Monitoring of adolescents' behavior has been repeatedly identified as a predictor of adolescent behavioral outcomes. However, there are few measures of parental supervision and monitoring in the chronic illness literature. Ellis and coworkers described the development and evaluation of a measure of parental monitoring of the illness management of adolescents with diabetes: the Parental Monitoring of Diabetes Care scale (PMDC). Ninety-nine parents of 12-18-year-old children with type 1 diabetes completed the PMDC; measures of illness management and metabolic control were also obtained. The PMDC demonstrated good internal consistency (alpha coefficient = .81) and test-rest reliability (ICC = .80). Supporting the instrument's construct validity, confirmatory factor analysis indicated that a five-subdomain structure had an acceptable fit to the data. Parental monitoring as assessed by the PMDC had a significant direct effect on adolescent diabetes management, accounting for 38% of the variance. Parental monitoring also had a significant indirect effect on metabolic control.

WHAT THE STUDY MAY MEAN TO YOU. The authors concluded that the PMDC represents an important first step in the development of measures of parental monitoring for use with adolescents with chronic medical conditions. Perhaps the instrument has some value with a few adolescents who cannot self-monitor their chronic condition, but it goes against what we already know about the self-monitoring of their condition by chronically-ill children: if taught how to accurately observe and record information on themselves, children as young as 5 years of age can do an excellent job of monitoring a chronic condition. In doing so, the adolescents take responsibility for their condition, a matter that may last for years as chronic conditions require chronic self-management. Self-monitoring by adolescents also avoids the rebellious actions, e.g., noncompliance, that often occur in adolescent patients during this age span. The investment in the development and implementation of self-management programs, based on self-management, for this adolescents is certainly well worth the time and effort. It's a short-term investment that may yield dividends across a lifetime.

DA Ellis et al. The parental monitoring of diabetes care scale: development, reliability and validity of a scale to evaluate parental supervision of adolescent illness management. Journal of Adolescent Health, 2008;42:146-153.