Relationships and health among emerging adults with and without Type 1 diabetes.

OBJECTIVE: The study's goal was to examine the impact of parent and peer relationships on health behaviors and psychological well-being of those with and without Type 1 diabetes over the transition to emerging adulthood. Emerging adulthood is an understudied developmental period and a high-risk period--especially for those with Type 1 diabetes. METHOD: Youth with (n = 117) and without Type 1 diabetes (n = 122) completed questionnaires during their senior year of high school and 1 year later. Measures included supportive and problematic aspects of parent and peer relationships, health behaviors, psychological well-being, and, for those with diabetes, self-care behavior and glycemic control. RESULTS: Prospective multiple and logistic regression analysis revealed that friend conflict was a more potent predictor than friend support of changes in health behaviors and psychological well-being. Parent support was associated with positive changes in psychological well-being and decreases in smoking, whereas parent control was related to increases in smoking and depressive symptoms. There was some evidence of cross-domain buffering such that supportive relationships in one domain buffered adverse effects of problematic relationships in the other domain on health outcomes. CONCLUSIONS: This longitudinal study showed that parent relationships remain an important influence on, and peer relationships continue to influence, the health behaviors and psychological well-being of emerging adults with and without Type 1 diabetes. Parent relationships also have the potential to buffer the adverse effects of difficulties with peers.

Early adolescent relationship predictors of emerging adult outcomes: youth with and without type 1 diabetes.

BACKGROUND: Emerging adulthood is a high-risk period for mental health problems and risk behaviors for youth generally and for physical health problems among those with type 1 diabetes. PURPOSE: The purpose of this study was to examine whether adolescents' relationships with parents and friends predict health and risk behaviors during emerging adulthood. METHOD: Youth with and without diabetes were enrolled at average age 12 and followed for 7 years. Parent and friend relationship variables, measured during adolescence, were used to predict emerging adulthood outcomes: depression, risk behavior, and, for those with diabetes, diabetes outcomes. RESULTS: Parent relationship quality predicted decreased depressive symptoms and, for those with diabetes, decreased alcohol use. Parent control predicted increased smoking, reduced college attendance, and, for control participants, increased depressive symptoms. For those with diabetes, parent control predicted decreased depressive symptoms and better self-care. Friend relationship variables predicted few outcomes. CONCLUSIONS: Adolescent parent relationships remain an important influence on emerging adults' lives.

Adolescents, parents and physicians: a comparison of perspectives on type 1 diabetes self-care.

OBJECTIVE: No research to date has compared the beliefs of adolescents, parents and physicians with respect to type 1 diabetes mellitus self-care perceptions and barriers. This study examined how adolescents with type 1 diabetes, their parents and physicians perceive 4 key diabetes self-care behaviours (testing blood glucose, taking insulin, exercise and diet) and what influences those behaviours. METHOD: Forty-eight adolescent/parent dyads and 21 pediatric endocrinologists rated importance, difficulty and proficiency for 4 self-care behaviours, and provided up to 5 perceived influences on these behaviours. We compared adolescents to parents and families to physicians. RESULTS: Groups rated all self-care behaviours as important, with taking insulin as most important. Families rated behaviours as relatively easy compared to physicians. All groups agreed that diet was both the most difficult self-care behaviour and the behaviour at which adolescents were least proficient. Although families rated teens as proficient overall, physicians disagreed. Adolescent and parent perception of diet difficulty was related to poorer glycemic control, and blood glucose testing and insulin administration proficiency were linked to better glycemic control. Compared to other groups, teens were especially likely to mention internal and hindering influences, and more likely to mention other people as negative influences. CONCLUSIONS: Although all groups agreed that all self-care behaviours are important, there are key areas of discrepancy in perceptions, particularly between families and physicians. Further research should connect the beliefs examined in this study to actual self-care behaviours.

Emerging adults with type 1 diabetes: a comparison to peers without diabetes.

