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S24 Poster Abstracts / 48 (2011) S18–S120

Purpose: During the period of adolescence, many nutrientsare of critical importance for health and development. VitaminD and calcium both contribute to bone density gain. Addition-ally, folate is an important nutrient in females of reproductiveage in order to protect against neural tube defects. In order toappropriately counsel patients regarding proper nutrition,healthcare providers need to appreciate the preexisting foodpreferences of the patient population. This study sought toidentify existing sources of vitaminD, calcium, and folate in anurban female adolescent population in order to improve theeffectiveness of nutritional counseling for this population.Methods: Urban adolescent females aged 13-18 who wereengaged in a study of contraception were interviewed regard-ing their food intake for a 24-hour dietary recall. Values from4study visits over a periodof 12monthswere averaged to createa representative 24-hour intake. This list of food types andquantities were processed through the Nutrition Data Systemfor Research (NDSR) software package in order to generateestimated intake of a wide variety of nutrients. NDSR is acomprehensive database that includes complete data for 160nutrients and is considered the gold standard for research(Nutrition Coordinating Center, University of Minnesota, Min-neapolis, MN, version 2009). Logistic regression was per-formed using the average intake of calcium, vitamin D, andfolate as dependent variables and the list of foods consumed asthe independent variables. Stepwise regression, eliminatingvariables with p � .2, was conducted to create a parsimoniousmodel. Logistic regressionmodels were performed using Statav 9.2 (College Station, TX).Results: Reduced fat milk (p � .001) and refined loaf typebread (p � .011) were significantly associated with increaseddietary calcium intake. Lean poultry (p � .006), fried vegeta-bles (p� .001), and reduced fatmilk (p� .001)were associatedwith increased dietary intake of folate. Reduced fat milk alone(p � .001) was significantly associated with increased dietaryintake of vitamin D.Conclusions: These data suggest that in an inner city adoles-cent population, reduced fatmilk, refined loaf type bread, friedvegetables, and lean poultry are existing food sources thathave some nutritional value. While the overall benefits ofthese foods must be considered, these findings provide sup-port for endorsing consumption of these foods in order topromote adequate intake of calcium, folate, and vitamin D inthis patient population.Sources of Support: None.

13.

“HAVE YOU HAD THAT?” CONTROL AND RESPONSIBILITY INMEDICATION ADHERENCENicola Gray, PhD1, Cristine Glazebrook, PhD2,achel Elliott, PhD2, Jacky Williams3, Natasherafond, BS(Hons), PGCert SSRM, MSc2.

1University of Central Lancashire 2University ofottingham 3University of Warwick

Purpose: Of 11.6 million children aged less than 16 years inthe UK, 20% have chronic illnesses requiring long-term medi-cations. UKhealth service policy andpractice is departing frompaternalistic care models such that children with chronic ill-

ness are cared for in terms of medical, social, and educational J

eeds, in light of their own views and decision-making. Theim of this project was to explore issues that affect adherenceo medications, from the perspectives of young people andheir parents, and to describe their partnerships inmedicationaking. This work informs the development of a screening toolo identify challenges to adherence in the office setting.ethods: Four chronic illnesses were identified – asthma,ongenital heart disease, diabetes, and epilepsy - where theres evidence supporting use of medications above other treat-ent options, and over doingnothing, and inwhichhigh levelsf adherence are essential to ensure efficacy. Adolescents aged0-17 years were recruited for the research by primary carend hospital clinicians. Semi-structured face-to-face qualita-ive interviews were conducted separately with the youngerson and a parent/caregiver in their home. Interviews wereudio-recorded and transcribed verbatim. Anonymized tran-cripts underwent qualitative analysis using constant compar-son techniques: four researchers participated in the iterativeoding process. Adolescent and parent transcripts were ana-yzed as separate groups, and then the themes from eachroup were compared.esults: Eighteen adolescents aged 10-17 years, and a parent/aregiver for each, participated in the interviews. The adoles-ent and parent interviews shared several main themes: pa-ental control; transfer of responsibility; concerns aboutedications; and perceived necessity of the medication. With

egard to parental control of medication-taking, adolescentsalked about reliance on parents, and relief that they helpedhem during visits to providers, whilst also describing transferf responsibility. Parents felt control and responsibility foredications was part of their care giving duty. Parents feltressure from health providers to transfer responsibility, andome were not comfortable with exclusion from discussionsuring routine visits.onclusions: Parents are a major source of support for youngeople who are taking long-term medications, and this workeflects and highlights the natural tensions that occur in anylose partnership. Adolescents need to accept responsibilityor medication taking as they become independent from par-nts, in order to maintain therapeutic control as they enterdulthood. Sensitivity should be exercised, however, regard-ng the unintended pressure that providers might exert overhe timing of this transfer. It is accepted as good practice forroviders to seek time alone with adolescents during a visit,ut in situations where chronic illness is a concern for theamily, and where adherence challenges are evident, parentaleelings of exclusion may disrupt a crucial partnership. Betternderstanding of adolescent-parent dynamics in chronic ill-ess will help providers to meet the medication informationeeds of both parties in order to facilitate effective transfer ofesponsibility and ongoing good adherence.ources of Support: National Institute of Health Research -ervice, Delivery, and Organization (NIHR SDO), England.

14.

THE EFFECTS OF A COMPUTER-BASED DRIVING GAME ONHYPOGLYCEMIA EDUCATION AMONG ADOLESCENTS WITHTYPE-1 DIABETESNathan Stupiansky, PhD3, Anthony Faiola, PhD2,

oseph Defazio, PhD Instructional Systems