Diabetes Interaction Study: Communicating Understanding And Social Support

The current study evaluated a brief individualized feedback intervention developed to improve communication style of parents with an adolescent with type 1 diabetes. Seventy-nine parent-adolescent dyads (13-18 years) were randomized to receive a single session of brief feedback to target parental person-centered communication skills (n = 39) or to receive an educational comparison group (n = 40). Families were asked to discuss a diabetes related problem. A clinician concurrently rated the parent’s communication skills to identify communication strengths and weaknesses. Parents in the feedback group received feedback on their use of person-centered communication during the conversation using motivational interviewing techniques. Person centered communication included using reflections, affirmations and open-ended questions. Subsequently, each dyad was asked to discuss another problem with diabetes care to assess for change in parent communication skills. Video recordings were coded by 2 independent raters. Dyads also completed measures of perceived communication skill, perceived emotional support, self-efficacy, diabetes social support and diabetes related conflict prior to the clinic visits, before the first conversation, after the second conversation and at follow-up. The results suggest this randomized trial of brief individualized feedback to parents regarding their communication skills is effective in improving communication between parents and adolescents about diabetes management. The findings demonstrate that this type of feedback increased observed parental communication skill, particularly the use of reflections and open-ended questions in the conversations with their adolescent. The parental feedback also increased adolescents’ perceptions of empathy and intimacy in the conversation following the feedback. Adolescents also reported marginal improvements in diabetes self-efficacy following the feedback, compared to controls. A brief intervention to provide feedback to parents on their use of person-centered communication with their adolescent showed preliminary efficacy for increasing person-centered communication skills. Such positive communication has previously been shown to relate to improved diabetes management. Brief interventions are optimal for use in busy multidisciplinary pediatric clinics