The Role of Parental Monitoring in Adolescent Health Outcomes: Impact on Regimen Adherence in Youth with Type 1 Diabetes

TLDR

General warmth and support alone may be insufficient to help youth achieve adequate levels of adherence. The study aimed to assess whether parental monitoring of adolescent behavior predicts regimen adherence and metabolic control in type 1 diabetes, and to compare the predictive power of monitoring versus parental support among 99 adolescents and their caregivers. The authors used path analysis on data from 99 adolescents and their caregivers to test models where diabetes‑specific monitoring and support directly influenced regimen adherence and indirectly affected metabolic control, and where support moderated monitoring’s effect on adherence. Results showed that diabetes‑specific monitoring was directly linked to better regimen adherence, indirectly improved metabolic control through adherence, and that parental support did not independently predict outcomes but modestly moderated the monitoring–adherence relationship, indicating that close monitoring contributes to better adherence in adolescents with type 1 diabetes.

Abstract

To determine if parental monitoring of adolescent behavior was related to regimen adherence and metabolic control among adolescents with type 1 diabetes. An additional objective was to compare the relative importance of instrumental parenting behaviors such as monitoring to affective behaviors such as parental support as predictors of regimen adherence.Ninety-nine adolescents aged 12-18 years and their primary caregiver completed self-report questionnaires. Path analysis was used to test a model where diabetes-specific parental monitoring and support were predicted to have direct effects on regimen adherence and indirect effects on metabolic control via regimen adherence and an alternative model where parental support moderated the effects of monitoring on adherence.Diabetes-specific, but not general, monitoring was found to be associated with regimen adherence based on both parent and youth report. Monitoring had an indirect effect on metabolic control through regimen adherence. Although adolescent-reported parental support was significantly associated with regimen adherence in bivariate analyses, multivariate analyses indicated that parental support was not a significant independent predictor of health outcomes when parental monitoring was considered simultaneously. Modest support was also found for parental support as a moderator of the relationship between monitoring and adherence.Close parental monitoring of care completion can contribute to better adherence in adolescents with diabetes. General warmth and support in the absence of careful parental supervision may be insufficient to help youth achieve adequate levels of adherence.