Children's Roles in Parents' Diabetes Self-Management
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.
aDepartment of Internal Medicine, University of Iowa, Iowa City, Iowa
bCenter 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
cDepartment of Internal Medicine, University of Michigan, Ann Arbor, Michigan
dChild Health Evaluation and Research Unit, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
eDepartment of Medical Education, University of Michigan, Ann Arbor, Michigan
fSchool of Social Work, University of Michigan, Ann Arbor, Michigan
gCenter for Practice Management and Outcomes Research, Health Services Research and Development, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan
hMichigan Diabetes Research and Training Center, Ann Arbor, Michigan
iCommunity Health & Social Services (CHASS) Center, Inc., REACH Detroit Partnership, Detroit, Michigan
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
ABSTRACT