CHILDREN'S HOSPITAL MEDICAL CENTER
Grant: $29,639 - National Institutes of Health - Jul. 15, 2009
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Award Description: To our knowledge, no research group has conducted and analyzed direct observation of family interactions that focus on promotion of adolescent autonomy in the management of Type 1 diabetes and the relationship to treatment adherence in a prospective study. Designed to address these unmet scientific needs, this supplement has the following specific aims: 1) To code videotapes of parent-child interaction in a sample of adolescents with Type 1 diabetes (N=240) at baseline and one year outcome in order to assess family interactions, including support of adolescent autonomy and establish acceptable levels of inter-rater reliability. 2) To test a predictive model of family interactions that support adolescent behavioral autonomy, treatment adherence, and blood sugar control. The data that are derived from the analyses of data that facilitated by this supplement will have both scientific and clinical significance. This will be the first test of the hypothesis that parental promotion of behavioral autonomy as measured by direct observation predicts treatment adherence and blood sugar control. Predictors that are identified will be logical targets of family-centered intervention.
Project Description: Videotaped observations of mother-adolescent interaction during a problem-solving task were coded using the Autonomy and Intimacy Rating System. Adolescent behavioral autonomy was rated from the same problem solving task that will be used to assess family communication. The AIRS is a micro-analytic coding system that evaluates parent-child verbal and nonverbal communication patterns concerning the ways in which autonomy is negotiated in parent-adolescent relationships. Autonomy is expected to correlate with self-management and treatment adherence among adolescents with Type 1 diabetes. The PI supervised the coding procedures. Each 10 minute interaction sample were coded on the IBC and AIRS by two independent raters, who were blind to the purpose and hypotheses of the study. Coders were trained by watching an initial group of 3 videos and then discussing their results with Master's level study coordinators. To assist with proper coding and scoring using both types of coding systems, scoring databases were developed to automatically score the reatings. In addition, a form was developed to assist with the AIRS coding that provides the coder with specific coding instructions and a scoring sheet to track and assist with their ratings. In instances of low inter-rater reliability between the coder and study coordinator, the two coders met to discuss the video. Thus far, 240 tapes have been coded with each of two systems. They study will provide the first test of the hypotheses that direct observation of background autonomy will be related to treatment adherence and blook dugar control in Type 1 diabetes.
Jobs Summary: none (Total jobs reported: 0)
Project Status: More than 50% Completed
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