Abstract
Introduction: Self-management behavior requires executive function
(EF; goal-directed behavior) skills. Behavior regulation (BR), a
subcomponent of EF has been linked to diabetes self-management.
Additionally, motivation may be key for changing and sustaining selfmanagement behaviors in youth with type 1 diabetes (T1D), but is
understudied in pediatric diabetes.
Objectives: Against the background of the Self-Determination Theory,
we investigated the dynamics between motivation of youth for selfmanagement, BR and HbA1c using network analyses.
Methods: Youth with T1D completed questionnaires. The SelfRegulation Questionnaire assessed motivation on three dimensions of
internalization (external regulation, introjection, identification) and a
rebellion scale. BR (inhibition, behavioral evaluation, emotion regulation, shift) was assessed by the Behavior Regulation Index (BRI) of
Executive Function (BRIEF) composite scale. Self-management was
assessed with the Diabetes Self-management Profile and by HbA1c.
Network analyses in R explored partial correlations between BR, motivation and self-management, controlling for all other connections.
Results: 134 youth (11-18 y/o) with T1D (mean age 14.4+2.1; 54%
female; mean HbA1c 7.4%+1.0) participated. In the network analyses
(Figure), BR was not directly linked to self-management; motivation
was shown to be a bridging concept. More BR-shift problems related
to more rebellion against self-management guidelines (r=0.2) and
more BR-inhibition problems to more external regulation of motivation (r=0.24). More identification with self-management guidelines
related to better self-management behavior (r = 0.24) and more rebellion to higher HbA1c (r=0.28).
Conclusions: Results uncovered the importance of the clinically wellknown concept of rebellion against diabetes self-management in its
associations with both BR as well as HbA1c. This emphasizes the
importance for families and clinicians to focus on motivation in youth
with T1D
(EF; goal-directed behavior) skills. Behavior regulation (BR), a
subcomponent of EF has been linked to diabetes self-management.
Additionally, motivation may be key for changing and sustaining selfmanagement behaviors in youth with type 1 diabetes (T1D), but is
understudied in pediatric diabetes.
Objectives: Against the background of the Self-Determination Theory,
we investigated the dynamics between motivation of youth for selfmanagement, BR and HbA1c using network analyses.
Methods: Youth with T1D completed questionnaires. The SelfRegulation Questionnaire assessed motivation on three dimensions of
internalization (external regulation, introjection, identification) and a
rebellion scale. BR (inhibition, behavioral evaluation, emotion regulation, shift) was assessed by the Behavior Regulation Index (BRI) of
Executive Function (BRIEF) composite scale. Self-management was
assessed with the Diabetes Self-management Profile and by HbA1c.
Network analyses in R explored partial correlations between BR, motivation and self-management, controlling for all other connections.
Results: 134 youth (11-18 y/o) with T1D (mean age 14.4+2.1; 54%
female; mean HbA1c 7.4%+1.0) participated. In the network analyses
(Figure), BR was not directly linked to self-management; motivation
was shown to be a bridging concept. More BR-shift problems related
to more rebellion against self-management guidelines (r=0.2) and
more BR-inhibition problems to more external regulation of motivation (r=0.24). More identification with self-management guidelines
related to better self-management behavior (r = 0.24) and more rebellion to higher HbA1c (r=0.28).
Conclusions: Results uncovered the importance of the clinically wellknown concept of rebellion against diabetes self-management in its
associations with both BR as well as HbA1c. This emphasizes the
importance for families and clinicians to focus on motivation in youth
with T1D
| Original language | English |
|---|---|
| Pages (from-to) | 157 |
| Journal | Pediatric diabetes |
| Volume | 22 |
| Issue number | Suppl 30 |
| Publication status | Published - Oct 2021 |