The role of parental monitoring in adolescent health outcomes: impact on regimen adherence in youth with type 1 diabetes.

OBJECTIVE 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. METHOD 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. RESULTS 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. CONCLUSIONS 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.