Teens with Type 1 Diabetes: A Focus on Friendship

患有 1 型糖尿病的青少年：关注友谊

• 批准号: 10189569
• 负责人: VICKI S HELGESON
• 金额: $ 45.97万
• 依托单位: CARNEGIE-MELLON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-28 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10189569
• 关键词: Address; Adherence; Adolescence; Adolescent; Adult; Affect; American; Behavior; Behavioral; Blood Glucose; Caring; Cessation of life; Child; Chronic Disease; Conflict (Psychology); Development; Diabetes Mellitus; Diet Monitoring; Disclosure; Eating; Ecological momentary assessment; Enrollment; Exclusion; Exercise; Face; Failure; Family; Family Relationship; Friends; Friendships; Health; Health Care Costs; Heart Diseases; Hormones; Incidence; Insulin; Insulin-Dependent Diabetes Mellitus; Intervention; Kidney Diseases; Knowledge; Link; Literature; Measures; Mediating; Mediation; Mental Health; Methods; Monitor; Organ; Outcome; Parents; Perception; Personality Traits; Persons; Play; Procedures; Regimen; Research; Research Personnel; Retinal Diseases; Role; Seizures; Self Care; Self Disclosure; Social Environment; Surveys; Teenagers; Time; Unconscious State; United States; Well in self; Youth; adolescent health; base; behavioral health; commune; contextual factors; diabetes self-management; diet and exercise; distraction; eleventh grade; experience; family support; glycemic control; innovation; multilevel analysis; neglect; parental involvement; peer; peer influence; peer networks; physical conditioning; prevent; psychological distress; response; self esteem; self-neglect; social media; synergism; trait

Abstract Type 1 diabetes is one of the most common chronic diseases among children. Managing type 1 diabetes is a complicated, labor intensive effort as one has to monitor blood glucose levels throughout the day, monitor diet, exercise, inject insulin, and adjust insulin based on these activities. The failure to engage in appropriate self- care behavior is problematic as uncontrolled blood sugars can pose both short-term and long-term threats to health. Adolescence is characterized as a developmental period in which youth with type 1 diabetes face difficulties in maintaining good glycemic control, in part due to declines in self-care behavior. Much of the research aimed at this decline has focused on the family, but peer relationships are another important and neglected aspect of youth's social environment. Thus, the present proposal focuses on the role that friends play in the psychological, behavioral, and physical health of adolescents with type 1 diabetes. We have three specific aims: (1) to examine the relations of friend integration and friend conflict to psychological well-being and diabetes outcomes (self-care behavior, glycemic control); (2) to identify potential mechanisms that explain the link of friend integration and friend conflict to these outcomes; (3) to examine the trait of unmitigated communion (i.e., overinvolvement in others to the neglect of the self) as a moderator of the relations of friend integration and friend conflict to outcomes, predicting that links will be stronger for those high in unmitigated communion. We hypothesize that friend conflict will lead to increased psychological distress, distraction from self-care, failure to discuss diabetes, and the perception that friends will respond negatively to the enactment of diabetes self-care. Because the literature on the positive aspects of friendship to diabetes outcomes is mixed, we examine mechanisms for potential positive and negative relations. To the extent that friend integration is beneficial, potential mechanisms include positive affect, disclosure to friends about diabetes, and the perception that friends will respond positively to self-care. To the extent that friend integration is detrimental, potential mechanisms include vulnerability to friend influence and distraction. Because peer relationships occur in the context of family relationships, we also will examine the synergy between the two relationships. We will enroll 160 teens with diabetes in 9th through 11th grades and conduct an ecological momentary assessment (EMA) study over a 4-day period in which interactions with friends and family are assessed as well as previously noted mechanisms. EMA is an innovative method that allows one to tap ongoing experiences as they naturally unfold and to examine within-person variability in links of friend relations to outcomes. The procedure will be repeated 6 months later at yearend. Survey measures of variables will be assessed as a 2nd approach to address the same questions. Regression, multi-level modeling, mediation, moderation, and mediated moderation will be used. The research is highly significant in focusing on friends, using multiple methods, creating an innovative measure of friend knowledge, and employing a strong focus on mechanisms. 1

抽象的 1型糖尿病是儿童中最常见的慢性疾病之一。管理1型糖尿病是 复杂的，劳动密集型的努力，因为人们必须全天监测血糖水平，监测饮食， 根据这些活动运动，注入胰岛素并调整胰岛素。未能进行适当的自我 护理行为是有问题的，因为不受控制的血糖会构成短期和长期威胁 健康。青春期的特征是1型糖尿病青年人面对的发展时期 保持良好的血糖控制的困难部分是由于自我保健行为的下降。大部分 针对这种下降的研究集中在家庭上，但同伴关系是另一个重要的研究， 被忽视的青年社会环境方面。因此，本提案的重点是朋友扮演的角色 在患有1型糖尿病的青少年的心理，行为和身体健康中。我们有三个特定的 目的：（1）研究朋友融合和朋友冲突与心理健康的关系 糖尿病结局（自我保健行为，血糖控制）； （2）确定解释的潜在机制 朋友集成和朋友冲突与这些结果的链接； （3）检查未避免的特征 交流（即，在他人中过度忽视自我）作为朋友关系的主持人 整合和朋友冲突与结果的冲突，预测链接对于那些不容置疑的人会更牢固 圣餐。我们假设朋友冲突将导致心理困扰增加，分心 自我保健，未能讨论糖尿病以及对朋友将对制定作出负面反应的看法 糖尿病自我保健。因为关于友谊与糖尿病结果的积极方面的文献混杂在一起，所以 我们检查了潜在的正相关和负面关系的机制。在朋友整合的程度上 有益的潜在机制包括积极影响，向朋友披露糖尿病以及 人们认为朋友会对自我保健做出积极反应。在一定程度上，朋友融合有害， 潜在的机制包括对朋友影响和分心的脆弱性。因为同伴关系 发生在家庭关系的背景下，我们还将研究两种关系之间的协同作用。 我们将在9至11年级的160名青少年中注册160名青少年，并进行生态时刻 评估（EMA）在为期4天的研究中，对与朋友和家人的互动也进行了评估 如前所述。 EMA是一种创新方法，允许人们将持续的经验挖掘为 他们自然会展开并检查朋友关系与结果的联系内的内部变异性。这 程序将在6个月后的年度重复。变量的调查度量将被评估为第二 解决相同问题的方法。回归，多级建模，中介，适度和 将使用中介节制。这项研究在专注于朋友时非常重要，使用多个 方法，创造了对朋友知识的创新度量，并采取了强烈的关注机制。 1