on addressing the social and behavioral roles that parents play in managing their child's type 1 diabetes. Specifically, I am seeking to deepen my understanding of the interrelationships among parenting style (e.g., responsiveness and demandingness), pediatric parenting stress (i.e., stress associated with caring for a child with diabetes), and diabetes control (i.e., metabolic control and behavioral adherence). I will do this first (Phase I) by conducting a cross-sectional, descriptive investigation of these and other related factors in a clinical sample of N=120 parents of children ages 8-11 years with type 1 diabetes. Next, I will develop and pilot test a parenting adjunct to the ongoing RCT with N=10 parents (Phase II). This work will be conducted as an independent but related study to my K23 utilizing a different/not active pool of subjects. The institutional resources available to me at Children's National Medical Center and my established, productive working relationships with my Mentors all contribute to the feasibility of accomplishing these aims in a timely manner. The results of this R03 will ultimately be interpreted in light of the ongoing RCT's results. They will be used to guide and inform the development of a family management program which will subsequently be tested in an effectiveness trial (R01) to promote diabetes control among affected youth.

描述（由申请人提供）： 我将此申请提交进一步的研究计划和我的K23的具体目标。在我的K23中，我正在进行一项随机对照试验（RCT），以增强的亲子糖尿病教育/咨询计划，以促进1型糖尿病儿童的代谢控制/行为遵守。在干预部门中，家庭获得了患者的教育和简短的咨询，涉及父母继续参与孩子的糖尿病护理。初步数据表明，这是干预的重要组成部分，所教导的信息和技能与我们的父亲受试者产生了很好的共鸣。但是，临床信息已经揭示了一些父母在糖尿病参与中遇到的挑战。这些挑战包括过度使用无效的育儿行为（例如，胁迫，监督不良，拒绝，严厉/不一致的惩罚），没有有效的育儿行为（例如，对可预测和成熟行为的建模，清晰的期望，限制，限制/赞美/奖励）以及与孩子的糖尿病相关的存在。这些信息引发了有关育儿行为正常变化以及这些变化如何与孩子的糖尿病控制有关的问题。它还提出了有关父母心理压力如何与孩子的糖尿病控制相关的问题。因此，该应用程序着重于解决父母在管理孩子的1型糖尿病中发挥的社会和行为作用。具体而言，我正在寻求加深对育儿风格之间相互关系（例如，反应性和要求的），小儿育儿压力（即与照顾糖尿病儿童相关的压力）和糖尿病控制（即代谢控制和行为坚持）相关的相互关系的理解。我将通过对n = 120名8-11岁儿童患有1型糖尿病的儿童的临床样本中的这些和其他相关因素进行横截面，描述性研究。接下来，我将开发并进行试验测试持续的RCT的育儿辅助，n = 10个父母（II阶段）。这项工作将作为对我的K23进行独立但相关的研究，利用不同的主题库。我在儿童国家医疗中心提供的机构资源以及我与我的导师建立的，富有成效的工作关系都有助于及时实现这些目标的可行性。该R03的结果最终将根据正在进行的RCT结果来解释。他们将用于指导和告知家庭管理计划的制定，该计划随后将在有效试验（R01）中进行测试，以促进受影响青年的糖尿病控制。