Team Relationships Research Articles

Teamwork in community health committees: a case study in two urban informal settlements

BackgroundCommunity health committees (CHCs) are mechanisms for community participation in decision-making and overseeing health services in several low-and middle-income countries (LMICs). There is little research that examines teamwork and internal team relationships between members of these committees in LMICs. We aimed to assess teamwork and factors that affected teamwork of CHCs in an urban slum setting in Nairobi, Kenya.MethodsUsing a qualitative case-study design, we explored teamwork of two CHCs based in two urban informal settlements in Nairobi. We used semi-structured interviews (n = 16) to explore the factors that influenced teamwork and triangulated responses using three group discussions (n = 14). We assessed the interpersonal and contextual factors that influenced teamwork using a framework for assessing teamwork of teams involved in delivering community health services.ResultsCommittee members perceived the relationships with each other as trusting and respectful. They had regular interaction with each other as friends, neighbors and lay health workers. CHC members looked to the Community Health Assistants (CHAs) as their supervisor and “boss”, despite CHAs being CHC members themselves. The lay-community members in both CHCs expressed different goals for the committee. Some viewed the committee as informal savings group and community-based organization, while others viewed the committee as a structure for supervising Community Health Promoters (CHPs). Some members doubled up as both CHPs and CHC members. Complaints of favoritism arose from CHC members who were not CHPs whenever CHC members who were CHPs received stipends after being assigned health promotion tasks in the community. Underlying factors such as influence by elites, power imbalances and capacity strengthening had an influence on teamwork in CHCs.ConclusionIn the absence of direction and support from the health system, CHCs morph into groups that prioritize the interests of the members. This redirects the teamwork that would have benefited community health services to other common interests of the team. Teamwork can be harnessed by strengthening the capacity of CHC members, CHAs, and health managers in team building and incorporating content on teamwork in the curriculum for training CHCs.

Influence of emotional intelligence attributes on human resource management practices implementation in the Nigerian construction industry

Purpose The workforce upon which the construction industry relies, known as human resources (HRs), faces challenges such as poor management, inadequate implementation of human resource management practices (HRMPs) and psychosocial issues. This study aims to identify and assess the impact of emotional intelligence (EI) attributes on the implementation of HRMPs in the Nigerian construction industry (NCI) to enhance business performance as well as the performance and productivity of HRs. Design/methodology/approach A mixed-methods research design combining qualitative and quantitative approaches was used to gather expert perspectives on specific EI attributes. Data analysis involved the use of interquartile deviation, median, standard deviation, mean, Cronbach’s alpha and exploratory factor analysis (EFA). Findings The study identified 12 EI attributes that influenced HRMPs implementation, with 1 attribute having a very high impact (9.00–10.00) and 11 scoring high impact (7.00–8.99). Further analysis using EFA resulted in the identification of two major attribute clusters: “team relationship” and “self-management”. Practical implications These findings have significant implications for construction professionals, HRs and policymakers, as they address the challenges faced by construction stakeholders in terms of physical and mental well-being, which can affect their emotions while carrying out construction activities. Construction organizations should consider incorporating support systems into their policies to influence HRMPs implementation in the workplace. Originality/value The study provides valuable insights for developing nations such as Nigeria regarding the essential EI attributes for successful HRMPs implementation.

Impact of Emotional Intelligence on Job Performance: Evidence from the Employees of the Commercial Banks in Dhangadhi

The ability to recognize our feelings and those of others and manage emotions well in ourselves is the major contributing factor to employees’ performance. Emotional intelligence is relevant for predicting employees’ work performance because most jobs require the ability to manage emotions. The objective of the study is to examine the impact of emotional intelligence on employees’ performance in the commercial banks in Dhangadhi City. This study adopted quantitative research design and used descriptive as well as inferential statistical tool to analyze the data. 100 questionnaires were randomly administered to respondents out of which 82 were returned that were used for analysis. Regression analysis was used to analyze the collected data. The study revealed that there was a significant relationship between employees’ emotional intelligence and employee’s job performance. The coefficient of determination between EI and employees job performance was 82 percent. Similarly, the regression analysis also depicted that he emotional intelligence factors positively impacts the performance of employees in the organization. Hence, it is recommended that organization should introduce various training programs and developmental activities related to EI in their workplace for employees at every level in order to create better management of talent and performance on the one hand, and more effective team outcomes, service outcomes and relationship outcomes on the other.

