Defense Date


Document Type


Degree Name

Doctor of Philosophy


Clinical Psychology

First Advisor

Clarissa Holmes


The aim of the current study was to examine the associations among youth diabetes self-efficacy, family conflict, disease care and glycemic control via a comprehensive path model. Data were from a baseline assessment of a longitudinal RCT of 257 adolescent/parent dyads (adolescents aged 11–14). Each member of the dyad separately completed the Self-efficacy for Diabetes Self-Management Scale, Family Environment Conflict subscale, Diabetes Family Conflict Scale, Diabetes Behavior Rating Scale, and 24-hr Diabetes Interview Blood Glucose Frequency subscale. Additionally, a biological marker of glycemic control, or HbA1c, and relevant demographic variables were collected. A mediation model found higher youth diabetes self-efficacy mediated the link between lower family conflict and better disease care (β = -.08, p <.01) to glycemic control (β = .05, p <.05.). Further, the relation of higher self-efficacy to better glycemic control was mediated by better disease care (β = -.06, p <.05). Higher youth diabetes self-efficacy (β = -.16, p <.05), lower family conflict (β = .19, p <.001), and better disease care (β = -.17, p <.01) each were directly related to better glycemic control. The overall model with relevant demographic factors fit the data well [χ² (2) = .50, p = .78, CFI = 1.00, RMSEA= .00] and accounted for 13% of the variance in self-efficacy, 32% of the variance for disease care, and 25% of the variance in glycemic control. Interventions that target better youth diabetes self-efficacy and lower family conflict concurrently may promote better disease care and glycemic control.


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