PT  - JOURNAL ARTICLE
AU  - Hannah Case
AU  - David D Williams
AU  - Shideh Majidi
AU  - Diana Ferro
AU  - Mark Allen Clements
AU  - Susana R Patton
TI  - Longitudinal associations between family conflict, parent engagement, and metabolic control in children with recent-onset type 1 diabetes
AID  - 10.1136/bmjdrc-2021-002461
DP  - 2021 Oct 01
TA  - BMJ Open Diabetes Research & Care
PG  - e002461
VI  - 9
IP  - 1
4099  - http://drc.bmj.com/content/9/1/e002461.short
4100  - http://drc.bmj.com/content/9/1/e002461.full
SO  - BMJ Open Diab Res Care2021 Oct 01; 9
AB  - Introduction We prospectively investigated the associations between diabetes-related family conflict, parent engagement in child type 1 diabetes (T1D) care, and child glycated hemoglobin (HbA1c) in 127 families of school-age children who we recruited within the first year of their T1D diagnosis.Research design and methods Parents completed the Diabetes Family Conflict Scale-Revised (DFCS-R) to assess for diabetes-related family conflict and the Diabetes Self-Management Questionnaire-Brief (DSMQ-Brief) to assess parent engagement in child T1D care at the initial study visit (T1) and at 12 (T2) and 27 (T3) months later. We also collected child HbA1c at these time points. Our analyses included Pearson correlations and repeated measures linear mixed models controlling for child age, sex, and T1D duration at T1.Results Parents’ DFCS-R scores negatively correlated with DSMQ-Brief scores (r=−0.13, p<0.05) and positively correlated with children’s HbA1c (r=0.26, p<0.001). In our linear mixed models, parents’ DSMQ-Brief scores were unchanged at T2 (β=−0.71, 95% CI −1.59 to 0.16) and higher at T3 (β=8.01, 95% CI 6.89 to 9.13) compared with T1, and there was an association between increasing DFCS-R and decreasing DSMQ-Brief scores (β=−0.14, 95% CI −0.21 to −0.06). Child HbA1c values were significantly higher at T2 (β=0.66, 95% CI 0.38 to 0.94) and T3 (β=0.95, 95% CI 0.63 to 1.27) compared with T1, and there was an association between increasing DFCS-R scores and increasing child HbA1c (β=0.04, 95% CI 0.02 to 0.06).Conclusions Increasing diabetes-specific family conflict early in T1D may associate with decreasing parent engagement in child T1D care and increasing child HbA1c, suggesting a need to assess and intervene on diabetes-specific family conflict. Trial registration number NCT03698708.Data are available upon reasonable request. De-identified data that support the findings of this study are available from the corresponding author (SRP) upon reasonable request.