Leaders’ induced justice perceptions as mediator of the relation between participative leadership behaviors and team learning

IntroductionIn today’s complex and changing business environment organizations need to learn and adapt to emerging circumstances. Teams can be a preferred vehicle to facilitate solving challenges that require diverse perspectives and expertise, collaboration, and knowledge sharing among members. To support team learning, organizations need to understand and promote an appropriate environment that facilitates learning within teams. By drawing on Fairness Theory and Social Exchange Theory, this study explores the role of leader-induced justice perceptions as a mediator in the relationship of participative leadership and team learning.MethodsUsing a split-half team survey methodology with a sample of 211 teams, the study analyzes the role of team justice climate as a mediation mechanism in the relationship between participative leadership behaviors and team learning.ResultsResults from structural equation modeling analyses suggest that, at a team level, participative leadership behaviors have both a direct association with team learning and are partially mediated by the team’s justice climate.DiscussionThis study contributes to existing literature by offering evidence that the perceptions of justice instilled by leaders play a role mediating participatory leadership and team learning. Moreover, the study supports the idea that leader induced justice perceptions can be considered as an aggregated construct at the team level. From a practical standpoint, the findings imply that team leaders can contribute to create an environment conducive to team learning by treating team members with fairness.

Flexible working arrangements as privilege or entitlement? Type of access to flexible working arrangements shapes reciprocal beliefs and social exchange relationships in hybrid work teams

Literature suggests that employees reciprocate the ‘privilege’ for flexible working arrangements (FWA) with higher effort. Drawing on social exchange theory, our interview study investigated how leaders shape members’ beliefs about the need to reciprocate the access to FWA. Based on 20 interviews nested in ten teams from two organisations, we analysed how FWA are perceived and negotiated between team leaders and their members, and whether low or high prevalence of FWA in teams plays a role for establishing social exchange relationships. The interviews took place prior to Covid-19. While in one organisation access to FWA was negotiated individually only due to a specific need, in the other organisation it was facilitated more easily and granting FWA had evolved as a social norm. Our findings indicate that in both contexts FWA indeed initiated social exchange relationships, as team members often tried to return the favour for access to FWA by maintaining the performance and/or by showing high flexibility. When FWA were granted to selected members only (low prevalence), ‘score-keeping’ and ‘quid-pro-quo exchanges’ were mentioned as important exchange rules in the accounts. In the organisation with high FWA prevalence, cooperative team routines showed that members felt the need to reciprocate the favour to other team members or the organisation rather than directly to the leader. However, even in this organisation, leaders were able to establish employees’ belief in privilege and their obligation to reciprocate in order for them not to lose access to FWA. Our findings show the role of the leader in shaping and instrumentalising FWA. The study has high practical relevance for hybrid teams and discusses the essential role of leaders in FWA.

Effects of COVID-19 pandemic on provision and use of maternal health services in Allada, southern Benin: a local health system perspective.

To assess the effects of the COVID-19 pandemic on the provision and use of maternal health services in southern Benin from a local health system perspective. We conducted a qualitative study from April to December 2021 in a health district in southern Benin. We interviewed health workers involved in antenatal, delivery, postnatal and family planning care provision, alternative and spiritual care providers, administrative staff of the district hospital, community health workers, adolescents and women who had given birth in the past six weeks in public health centers were interviewed. The World Health Organization health systems building blocks framework was used to guide the thematic analysis from a local health system perspective. The COVID-19 pandemic changed the lines of command and the institutional arrangements in the local health systems leadership; it put the interpersonal relationships in the health care provision team under stress and reduced the overall revenues of the district hospital. The motivation of allopathic health workers was undermined. Communities underutilized maternal health services in the COVID-19 period. Plausible causes included negative patient perceptions of COVID-19 measures taken at the public health facility level as well as well as fear of being forcibly vaccinated against COVID-19 in the health facilities. In times of health crises, appropriate local health system governance that integrates providers' concerns into effective guidelines is critical to reach and maintain a sufficient level of work motivation to ensure quality maternal health services.

