Principal investigator: Tonja R. Nansel, Ph.D.
A series of pilot studies are guiding the Prevention Research Branch program of research on management of childhood diabetes. Each of these studies is described below.

Developmental Influences on Management of Type 1 Diabetes
This longitudinal study examined the influence of family, social, and behavioral variables on diabetes self-management behaviors with a particular focus on adolescent developmental transitions. One goal of this study is to identify factors that predict adherence and glycemic control of youth during this transition period. Self-efficacy, maturity, family and social support, and attitudes toward diabetes management were assessed in a sample of 87 adolescents with type 1diabetes (ages 10 to 16) and their parents. Assessments were obtained at baseline, six months, 12 months, and 24 months.

Diabetes Personal Trainer Study
Participants in this study were recruited from two pediatric clinical sites: a university-affiliated clinic and a clinic housed in a pediatric hospital. A total of 81 youth (ages 11 to 16) with type 1 diabetes, along with a parent or guardian, were recruited and randomized to receive either educational materials or a "personal trainer" intervention. Based on principles of motivational interviewing and applied behavior analysis, the intervention included six in-person contacts over approximately two months supplemented with telephone contacts. The intervention protocol was administered by specially trained undergraduate and graduate students, who served as "diabetes personal trainers." They assisted youth to assess diabetes management practice difficulties and barriers, set goals for improving diabetes management practices, and engaged in problem-solving to meet these goals.

Transition from Pediatric to Adult Diabetes Care
The purpose of this pilot study is to examine diabetes self-management and psychosocial concomitants before, during, and after the transition from pediatric diabetes clinic to adult diabetes care. It includes: a survey of youth who are more than one year from turning 18 to determine their expectations regarding the transition; an assessment of the experiences of youth ages 18 to 22 who provide their retrospective views on the transition period; and a comparison of the experiences of youth in a pediatric clinic that involve an adult care physician in the transition to adult care with the experiences of youth in a matched clinic that provides the standard transition experience. It is expected that parents and children who have not been provided with a coordinated transition will have a poorer psychosocial profile and that there will be a decline in diabetes management and glycemic control relative to those youth who have a coordinated transition.

DESPR Collaborators

· Ronald J. Iannotti, Ph.D.
· Denise L. Haynie, Ph.D., M.P.H.
· Bruce Simons-Morton, Ed.D., M.P.H.

Nansel TR, Rovner A, Haynie DL, Iannotti RJ, Simons-Morton B, Wysocki T, Anderson B, Weissberg-Benchell J, & Laffel L. (In press). Development and validation of the Collaborative Parent Involvement scale. Journal of Pediatric Psychology.

Botello-Harbaum M, Nansel TR, Iannotti RJ, & Simons-Morton B. (In press). Parenting style and quality of life in youth with type 1 diabetes. Child: Care and Development.

Nansel TR, Iannotti RJ, Plotnick LP, Zeitzoff L, Simons-Morton B, & Cox C. (2007). Diabetes personal trainer outcomes: short-term and 1-year outcomes of a diabetes personal trainer intervention among youth with type 1 diabetes. Diabetes Care, 30, 2471-2477. PMC2365717 [Abstract]

Schneider S, Iannotti RJ, Nansel TR, Haynie DL, Simons-Morton B, Sobel DO, Zeitzoff L, Clark L, & Plotnick LP. (2007). Identification of distinct self-management styles of adolescents with type 1 diabetes. Diabetes Care, 30:1107-1112. [Abstract]

Iannotti RJ, Nansel TR, Schneider S, Haynie DL, Simons-Morton B, Sobel DO, Plotnick LP & Clark L. (2006). Assessing regimen adherence of adolescents with type 1 diabetes. Diabetes Care, 29:2263-2267. [Abstract]

Iannotti RJ, Schneider S, Nansel TR, Haynie DL, Plotnick LP, Clark LM, Sobel DO, & Simons-Morton B. (2006). Self-efficacy, outcome expectations, and diabetes self-management in adolescents with type 1 diabetes. Journal of Developmental and Behavioral Pediatrics, 27:98-105. [Abstract]