Exploring the role of motivational interviewing in adolescent patient-provider communication about type 1 diabetes

EXPLORING THE ROLE OF MOTIVATIONAL INTERVIEWING IN ADOLESCENT PATIENT-PROVIDER COMMUNICATINON ABOUT TYPE 1 DIABETES By Laura Jean Caccavale, M.S. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University, 2017 Major Director: Melanie K. Bean, Ph.D. Associate Professor Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University Co-Director: Rosalie Corona, Ph.D. Associate Professor Department of Psychology, Virginia Commonwealth University Type 1 diabetes (T1D) is one of the most common pediatric chronic illnesses. Glycemic control among patients with T1D often deteriorates during adolescence; yet little is known about the most effective way for providers to communicate with adolescents to prevent this decline. Given the importance of effective communication, examination of effective patient-provider communication strategies is needed. The current investigation used Motivational Interviewing (MI) as a framework to help characterize naturally-occurring adolescent patient-provider communication in medical encounters and examined the relations between provider communication and T1D self-management and control. Participants were five pediatric endocrine providers and 55 adolescents with T1D (49% female; 76% White; M age= 14.8 years, SD= 1.6). Mean T1D duration was 7.9 years (SD= 3.9) and mean baseline HbA1c was 8.58% (SD= 1.4). Adolescents and caregivers completed surveys related to diabetes self-management and psychosocial functioning at a routine endocrinology