OBJECTIVE: This longitudinal study compared emerging adults with and without type 1 diabetes on life path decisions, health behaviors, and psychological well-being during the transition out of high school. METHODS: Administered questionnaires during the senior year of high school and 1 year later to 117 emerging adults with diabetes and 122 emerging adults without diabetes. Comparisons were conducted with respect to health status, sex, and school status. RESULTS: Those with and without diabetes chose similar life paths and engaged in similar levels of risky behaviors, but disturbed sleep increased for males with diabetes only. Having diabetes was not associated with depressive symptoms, loneliness, or bulimic symptoms, but was associated with lower life satisfaction and lower life purpose over time. CONCLUSIONS: Emerging adults with and without diabetes fare similarly on most dimensions studied during the first year out of high school.

Spearcons (speech-based earcons) improve navigation performance in advanced auditory menus.

OBJECTIVE: The goal of this project is to evaluate a new auditory cue, which the authors call spearcons, in comparison to other auditory cues with the aim of improving auditory menu navigation. BACKGROUND: With the shrinking displays of mobile devices and increasing technology use by visually impaired users, it becomes important to improve usability of non-graphical user interface (GUI) interfaces such as auditory menus. Using nonspeech sounds called auditory icons (i.e., representative real sounds of objects or events) or earcons (i.e., brief musical melody patterns) has been proposed to enhance menu navigation. To compensate for the weaknesses of traditional nonspeech auditory cues, the authors developed spearcons by speeding up a spoken phrase, even to the point where it is no longer recognized as speech. METHOD: The authors conducted five empirical experiments. In Experiments 1 and 2, they measured menu navigation efficiency and accuracy among cues. In Experiments 3 and 4, they evaluated learning rate of cues and speech itself. In Experiment 5, they assessed spearcon enhancements compared to plain TTS (text to speech: speak out written menu items) in a two-dimensional auditory menu. RESULTS: Spearcons outperformed traditional and newer hybrid auditory cues in navigation efficiency, accuracy, and learning rate. Moreover, spearcons showed comparable learnability as normal speech and led to better performance than speech-only auditory cues in two-dimensional menu navigation. CONCLUSION: These results show that spearcons can be more effective than previous auditory cues in menu-based interfaces. APPLICATION: Spearcons have broadened the taxonomy of nonspeech auditory cues. Users can benefit from the application of spearcons in real devices.

Friends or foes? A review of peer influence on self-care and glycemic control in adolescents with type 1 diabetes.

OBJECTIVE: We reviewed studies published from 1990 to 2010 examining the relation of peer influence to diabetes outcomes for adolescents with type 1 diabetes. METHODS: We searched PsychInfo and MedLine databases and personal archives for studies meeting our criteria. 24 articles were included in the final review. RESULTS: Qualitative studies revealed that teens believe peers have an impact on diabetes behaviors, but quantitative findings are inconclusive. We found more evidence that social conflict was harmful than social support was helpful. Associations were more likely in studies that measured specific support and specific self-care variables. Studies addressing how individual differences interact with social context had promising findings. CONCLUSIONS: The literature linking peer relations to diabetes outcomes is mixed. Future research should consider moderator variables, expand the conceptualization of peer relationships, and consider interactions between person and social context.

Agentic and communal traits and health: adolescents with and without diabetes.

The authors examined whether agentic and communal traits are associated with relationship and health outcomes among adolescents with and without diabetes. They interviewed 263 teens (average age 12; 132 Type 1 diabetes; 131 healthy) on an annual basis for 5 years. The authors measured agency, communion, unmitigated agency, and unmitigated communion as well as parent and peer relationship quality, psychological distress, and diabetes health. In concurrent and lagged multilevel models, unmitigated communion and unmitigated agency were associated with poor relationship outcomes and greater psychological distress for those with and without diabetes. In lagged analyses, unmitigated communion predicted deterioration in diabetes health. Communion and agency were associated with positive relationship and health outcomes, with the former being stronger than the latter. These results underscore the need to focus on unmitigated agency and unmitigated communion when studying the implications of personality for health during adolescence.