Anna Maria Patiño-Fernández

Neurocognitive functioning in preschool-age children with type 1 diabetes mellitus

Patiño‐Fernández AM, Delamater AM, Applegate EB, Brady E, Eidson M, Nemery R, Gonzalez‐Mendoza L, Richton S. Neurocognitive functioning in preschool‐age children with type 1 diabetes mellitus.

Measurement of diabetes stress in older children and adolescents with type 1 diabetes mellitus

Studies indicate general psychological stress plays a role in the glycemic control of individuals with type 1 diabetes mellitus (T1DM). Disease‐specific rather than general measures may be more closely related to measures of health outcomes. Therefore, measurement of diabetes‐related stress is needed to advance knowledge of significant relationships between stress and glycemic control. The objective of this study was to evaluate the psychometric properties of a measure of diabetes‐related stress for youth with T1DM.

School-Based Health Promotion Intervention: Parent and School Staff Perspectives.

BACKGROUND The prevalence of childhood obesity is high, particularly among minority youth. The objective of this article was to evaluate parent and school staff perspectives of childhood health and weight qualitatively to guide the development of a school-based obesity prevention program for minority youth. METHODS Hispanic parents (N = 9) of first graders participated in 1 of 3 focus groups, consisting of 3 parents each. School staff (N = 7) participated in 1 focus group. All sessions were digitally recorded and transcribed verbatim. Using NVivo, 2 independent coders rated the transcriptions to identify themes and a third coder addressed commonalities and discrepancies in the coding schemes. RESULTS Parents and school staff have conflicting views over whose responsibility it is to provide nutritional education and participation in physical activity (PA). Parents felt the school should teach children about healthy nutrition, provide guidance in the cafeteria, and offer more structured PA in school. In contrast, school staff noted that parents have the primary responsibility of ensuring children get adequate nutrition and PA. CONCLUSIONS Despite contrasting views, parents and staff agreed with the need for comprehensive school-based obesity prevention efforts emphasizing parent and teacher collaboration to promote healthy school and home environments.

Measurement of Parental Self-Efficacy for Diabetes Management in Young Children

Self-efficacy is an important construct in diabetes management, especially for parents of young children. The Parental Self-Efficacy Scale for Diabetes Management (PSESDM) was adapted from the Perceived Diabetes Self-Management Scale (PDSMS) to measure parental self-efficacy for diabetes management of young children. The PSESDM was administered to 49 primary caregivers of youth between 2–9 years of age with type 1 diabetes (T1D). Cronbach’s alpha for the 8-item measure demonstrated adequate internal consistency (α = 0.84). Criterion-related validity was established. Higher scores on the PSESDM were associated with better glycemic control and quality of life in children. These preliminary findings provide support for the reliability and validity of the PSESDM, which may be a useful screening measure of diabetes-related parental self-efficacy for young children.

A Prospective Study of Weight and Metabolic Syndrome in Young Hispanic Children

This study examined weight in young Hispanic children over a 2-year period and investigated the relations among overweight, physical activity (PA), caloric intake, and family history in the development of the metabolic syndrome (MS). Forty-seven children (ages 5–8) from diverse Hispanic backgrounds recruited from elementary schools were evaluated. Laboratory analyses, anthropometric data, and measures of PA and caloric intake were included. The majority of the children were overweight at baseline (66%) and at follow up (72%). Children who were overweight at baseline were more likely to exhibit MS at follow up than were those who were not overweight at baseline. Overweight appears to be an independent predictor of MS among Hispanic children.

Clinic attendance and health outcomes of youth with type 2 diabetes mellitus

Abstract This study assessed whether clinic attendance was related to health outcomes for youth with type 2 diabetes mellitus (type 2 DM). Medical records of pediatric patients with type 2 DM were retrospectively reviewed. Clinic attendance was much more infrequent than recommended by physicians, and 42% of the sample withdrew from medical care. Patients who had a history of not showing during appointments had higher HbA1c levels than those who attended regularly scheduled visits; however, contrary to our hypotheses, average number of clinic visits was not associated with HbA1c levels or zBMI. Given the increased risk for health complications, new strategies are needed to keep patients engaged with medical care.

Intrinsic motivation in ethnic minority youth with type 1 diabetes

ABSTRACT Increasing intrinsic motivation (IM) may be an effective way to improve regimen adherence and glycemic control in youth with type 1 diabetes (T1D). This preliminary study evaluated the reliability and validity of a new measure of intrinsic motivation for diabetes management for ethnic minority youth with T1D. The 12-item Intrinsic Motivation Inventory for Diabetes Management (IMI-DM) was developed to assess perceptions of confidence in and the importance of engaging in self-care behaviors for diabetes management. Participants included 51 11–16 year-old minority adolescents (mean age = 13.5 years) with T1D and their parents. The IMI-DM demonstrated excellent internal consistency (α = 0.92). Higher IM was associated with better diabetes self-management behaviors and glycemic control, better youth self-concept, less depression and family conflict, and greater youth responsibilities for diabetes management. These findings provide preliminary support for the reliability and validity of a new diabetes-specific IM measure for youth with T1D, and identified some key individual and family factors that may be important to consider in interventions to improve regimen adherence and glycemic control in minority youth with T1D.

Neurocognitive and Psychological Correlates of Metabolic Syndrome in Childhood

A considerable amount of research has been conducted in recent years concerning metabolic syndrome in children and adolescents. Even though many studies have found that components of the metabolic syndrome cluster in children and adolescents, few have examined the role of psychosocial and neurocognitive factors in risk factor clustering. The purpose of this chapter is to review findings related to psychosocial and neurocognitive functioning in children identified as having metabolic syndrome.