Date of Award
Master of Science
Predicting long-term trajectories in HbA1c can inform interventions to improve health outcomes for those with type 1 diabetes (T1D) throughout the lifespan. Higher negative attributions of friends’ reactions (NAFR) while participating in health behaviors is related to higher anticipated adherence difficulties (AAD), higher diabetes-related stress (DS), and higher HbA1c, cross-sectionally. The purpose of the present study was to determine if these social information- processing variables can predict membership into empirically derived subgroups of longitudinal HbA1c trajectories in youth with T1D. One hundred ninety-five adolescents with T1D completed the Diabetes Stress Questionnaire and the Attributions of Peer Reactions scale. HbA1cs were extracted from medical records at three time points over one year. Growth mixture modeling was used to derive classes of HbA1c trajectories and determine if NAFR, AAD, and DS predict class membership, controlling for T1D duration. Three distinct classes emerged: High Decelerating HbA1c (intercept= 13.917, slope=3.768, quadratic=-2.867), Mid-High Decelerating HbA1c (intercept= 11.289, slope= nonsignificant, quadratic= .747), and Near-Optimal Accelerating HbA1c (intercept= 8.147, slope=-.376, quadratic=.590; ps <.01). NAFR and T1D duration were not significant predictors of latent class membership. Increased AAD predicted increased odds of being in the Mid-High vs. Near-Optimal group. Increased diabetes-related stress predicted increased odds of being in the High vs. Near-Optimal group. Higher AAD in imagined social situations and higher DS were associated with suboptimal glycemic control trajectories. Incorporating this knowledge into clinical treatment can allow providers to minimize the deleterious effects of negative peer cognitions and stress on long-term health outcomes in youth with T1D.
dissertation or thesis originally submitted to the local University of Memphis Electronic Theses & dissertation (ETD) Repository.
Keenan, Mary Elizabeth, "Social Information- Processing Variables Predict Hemoglobin A1c Trajectories in Youth with Type 1 Diabetes" (2019). Electronic Theses and Dissertations. 1976.