Social Support for Adolescents with Diabetes: Support for Adolescents and Caregivers

Background and Purpose: Diabetes is a chronic illness with a very complex and demanding self-care regimen. However, previous social support research in this area has focused on the protective benefits of the social support adolescents receive from their family and friends and has not investigated the role of, social support for the caregiver. Study hypotheses were (1) that social support for the caregiver would positively impact both adolescents' perception of social support from their family and friends, characterized as social support within the adolescents' microsystems, as well as contribute to adolescents' illness management behavior (2) that social support within the adolescents' microsystem would relate positively to adolescent illness management behavior, after controlling for adolescent and caregiver demographics, and (3) that adolescents' microsystem support would mediate the relationship between social support and diabetes health, after controlling for adolescent and caregiver demographics.

Methods: Structural equation modeling (SEM) was used to test this model of social support. A total of 146 adolescents and their primary caregivers completed self-report measures of social support and illness management; health status was assessed via hemoglobin A1c (HbA1c), a laboratory blood draw. Participants were primarily African American, low-income, single-parent families.

Results: Results from the SEM analysis found partial evidence for hypothesis 1. Social support for the caregiver was positively related to microsystem support after controlling for the effect of adolescent age (.26, p<.01); however, social support for the caregiver was not related to adolescents' illness management behavior. Thus, caregivers who reported higher levels of social support from others had adolescents who reported higher levels of social support from family and friends (microsystem support). Hypotheses 2 and 3 were supported. Adolescents' microsystem support was positively related to adolescents' illness management behavior, after controlling for adolescent age, adolescent ethnicity, and type of diabetes (.22, p<.05). This suggests that higher levels of support from family and friends are related to higher levels of illness management behavior. Adolescent illness management behavior mediated the relationship between microsystem support and adolescent health status, after controlling for adolescent ethnicity and caregiver education (-.12, p<.05). This model explained 5% of the variance in illness management and 19% of the variance in adolescent health status.

Conclusions and Implications: Results from this study provide social workers providing care to families with an adolescent with diabetes an additional point of intervention. Introducing or bolstering the social support the caregiver receives from others for their child's diabetes care may have a beneficial impact on the social support environment in which adolescents perform their daily illness care. A more supportive daily care environment, in turn, may translate to better illness management and better diabetes health outcomes.