Parental Involvement and Adolescents' Diabetes Management: The Mediating Role of Self-Efficacy and Externalizing and Internalizing Behaviors

Objective To examine mediating processes linking parental involvement to diabetes management (adherence and metabolic control) during adolescence. Methods A total of 252 young adolescents (M age = 12.49 years, SD = 1.53, 53.6% females) with type 1 diabetes reported their parents' involvement in diabetes management (relationship quality, monitoring, and behavioral involvement), their own externalizing and internalizing behaviors, diabetes-self efficacy, and adherence behaviors. HbA1c was drawn from medical records. Results SEM analyses indicated that the associations of mothers' and fathers' relationship quality with diabetes outcomes were mediated by adolescents' perceptions of self-efficacy and externalizing behaviors, and the associations of fathers' monitoring and behavioral involvement with adherence were partially mediated by adolescents' self-efficacy. There were also direct (non-mediated) associations between mothers' monitoring and adherence, and fathers' monitoring and adherence and metabolic control. Conclusions Quality of the parent-adolescent relationship and monitoring are important for better adherence and metabolic control among adolescents through higher diabetes self-efficacy.