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Children's Roles in Parents' Diabetes Self-Management

  • Helena H. Laroche
    Correspondence
    Address correspondence and reprint requests to: Helena H. Laroche, MD, Division of General Medicine, University of Iowa, VA Medical Center, Mailstop 152, 601 Highway 6 West, Iowa City IA 52246
    Affiliations
    Department of Internal Medicine, University of Iowa, Iowa City, Iowa

    Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP), Health Services Research and Development, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
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  • Matthew M. Davis
    Affiliations
    Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan

    Child Health Evaluation and Research Unit, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
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  • Jane Forman
    Affiliations
    Center for Practice Management and Outcomes Research, Health Services Research and Development, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan
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  • Gloria Palmisano
    Affiliations
    Community Health & Social Services (CHASS) Center, Inc., REACH Detroit Partnership, Detroit, Michigan
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  • Heather Schacht Reisinger
    Affiliations
    Department of Internal Medicine, University of Iowa, Iowa City, Iowa

    Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP), Health Services Research and Development, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
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  • Cheryl Tannas
    Affiliations
    Department of Medical Education, University of Michigan, Ann Arbor, Michigan

    Community Health & Social Services (CHASS) Center, Inc., REACH Detroit Partnership, Detroit, Michigan

    Wayne State University, Detroit, Michigan
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  • Michael Spencer
    Affiliations
    School of Social Work, University of Michigan, Ann Arbor, Michigan
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  • Michele Heisler
    Affiliations
    Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan

    Center for Practice Management and Outcomes Research, Health Services Research and Development, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan

    Michigan Diabetes Research and Training Center, Ann Arbor, Michigan
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      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.
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