• Helena H Laroche, Matthew M Davis, Jane Forman, Gloria Palmisano, Heather Schacht Reisinger, Cheryl Tannas, Michael Spencer, and Michele Heisler.
• Department of Internal Medicine,Division of General Medicine, University of Iowa, VA Medical Center, 601 Highway 6 West, Iowa City, IA 52246, USA. Helena-laroche@uiowa.edu
• Am J Prev Med. 2009 Dec 1; 37 (6 Suppl 1): S251S261S251-61.

BackgroundFamily support is important in diabetes self-management. However, children as providers of support have received little attention. This study examines the role of children in their parents' diabetes self-management, diet, and exercise.MethodsThis research used community-based participatory research principles. Researchers conducted semi-structured parallel interviews of 24 Latino and African-American adults with diabetes and with a child (aged 10-17 years) in their home (2004-2006). Interviews were transcribed, coded, and analyzed for themes (2004-2007).ResultsAdults and children perceived that children play many roles related to adults' diabetes self-management. Parents described children as monitoring parents' dietary intake and reminding them what they should not be eating. Some children helped with shopping and meal preparation. Families described children reminding parents to exercise and exercising with their parents. Children reminded parents about medications and assisted with tasks such as checking blood sugar. Parents and children perceived that children played a role in tempting parents to stray from their diabetes diet, because children's diets included food that parents desired but tried to avoid.ConclusionsChildren and parents perceived that children have many roles in both supporting and undermining adults' diabetes self-management. There is more to learn about the bi-directional relationships between adults and children in this setting, and the most beneficial roles children can play. Healthcare providers should encourage family lifestyle changes, strengthen social support for families, and direct children toward roles that are beneficial for both parent and child without placing an unreasonable level of responsibility on the child.

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