A framework for developing team science expertise using a reflective-reflexive design method (R2DM)

Effective integration and implementation of knowledge in research are dependent on team science expertise grounded in collaboration principles and techniques that advance individual and group scientific agendas. The Science of Team Science (SciTS) provides evidence-based research and best practices that strive to develop scientists’ collaborative skills so that they can work across disciplinary boundaries while developing strong and diverse teaming relationships. Identifying the motivations of those involved in collaborative teaming can contribute to maximizing team effectiveness and applying the knowledge emerging from understanding these to shape teams’ adaptation of a shared mutual learning mindset as a core tenet of scientific teamwork. In addition, surfacing motivations has the potential of helping team members examine their own needs in relation to their scientific and career goals. In this paper we draw from the domains of the Motivation Assessment for Team, Readiness, Integration, and Collaboration (MATRICx) framework, Maslow’s Hierarchy of Needs motivational theory, and The Team Effectiveness Model for Science (TEMS) to develop a Reflective-Reflexive Design Method (R2DM) that focuses on the development of intra-personal attributes within the context of a team. Approaching expertise development from this design method invites individual reflection in the context of group reflexivity to serve as the cornerstone of deep team science expertise. We used a design thinking approach to identify a framework that merges individual reflection with group reflexivity. The core questions we asked are: (i) What constitutes expertise to succeed in science teams? and (ii) How might we approach the design of learning engagements that enable the development of the needed expertise?

Behavior Intervention Response Team: Piloting an Effective Means to Manage Patient- and Family-Disruptive Behaviors.

This article describes the development and implementation of a behavior intervention response team (BIRT). Pilot data indicate the successful implementation of BIRT interventions with patients and families and the positive staff response to these interventions. Patient- and family-disruptive behaviors are increasing in hospitals. Those behaviors arise from stress, financial burdens, and the mental weight of the patient's medical condition on the family. These distressed patients and their families tax an already overwhelmed staff, exacerbating the caregivers' exhaustion, depersonalization, and frustration. We recognized the need to proactively address these disruptions at our children's hospital with an interdisciplinary response. Disciplines engaged in the BIRT development included risk management, behavioral health, child life, service excellence, patient and family services, social work, and chaplaincy. Following multiple brainstorming sessions, we created a comprehensive, clear intervention strategy to engage with a disruptive patient or family. The BIRT was developed to work with both the family and their medical team to intervene at the first signs of potential disruption. With the BIRT, we were able to reduce disruptive behaviors and limit the subsequent removal of problematic individuals from the facility. Of the families who worked with the BIRT, 75.8% required no postintervention follow-up. The development of a BIRT can help head off disruptive behaviors and improve family-medical team relationships to support the highest quality and safest healthcare.

The Critical Review to Evaluate Performance of Ready-Mix Concrete Production Plant

In Republic of Iraq, ready-mix concrete production plants have been adversely affected by the lack of modern and advanced technology to assess their performance in line with technological advancements. Current evaluation methods rely on traditional approaches and financial measures, yielding unrealistic performance results. To address this problem, there is a need to utilize modern models and methods for performance evaluation. The study's main objective This was achieved by employing a literature survey methodology and utilizing digital databases such as the Iraqi Scientific Journals website, virtual libraries, and scientific platforms like ScienceDirect, Springer, Google Scholar, and Gate Research between 2015 and 2023. The research study provided a comprehensive overview of performance evaluation, including its definitions, importance, and an introduction to modern models and evaluation methods. The study found that no previous studies have been conducted in Iraq to evaluate ready-mix concrete production plants. However, four studies were found in Egypt, Sudan, and India. The previous similar relevant studies discussed various topics and related studies. Firstly, they discussed the classification, advantages, and disadvantages of concrete mixing plants. Additionally, the previous studies analyzed the factors that most influence the performance of concrete production plants, including laboratory manager efficiency, work team efficiency, communication and relationships within work teams, plant operator, material transportation method, and time and courses. Furthermore, the previous research studies present a comprehensive analysis of all variable data simultaneously using the statistical package for Social Science (SPSS) input stage. The evaluation also extends to the evaluation of laboratories, encompassing plant arrangement, internal quality control systems, and final product quality. The overall evaluation results of previous studies. Indicate that 75% of the concrete production plants failed to meet the required criteria, while only 25% demonstrated satisfactory performance. The study proposed improvements to enhance the performance rate of ready-mix concrete production plants by leveraging the most influential variables, which will be considered in the study.

