Electronic Theses and Dissertations

Date of Award


Document Type


Degree Name

Ph.D. in Pharmaceutical Sciences


Pharmacy Administration

First Advisor

Alicia S. Bouldin

Second Advisor

Karen A. Christoff

Third Advisor

Donna West-Strum

Relational Format



Objectives: To examine the impact of various psychosocial factors (perceived stress, diabetes-specific parental involvement, self-efficacy for diabetes management, and perceived peer support) on adolescents’ self-reported health-related quality of life (HRQoL) and assess the association between these factors and their self-reported HRQoL. To determine if differences in perceptions exist between diabetes camp and non-camp adolescent attendees on the various aforementioned psychosocial factors and their impact on their HRQoL. Methods: The study employed a cross-sectional, non-experimental, quantitative design to address the aforementioned objectives. Adolescents were recruited from multiple sites including diabetes summer camps and university-based and community-based private clinics. Self-administered paper-based surveys were administered to adolescents with T1DM by a member of the research team. Structural equation modeling was utilized to test the proposed study model and examine the relationships hypothesized therein. Results: The final model fit the data well and explained 49.1%, 40.4%, 59.1%, and 26.9% of the variance in physical, emotional, social and school functioning (i.e., domains of HRQoL) among adolescents with T1DM, respectively. Higher levels of perceived diabetes severity were found to be associated with higher levels of perceived stress and poorer HRQoL. Higher levels of self-efficacy for diabetes management were found to be associated with lower levels of perceived stress and better HRQoL. Lastly, higher levels of perceived stress were also associated with poorer HRQoL. No significant differences in the various illness perceptions that were assessed in this study or their impact on perceived stress and quality of life were found among adolescents with T1DM who frequent diabetes camps versus those who don’t (diabetes clinic population). Conclusion: This research addresses an important gap in the literature by clarifying the impact of various social-behavioral factors, which are amenable to intervention, on the HRQoL of adolescents with T1DM. The findings from this study will enable the delivery of more directed patient-centered care by providing insight to help improve the HRQoL of young people living with T1DM. It opens a window of observation in an area that has not been widely researched before -- social behavioral influences on comprehensive care for youth with T1DM, an underrepresented population.


Emphasis: Pharmacy Administration



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