Pathways Between Maternal Relationship Quality, Perceived Patient-Centered Communication, Self-Efficacy, and Type 1 Diabetes Management Among Early Emerging Adults
This study examined whether maternal relationship quality provides a context for patient-centered communication with providers leading to better type 1 diabetes management through self-efficacy among early emerging adults, and whether associations were stronger among those who transferred to adult care. Early emerging adults with type 1 diabetes one year post high school participated when 51% had transferred to adult care (N=203; 60% female; M age=18.81). On-line surveys measured perceived relationship quality with mothers, patient-centered communication with providers, self-efficacy for diabetes management, and adherence. Glycemic control was measured via HbA1c mail-in assay kits. Structural equation modeling indicated that higher maternal relationship quality was associated with higher patient-centered communication, which was indirectly associated with better adherence and glycemic control through self-efficacy; no moderation occurred by transfer to adult care status. Perceptions of patient- centered communication with providers occur in families with high mother relationship quality. These results suggest that the social context may be beneficial for early emerging adults’ diabetes management in part, because it contributes to higher self-efficacy among early emerging adults.