The Role of Distance from Home to Hospital on Parental Experience in the NICU: A Qualitative Study.

Prolonged admission to the neonatal intensive care unit presents challenges for families, especially those displaced far from home. Understanding specific barriers to parental engagement in the NICU is key to addressing these challenges with hospital-based interventions. The objective of this qualitative study was to explore the impact of distance from home to hospital on the engagement of parents of very preterm infants (VPT) in the neonatal intensive care unit (NICU). We used a grounded theory approach and conducted 13 qualitative interviews with parents of VPT who were admitted ≥14 days and resided ≥50 miles away using a semi-structured interview guide informed by the socio-ecological framework. We used constant comparative method with double coders for theme emergence. Our results highlight a multitude of facilitators and barriers to engagement. Facilitators included: (1) individual-delivery preparedness and social support; (2) environmental-medical team relationships; and (3) societal-access to perinatal care. Barriers included: (1) individual-transfer stressors, medical needs, mental health, and dependents; (2) environmental-NICU space, communication, and lack of technology; and (3) societal-lack of paid leave. NICU parents with geographic separation from home experienced a multitude of barriers to engagement, many of which could be addressed by hospital-based interventions.

182 Pharmacists’ opinions on deprescribing Fall Risk Increasing Drugs in older people

Abstract Background Falls are prevalent in older adults and can be associated with medication use. Pharmacists play a role in deprescribing Fall Risk Increasing Drugs (FRIDs) and fall prevention. The aim of this study was to explore the factors that prevent or influence the process of deprescribing of FRIDs in older adults, from a pharmacist’s point of view. Methods Individual online semi-structured interviews, involving clinical pharmacists (CPs) who work with older adults in hospitals, were conducted. The interviews were steered by an interview guide based on the Theoretical Domains Framework (TDF) and interviews continued until saturation. The transcripts were coded using NVivo 12. Challenges and enablers were matched with possible behavioural change techniques, to identify potential future intervention strategies. Results Twelve senior CPs participated in the study (11 female and 1 male; years of practice range 5–30 years). Common challenges included: deprescribing FRIDs not being prioritised by medical teams; medication review is time-consuming; written recommendations to doctors not always read/actioned; fear of withdrawal symptoms; and follow up on patients after discharge is difficult. Deprescribing enablers included: building good team relationships, the belief that medication review is a shared responsibility, verbal being the most effective method of communication, medication review being a core part of pharmacists’ workload, and having the opportunity to review medication and monitor during the inpatient stay. Conclusion Work environment challenges and concerns about safety after discharge were considered significant barriers to deprescribing FRIDs in hospitals. Involving pharmacists in multidisciplinary teams in hospitals may facilitate deprescribing.

COMMUNICATIVE CULTURE AS A PROFESSIONAL VALUE OF YOUNG SPECIALISTS

The article highlights the problem of forming the communicative culture of students of higher education institutions. It is noted that in determining the professional qualities of young specialists, their communicative culture plays an important role as a set of professional qualities, moral values and communicative skills that are realized during communication. The essence of the concept of "communicative culture of a student" is determined and approaches to understanding the communicative culture of an individual and the main ways of its formation are considered. The importance of the problem of forming students' communicative culture in the process of learning native and foreign languages is proven. The necessity of forming a communicative culture of future specialists is substantiated. The content of the concept of competence in the professional training of young specialists is analyzed. The concept of communicative competence as a determinant of the formation of a person's communicative culture is revealed. The importance of communicative culture in professional education is outlined, as the presence of certain personal qualities, abilities and skills in each specialist, which ensure the achievement of goals in interpersonal interaction with other people, make it possible to communicate constructively, focus on success in professional activities, adapt to a new system of relationships in team, strive for self-improvement and self-realization.

Masculinity on ice: masculinity, friendships, and sporting relationships in midlife and older adulthood

ABSTRACT While researchers have established that young men’s sporting friendships are often structured by violence, minimal intimacy, competition, and the degradation of all things feminine (Messner, 1992b), we know relatively little about sporting relationships between older men. Drawing on interviews with and ethnographic research of older male hockey players in two Canadian cities, this article finds that while those in late midlife (ages 54–71) continue to enact patterns of male relationships associated with younger men, those in later life (ages 71–82) break with these masculine patterns. Instead, their team relationships involve joking about themselves in the locker room (instead of mocking others) and an ethic of care. Many defined true or close friendships as those which extended beyond sport. These findings suggest that men’s alignment with the dominant sporting masculinity of the young is not static over the life course and may wane in certain arenas as men reach later life.

