Family Perspectives of Components of a Diabetes Transition Program

To evaluate the perspectives of adolescent/parent dyads about a diabetes program on: (1) perception of knowledge, self-efficacy, importance of transition behaviors and ability to self-manage diabetes, (2) the congruency of knowledge and skills important for transition, (3) program specifics families determined helpful for transition, and (4) the relationship of adolescents' self-efficacy to self-management behaviors (SMB) and Hemoglobin A1C (HbA1C).

The individual and family self-management theory guided this prospective cross-sectional study. Sample included 45 dyads from a pediatric diabetes program. Dyads independently completed questionnaires related to knowledge, self-efficacy, the importance of specific diabetes knowledge and skills, and behaviors helpful for self-management and transition readiness. Analysis included frequencies, correlations, Cronbach's alpha, and paired t-tests.

Knowledge was high and self-efficacy even higher in the dyads. However, they did not agree on behaviors important for transition such as, knowing what the HbA1C should be, accurately counting carbohydrates, how to check ketones, how alcohol and drugs affect diabetes, or consistent documentation of blood sugar, carbohydrates and insulin doses. Adolescents indicated talking with providers and program materials as helpful, but attending regular visits and talking with parents as most helpful for transition. Adolescent and parent assessment of adolescent self-efficacy and self-management behaviors were strongly correlated. Family dyad's perceptions of adolescent self-efficacy were similar but not related to HbA1C.

A diabetes transition program has the opportunity to impact an adolescent's ability to self-manage their chronic illness by increasing self-efficacy and recognizing the strengths of the parent, adolescent and provider in the transition process.