Adolescents with and without Diabetes: Transition to Emerging Adulthood

描述（由申请人提供）：从青春期到成年早期的过渡是一个被忽视的研究领域，尽管出现的风险行为非常普遍，并且这些风险行为有可能引发一种行为模式，这种行为模式将持续整个成年期，并使一个人面临患慢性病的风险。这种转变对于青少年糖尿病患者来说更为关键，因为他们承担了自我护理行为的主要责任，并从儿科医疗保健系统中过渡出来。然而，人们对这种转变是如何发生的知之甚少。本研究的主要目的是研究有糖尿病和没有糖尿病的青年过渡到青年期对健康的影响，并比较两组之间的困难程度。为此，我们正在对患有糖尿病和没有糖尿病的青少年进行纵向研究，这些青少年在5-7年级时入学。因为我们每年都采访他们，所以我们有广泛的社会心理和医疗数据。这种竞争延续的主要目标是跟踪这些年轻人完成高中学业以及高中毕业后的头两年。我们将(a)描述糖尿病患者和非糖尿病患者的生活状况，并确定是否存在群体差异；(b)检查群体和时间对在原始研究中确定为重要的社会心理变量的影响：抑郁症状、饮食行为紊乱、躯体化和同伴关系；(c)审查群体和时间对与青年期有关且对健康至关重要的危险行为的影响：酒精、吸烟、饮食和活动；(d)研究时间和生活状况对青年糖尿病患者保健利用模式的影响。第二个目标是将父母关系的关键方面与两组的风险行为和心理健康结果以及糖尿病青年的保健利用和糖尿病结果联系起来。第三个目标是将目标1和目标2中规定的关键社会心理变量与同一组结果联系起来。我们将利用这项研究的结果来确定糖尿病是否以及何时影响重要生活选择的转变；抑郁症状，成年期糖尿病的重要合并症；饮食行为紊乱；以及对健康有重要影响的危险行为。对于患有糖尿病的青少年，我们将利用我们丰富的人口统计和社会心理数据来预测与卫生保健系统的接触，并确定哪些青少年有过早离开卫生保健系统的风险。

DESCRIPTION (provided by applicant): The transition from adolescence to early adulthood is a neglected area of research, despite the high prevalence of risk behaviors that emerge and the potential for these risk behaviors to set in motion a pattern of behavior that will persist throughout adulthood and put one at risk for chronic disease. This transition is even more critical for youth with diabetes as they assume primary responsibility for self-care behavior and transition out of the pediatric health care system. Yet, very little is known about how this transition occurs. The primary goal of this study is to examine the health implications of the transition to young adulthood for youth with and without diabetes and to compare the level of difficulties between the two groups. To this end, we are in the middle of a longitudinal study of adolescents with and without diabetes who were enrolled when they were in grades 5-7. Because we interview them every year, we have extensive psychosocial and medical data available. The primary goal of this competing continuation is to follow these youth as they complete high school and during the first two years after high school. We will (a) describe the life situations of those with and without diabetes, and determine if there are group differences; (b) examine the effects of group and time on psychosocial variables determined to be important in the original study: depressive symptoms, disturbed eating behavior, somatization, and peer relationships; (c) examine the effects of group and time on risk behaviors that are relevant to young adulthood and critical to health: alcohol, smoking, diet, and activity; and (d) examine the impact of time and life situations on the health care utilization patterns of youth with diabetes. A second goal is to link key aspects of the parent relationship to risk behaviors and mental health outcomes for both groups and to health care utilization and diabetes outcomes for youth with diabetes. A third goal is to link key psychosocial variables, as specified in aims 1 and 2, to the same set of outcomes. We will use the results of this study to determine if and when diabetes affects the transition in terms of important life choices made; depressive symptoms, an important comorbid condition of diabetes in adulthood; disturbed eating behavior; and risk behaviors that have important consequences for health. For youth with diabetes, we will use our wealth of demographic and psychosocial data to predict contact with the health care system and to identify youth who are at risk for leaving the health care system prematurely.