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Parent and adolescent distribution of responsibility for diabetes self-care: links to health outcomes.

OBJECTIVE
To examine the relation of adolescent and parent responsibility distribution for diabetes self-care to psychological and physical health.


METHODS
We interviewed children (mean age 12 years) annually for 3 years and asked parents to complete a questionnaire. Both reported how diabetes self-care was distributed in the family. Amount of responsibility held by the child only, the parent only, and shared between child and parent was calculated. Psychological distress, competence, and diabetes outcomes were assessed at each wave.


RESULTS
In both cross-sectional and longitudinal (lagged) analyses, multilevel modeling showed that shared responsibility was consistently associated with better psychological health, good self-care behavior, and good metabolic control, whereas child and parent responsibility were not. In some cases, links of shared responsibility to health outcomes were stronger among older adolescents.


CONCLUSIONS
These findings highlight the importance of shared responsibility for diabetes self-care through early to middle adolescence.