1. Parent and Adolescent Discrepancies in Diabetes Self- Management By: Joanna Price Mentors: Dr. Ken Wallston and Dr. Shelagh Mulvaney

2. Themes  Adolescent self-management during transition from parent to self-care  Adolescent has more responsibilities  Discrepancy between parents and their adolescents  Communication about diabetes care

3. Research Questions  Does the degree of congruency between children’s and parents’ questionnaire responses relate to the HbA1c levels of the adolescent?  Will parent-child discrepancy on one questionnaire be associated with the amount of discrepancy on the other questionnaire?  Will the age and/or gender of the adolescent play a role in the amount of discrepancy between adolescents and their parents?

4. Participants and Measures  115 Parent-Adolescent Dyads Adolescents aged 13-17 years old Diagnosed with Type I Diabetes for at least 6 months Seen at the Vanderbilt Eskind Diabetes Clinic  Two Questionnaires  Baseline HbA1c Levels

5. Measures  Diabetes Behavior Management Survey How often adolescent carried out necessary diabetes self-management tasks  41 Questions  Problem Solving Behaviors Survey Ability of adolescents to deal with psychosocial self-management problems associated with Diabetes by solving problems  27 Questions

6. Variables  Mean Scores on each Questionnaire Psm, Csm, Pps, Cps  Simple Discrepancy Scores D_sm, and D_ps  Squared Discrepancy Scores D2_sm, and D2_ps  Child’s Age  Child’s Gender (0= male, 1= female)

7. Discrepancy Scores  Simple Discrepancy  Parent Mean- Child Mean for each survey question and then summed across items  Squared Discrepancy  (Parent Mean- Child Mean)^2 for each survey question and then summed across items

12. Results  The only questionnaire associated with HbA1c was the child’s rating of their problem solving ability (r = -0.21, p< 0.05). The higher the child’s self-rated ability to problem solve, the lower the HbA1c value (i.e., diabetes was in better control).

13. Results  Parent-child dyads were correlated across both questionnaires meaning that their degree of discrepancy on one questionnaire was significantly correlated with their degree of discrepancy on the other questionnaire for both the simple discrepancy scores (r = 0.46, p < 0.01) and the squared discrepancy scores (r = 0.36, p < 0.01).

14. Results  Adolescent’s gender was positively correlated with the problem solving simple discrepancy score (r = 0.20, p < 0.05), meaning that girls were more likely to be discrepant from their parents on the problem solving questionnaire  Adolescent’s gender was negatively correlated with the self-management squared discrepancy score (r = -0.26, p < 0.01), meaning that boys are more likely to be discrepant from their parents on the self- management questionnaire

15. Limitations and Future Directions Limitations  May not be representative of the whole population of adolescents with Type I Diabetes  Both questionnaires (self-management and problem solving) are correlated with each other Future Research  Ways to measure self-management  Using both types of discrepancy scores to test validity of results

16. Acknowledgements  Dr. Ken Wallston  Dr. Shelagh Mulvaney  Professor Craig Smith  My Classmates

17. D_sm= mean((Psm1-Csm1), (Psm2-Csm2), (Psm3-Csm3), (Psm4-Csm4), (Psm5-Csm5), (Psm6-Csm6), (Psm7-Csm7), (Psm8- Csm8), (Psm9-Csm9), (Psm10-Csm10), (Psm11-Csm11), (Psm12-Csm12), (Psm13-Csm13), (Psm14-Csm14), (Psm15-Csm15), (Psm16-Csm16), (Psm17-Csm17), (Psm18-Csm18), (Psm19-Csm19), (Psm20-Csm20), (Psm21-Csm21), (Psm22-Csm22), (Psm23-Csm23), (Psm24-Csm24), (Psm25-Csm25), (Psm26-Csm26), (Psm29-Csm29), (Psm30-Csm30), (Psm31-Csm31), (Psm32-Csm32), (Psm33-Csm33), (Psm34-Csm34), (Psm35-Csm35, (Psm36-Csm36), (Psm37-Csm37), (Psm38-Csm38), (Psm39- Csm39), (Psm40-Csm40), (Psm41-Csm41)) D2_sm= mean(((Psm1-Csm1)**2), ((Psm2-Csm2)**2), ((Psm3-Csm3)**2), ((Psm4-Csm4)**2), ((Psm5-Csm5)**2), ((Psm6- Csm6)**2), ((Psm7-Csm7)**2), ((Psm8-Csm8)**2), ((Psm9-Csm9)**2), ((Psm10-Csm10)**2), ((Psm11-Csm11)**2), ((Psm12- Csm12)**2), ((Psm13-Csm13)**2), ((Psm14-Csm14)**2), ((Psm15-Csm15)**2), ((Psm16-Csm16)**2), ((Psm17-Csm17)**2), ((Psm18-Csm18)**2), ((Psm19-Csm19)**2), ((Psm20-Csm20)**2), ((Psm21-Csm21)**2), ((Psm22-Csm22)**2), ((Psm23- Csm23)**2), ((Psm24-Csm24)**2), ((Psm25-Csm25)**2), ((Psm26-Csm26)**2), ((Psm29-Csm29)**2), ((Psm30-Csm30)**2), ((Psm31-Csm31)**2), ((Psm32-Csm32)**2), ((Psm33-Csm33)**2), ((Psm34-Csm34)**2), ((Psm35-Csm35)**2), ((Psm36- Csm36)**2), ((Psm37-Csm37)**2), ((Psm38-Csm38)**2), ((Psm39-Csm39)**2), ((Psm40-Csm40)**2), ((Psm41-Csm41)**2)) D_ps= mean((Pps1-Cps1), (Pps2-Cps2), (Pps3-Cps3), (Pps4-Cps4), (Pps5-Cps5), (Pps6-Cps6), (Pps7-Cps7), (Pps8-Cps8), (Pps9- Cps9), (Pps10-Cps10), (Pps11-Cps11), (Pps12-Cps12), (Pps13-Cps13), (Pps14-Cps14), (Pps15-Cps15), (Pps16-Cps16), (Pps17- Cps17), (Pps18-Cps18), (Pps19-Cps19), (Pps20-Cps20), (Pps21-Cps21), (Pps22-Cps22), (Pps23-Cps23), (Pps24-Cps24), (Pps25- Cps25), (Pps27-Cps27)) D2_ps= mean(((Pps1-Cps1)**2), ((Pps2-Cps2)**2), ((Pps3-Cps3)**2), ((Pps4-Cps4)**2), ((Pps5-Cps5)**2), ((Pps6-Cps6)**2), ((Pps7-Cps7)**2), ((Pps8-Cps8)**2), ((Pps9-Cps9)**2), ((Pps10-Cps10)**2), ((Pps11-Cps11)**2), ((Pps12-Cps12)**2), ((Pps13- Cps13)**2), ((Pps14-Cps14)**2), ((Pps15-Cps15)**2), ((Pps16-Cps16)**2), ((Pps17-Cps17)**2), ((Pps18-Cps18)**2), ((Pps19- Cps19)**2), ((Pps20-Cps20)**2), ((Pps21-Cps21)**2), ((Pps22-Cps22)**2), ((Pps23-Cps23)**2), ((Pps24-Cps24)**2), ((Pps25- Cps25)**2), ((Pps27-Cps27)**2)) Formulas