Date of Award

Fall 2014

Document Type

Thesis - Restricted

Degree Name

Master of Science (MS)

Department

Clinical Psychology

First Advisor

Kaugars, Astrida

Second Advisor

Grych,John

Third Advisor

Van Hecke, Amy

Abstract

Health risk behaviors, like drinking alcohol or using tobacco, are a common problem among adolescents in the United States. For healthy adolescents, health risk behaviors may be hazardous to their health; for adolescents with chronic illnesses, the risks associated with these types of behavior are compounded and may further impact their health status. This is particularly true for adolescents with type 1 diabetes mellitus (T1DM), whose blood sugar may be directly impacted by consumption of alcohol or use of tobacco. Parent-child communication has been found to act as a protective factor against adolescent engagement in health risk behaviors; however, this relationship has not been explored within the context families raising an adolescent with T1DM. As such, the present study will examine the relationships among health risk behavior of adolescents with T1DM, aspects of maternal caregiver-female adolescent communication, diabetes management, and metabolic control. Fifty-four female caregivers and fifty-two female adolescents (ages 14-19) diagnosed with T1DM completed the study. Parents and adolescents completed questionnaires assessing adolescent lifetime and previous 12 month use of alcohol and cigarettes or tobacco, various aspects of communication, and adherence to diabetes management tasks. Additionally, adolescents' medical records were reviewed to collect most recent hemoglobin A1C (HbA1C values), which represent metabolic control during the past 2-3 months. In general, adolescents reported low rates of engagement in health risk behaviors. Results generally supported our hypotheses in that adolescents who reported lifetime or previous 12 month engagement in health risk behaviors had poorer parent- and self- reported treatment adherence; however, health risk behavior engagement was not associated with metabolic control. Additionally, parent- and adolescent-reported open and problem communication and parent-reported comfort with discussing risk behaviors were associated with and predicted adolescent-reported lifetime use of alcohol and cigarettes and previous 12 month use of alcohol. Together, aspects of parent- and adolescent-reported communication and adolescent health risk behavior engagement predicted parent- and adolescent-reported adherence to diabetes management tasks. Overall, present findings suggest that diabetes health care providers should discuss the potential impact of health risk behavior engagement on diabetes management and how the quality of parent-adolescent communication may influence adolescent health risk behaviors.

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