Mental health nurses' experience of resilience during COVID-19: Aqualitative inquiry.

The COVID-19 pandemic created unprecedented demands and additional stress for nurses in mental health settings. There is no prior evidence on nurses' experience of building and maintaining resilience in the context of work during COVID-19. The aim of this study was to explore the experience and impacts of the COVID-19 pandemic on the resilience of nurses in mental health settings. Data from semi-structured interviews with 20 nurses from an Australian mental health service were analysed using reflexive thematic analysis. Four main themes were generated: experiencing significant disruptions; making sense of shared chaos; having professional commitment; and growing through the challenges. Nurses' practice and teamwork were disrupted by COVID-19 related changes to care models and infection prevention policies. They successfully adjusted by having awareness of self and others' emotions, using mental and emotional self-regulatory strategies, engaging in self-care, using 'bricolage' to create different ways to provide care, and having mutually supportive relationships. Nurses connected to their sense of purpose and professional commitment to fuel their therapeutic work and sustain care delivery. They experienced personal and professional growth with an increased understanding of their strengths and resilience. In the post-pandemic period, although the challenges presented by the pandemic have lessened, there are ongoing negative impacts on nurses' wellbeing. To maintain and strengthen their wellbeing and practice, the findings indicate the importance of professional development in emotional regulation skills, and strategies to strengthen self-care and build collegial relationships in teams. Resilience education can be implemented to support nurses' resilient practice skills.

A mindfulness perspective on the link between abusive supervision climate and team conflict

Purpose The purpose of this study is to examine whether and how abusive supervision climate impacts team conflict from a mindfulness perspective. Prior research has identified serious dysfunctional effects of abusive supervision climate in teams. Team conflict, which is often a signal for dysfunctional relationships in teams, has however received limited attention. To contribute to this line of research, this study develops and tests a theoretical model on the role of team mindfulness in understanding the link between abusive supervision climate and task, process, and relationship conflict. Design/methodology/approach To test the theoretical model, this study collected and analyzed two-wave time-lagged data from 499 employees in 92 teams. Findings The results showed that abusive supervision climate aggravated task conflict and process conflict via diminishing levels of team mindfulness. Abusive supervision climate also exacerbated relationship conflict, but the effects did not occur via a decrease in team mindfulness. Practical implications While it may not always be possible to prevent the development of an abusive supervision climate in workplaces, other interventions may prevent conflict in teams with abusive leaders. As indicated by the findings, task conflict and process conflict may be reduced if teams are high on mindfulness. Interventions that stimulate team mindfulness might thus improve collaboration in teams with abusive leaders. Originality/value This research offers novel insights regarding how abusive leaders might instigate conflict within teams. Specifically, through the unique perspective of mindfulness, the authors are able to offer new insights into how abusive supervision climate affects task, process and relationship conflict. This study offers a novel, yet important, lens to examine how conflict occurs in teams.

Top Management Triads: Role Theory and Top Team Relationships Following Chair and CEO Separation

Top Management Triads: Role Theory and Top Team Relationships Following Chair and CEO Separation

Work success and the physician-nurse professional relationship in emergency departments

Background. Considering the importance of physician-nurse relationship in emergency departments and its role in improving the quality of services, patient satisfaction, job success and staff satisfaction, this study was conducted to investigate nurses' attitude about the professional doctor-nurse relationship and career success of the nurses in emergency departments. Methods. This study is a descriptive study in which 197 nurses working in the emergency departments of hospitals affiliated to Tabriz University of Medical Sciences participated. Data collection tools included demographic characteristic; physician-nurse professional communication questionnaire and nurses' career success questionnaire. The collected data were analyzed using descriptive and inferential statistical tests with SPSS ver.21 statistical software. Results. The findings showed that the mean (SD) of the professional physician-nurse relationship from the perspective of participating nurses was 3.07 (0.54). Cooperating dimension with the mean score of 3.34 (0.79) had the highest score and imposing opinions and tasks dimension with the mean score of 2.62 (0.85) had the lowest score. Also, the mean (SD) score of nurses’ career success was 4.21 (0.40) with the highest mean in the dimension of system assistant 4.33 (0.55) and the lowest mean in the effective dimension 4.08 (0.41). Conclusion. Considering the importance of the professional physician-nurse relationship, it is necessary to pay more attention to the effective factors in its promotion by implementing interventions such as professional communication skills training and effective interaction in strengthening the professional relationship of the treatment team. Practical Implications. The results of this study can be used to improve professional communication between health care team members and their work success. As a result, in addition to increasing job satisfaction and improving the psychological condition of personnel, the safety of patients will also be increased and the amount of injuries caused by communication defects will be decreased.

