Background
Family support is important in diabetes self-management. However, children as providers
of support have received little attention. This study examines the role of children
in their parents' diabetes self-management, diet, and exercise.
Methods
This research used community-based participatory research principles. Researchers
conducted semi-structured parallel interviews of 24 Latino and African-American adults
with diabetes and with a child (aged 10–17 years) in their home (2004–2006). Interviews
were transcribed, coded, and analyzed for themes (2004–2007).
Results
Adults and children perceived that children play many roles related to adults' diabetes
self-management. Parents described children as monitoring parents' dietary intake
and reminding them what they should not be eating. Some children helped with shopping
and meal preparation. Families described children reminding parents to exercise and
exercising with their parents. Children reminded parents about medications and assisted
with tasks such as checking blood sugar. Parents and children perceived that children
played a role in tempting parents to stray from their diabetes diet, because children's
diets included food that parents desired but tried to avoid.
Conclusions
Children and parents perceived that children have many roles in both supporting and
undermining adults' diabetes self-management. There is more to learn about the bi-directional
relationships between adults and children in this setting, and the most beneficial
roles children can play. Healthcare providers should encourage family lifestyle changes,
strengthen social support for families, and direct children toward roles that are
beneficial for both parent and child without placing an unreasonable level of responsibility
on the child.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The family and type 2 diabetes: a framework for intervention.Diabetes Educ. 1998; 24: 599-607
- The family and disease management in Hispanic and European-American patients with type 2 diabetes.Diabetes Care. 2000; 23: 267-272
- Is social support beneficial for dietary change?.Fam Community Health. 1997; 20: 70-82
- The influence of social support on chronic illness self-management: a review and directions for research.Health Educ Behav. 2003; 30: 170-195
- Children as carers: the impact of parental illness and disability on children's caring roles.J Fam Ther. 1999; 21: 303-320
- “In sickness and in health”: the development of alternative discourse in work with families with parental illness.J Fam Ther. 1999; 21: 267-283
- Parental illness and disability: a family systems framework.J Fam Ther. 1999; 21: 242-266
- The psychosocial impact of caregiving on young people who have a parent with an illness or disability: comparisons between young caregivers and noncaregivers.Rehabil Psychol. 2006; 51: 113-126
- Parental illness, family functioning, and adolescent well-being: a family ecology framework to guide research.J Fam Psychol. 2005; 19: 404-419
- Young carers: challenging the facts and politics of research into children and caring.Disability & Society. 1996; 11: 41-54
- Methods in Community-Based Participatory Research for Health.1st ed. Jossey-Bass, San Francisco CA2005
- Racial and Ethnic Approaches to Community Health (REACH) Detroit partnership: improving diabetes-related outcomes among African American and Latino adults.Am J Public Health. 2005; 95: 1552-1560
- What about the children?.Pub Health Nutr. 2008; 11: 427-436
- When adults with diabetes attempt to drink less soda: resulting adult-child interactions and household changes.J Natl Med Assoc. 2008; 100: 1004-1011
- Qualitative research and evaluation methods.Sage Publications, Thousand Oaks CA2002
- Focus on research methods: combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed-method studies.Res Nurs Health. 2000; 23: 246-255
- Focus on qualitative methods: sample size in qualitative research.Res Nurs Health. 1995; 18: 179-183
- Doing qualitative research.Sage Publications, Thousand Oaks CA1999
- Can addressing family relationships improve outcomes in chronic disease?.J Fam Pract. 2000; 49: 561-566
- The global spread of type 2 diabetes mellitus in children and adolescents.J Pediatr. 2005; 146: 693-700
- Grandmothers raising grandchildren: ethnic and racial differences in well-being among custodial and coparenting families.Journal of Family Issues. 2006; 27: 1605-1626
- Multi-level support for physical activity and healthy eating.J Adv Nurs. 2006; 54: 585-593
- The role of active family nutritional support in Navajos' type 2 diabetes metabolic control.Diabetes Care. 2003; 26: 2829-2834
- Social environment and regimen adherence among type II diabetic patients.Diabetes Care. 1988; 11: 377-386
- Social support among African-American adults with diabetes, part 2: A review.J Natl Med Assoc. 1998; 90: 425-432
- “They care but don't understand”: family support of African American women with type 2 diabetes.Diabetes Educ. 2004; 30: 493-501
- Social support in diabetes: a systematic review of controlled intervention studies.Patient Educ Couns. 2005; 59: 1-12
- Supporting autonomy to motivate patients with diabetes for glucose control.Diabetes Care. 1998; 21: 1644-1651
- Psychological issues and treatments for people with diabetes.J Clin Psychol. 2001; 57: 457-478
- Managing family support and dietary routines: type 2 diabetes in rural Appalachian families.Families, Systems, & Health. 2007; 25: 36-52
- Family and disease management in African-American patients with type 2 diabetes.Diabetes Care. 2004; 27: 2850-2855
- Influences on day-to-day self-management of type 2 diabetes among African-American women: spirituality, the multi-caregiver role, and other social context factors.Diabetes Care. 2000; 23: 928-933
- A literature review of the potential effects of having a parent with chronic renal failure.J Clin Nurs. 2008; 17: 98-105
- My child is not my carer: mothers with physical disabilities and the well-being of children.Disability & Society. 2004; 19: 209-223
- Relations between social support, appraisal and coping and both positive and negative outcomes for children of a parent with multiple sclerosis and comparisons with children of unhealthy parents.Clinical Rehabilitation. 2006; 20: 703-723
- Predictors of dietary change in Mexican American families participating in a health behavior change program.Am J Prev Med. 1988; 4: 194-199
- Developing and adapting a family-based diabetes program at the U.S.-Mexico border.Prev Chronic Dis. 2005; 2 (www.cdc.gov/pcd/issues/2005/jan/04_0083.htm): 1-9
- Can addressing family relationships improve outcomes in chronic disease?.J Fam Pract. 2000; 49: 561-566
- Help or hinderance?.Res Aging. 2007; 29: 375-409
- Adult children helping older patients: variations in likelihood and hours by gender, race, and family role.Res Aging. 2001; 23: 429-456
- Social support among African-American adults with diabetes, part 1: theoretical framework.J Natl Med Assoc. 1998; 90: 361-365
- Family support, diet, and exercise among older Mexican Americans with type 2 diabetes.Diabetes Educ. 2004; 30: 980-993
- Beliefs, fertility, and earnings of African American, Hispanic, and non-Hispanic white mothers.Hispanic J Behav Sci. 2008; 30: 299-323
- African American family dynamics as perceived by family members.J Black Stud. 2000; 30: 691-702
Article info
Identification
Copyright
© 2009 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
