November 19, 2009
BIRMINGHAM, Ala. - Both teens and their parents often have difficulty making the transition as teens take over management of their own diabetes. Now researchers from the University of Alabama at Birmingham (UAB) School of Nursing have received a grant from National Institute of Nursing Research to pilot a newly developed intervention to help ease families through the transition.
Professor Carol Dashiff, Ph.D., project principal investigator, said that self-management of Type 1 diabetes worsens and diabetes control declines across adolescence. Cognitive development during middle adolescence, ages 15 to 17, provides parents a unique opportunity to better enable adolescents to manage their diabetes, and this joint multifamily group-support program is designed to help adolescents develop - and parents support - the autonomy needed to accomplish that.
"One thing we know about that period is that there is great diversity in how adolescents self-manage, and parents often are at a loss for what to do to help them," Dashiff said.
Dashiff said the onset of Type 1 diabetes begins at school age or early adolescence, and as a result, parents are the chief managers of their child's diabetes for a long period of time. Parents are accustomed to having control, and they have difficulty with the transition because they do not know exactly how to be helpful to their teens. This intervention will help show them how to be helpful in a new way.
Teens encounter difficulty during this period, she said, because they are more socially active. They feel the onus of responsibility, and there are many distractions to self-management.
"Through this program, we're going to give the parents the framework to help their children make the transition to middle adolescence, and we're going to give the adolescent skills to make the transition, as well," Dashiff said.
In this study, 48 adolescents ages 15 to17 years with Type 1 diabetes and their parents will be enrolled; 24 families will be randomly assigned to the parental autonomy-support program, and 24 families will be assigned randomly to a placebo attention control.
In the study group, parents will be given information on transitioning responsibility, and then they will be asked to share their own experiences with one another and discuss how to use the tips given to them. The same approach will be taken with the adolescents.
"While adolescents do a very good job most of the time managing their disease, it is hard to sustain all of the time and they acknowledge that," Dashiff said. "We'll be talking with them about self-management, and we'll be sharing information to help them see the normality of what they are struggling with."
Dashiff said they will help adolescents and parents establish goals for themselves and bring them together at the end of the workshop to share them and talk about how they can support one another in meeting their goals.
Two intervention workshops will be conducted during a two-month period to provide face-to-face education and support and written materials; a telephone follow-up for education and support is included, and a baseline and two follow-up assessments also will be completed.
"We anticipate the results from this pilot study will provide data needed to plan a larger, more definitive, randomized trial on the effect of a parent-adolescent multifamily group interventions on adolescent self-management and diabetes control," Dashiff said
About the UAB School of Nursing
Building on a century of nursing education on the UAB campus, the UAB School of Nursing prepares nurse leaders to excel as clinicians, researchers, and educators and advances knowledge and the delivery of high-quality health care in Alabama and worldwide. The school offers leading-edge bachelors, graduate and doctoral programs, and offers the opportunity for students to learn with faculty and student teams from nursing, medicine, dentistry, health professions, public health and optometry.