Is it possible for the reception and the player-receiver to influence the offensive construction in volleyball? An ecological vision and Intragame procedural relationships in high-level teams

ABSTRACT The present study verified the differences in the offensive construction from the reception of the priority receivers in volleyball (libero, outsider hitter near and away from setter) through the Social Networks Analysis. The sample consisted of 3053 reception actions and 2743 attack actions of the 2018 Men’s Volleyball World Championship played between the eight best-ranked teams in this edition. The results showed that the attack organisation changed depending on the receiver condition, and the attack construction from the reception of the outside hitter near from setter when in zones 2, 3 and 4 presented an off-system characteristic. Thus, the ecological conditions, in which the offensive construction begins, specify the performance in high-level men’s volleyball and that different offensive constructions will generate adaptations in the defensive system and in the attack–defence relationships. Therefore, it is necessary for teams to be trained to play in- and off-system, as well as to self-organise for critical performance scenarios.

Influência da liderança clínica em enfermagem na qualidade e segurança dos cuidados: protocolo de scoping review

Introduction: The quality and safety of care is the degree of excellence resulting from the ability of health organizations to respond to people's needs and exceed their expectations. Clinical leadership is about demonstrating informal leadership in attitudes and skills. The clinical nurse leader performs in clinical practice and is recognized for its clinical skills and clinical experience, team building skills and relationships, and personal qualities that inspire peers. As a leader, the nurse designs and implements care, promotes the quality and safety of care and, therefore, influences the results that are sensitive to the clinical nursing practice. Objective: To map the available scientific evidence on the influence of clinical leadership in nursing on the quality and safety of care in hospital health organizations. Inclusion criteria: Primary studies that report the influence of clinical nursing leadership on the quality and safety of care in hospital health organizations. Methods: Scoping review protocol according to the method of the Joanna Briggs Institute. Published and unpublished studies, with a quantitative, qualitative, or mixed methods approach. Research strategy designed in three stages, with full search in MEDLINE Complete®, CINAHL Complete®, Web of ScienceTM, Scopus®, ProQuest Dissertations and Theses® and OpenGrey® search engines. The studies will be sorted by title and abstract, with subsequent analysis of the full text by two independent reviewers who will extract and categorize data according to the content. This research was registered in the Open Science Framework platform (https://doi.org/10.17605/OSF.IO/2EYAV).

673-P: Youth with Type 1 Diabetes and Elevated A1C during the Coronavirus Disease-2019 (COVID-19) Pandemic—Examination of Family, Caregiver, and Medical Team Factors

Introduction: A subset of youth with T1D experience avoidable health problems, but it is unclear how specific social factors relate to these problems, particularly during the COVID-19 pandemic. We examined how systemic factors (caregiver, family, medical team) were related to medical outcomes in youth with elevated A1c from five academic medical centers during the pandemic. Methods: Youth 12-17 yrs with 1) T1D for ≥1 yr and 2) A1c≥10% in the past year were enrolled. Caregivers and youth completed measures of family conflict (Diabetes Family Conflict Scale-R); parent practices, stress, and health literacy (Alabama Parenting Questionnaire, Stress Index for Parents of Adolescents, BRIEF Health Literacy Scale); youth strengths and social support (Diabetes Strengths and Resilience, PROMIS); and family-medical team relationship (Quality of Healthcare Relationship) with EHR review including baseline A1c and acute complications (e.g., ED visits). Results: Participants were 157 youth with mean age 14.6 ± 1.6 years and mean A1c 11.0% ± 1.9%. 51% self-identified as Non-Hispanic White. Caregiver, family, and relational factors were significantly (p<.05) related to frequency of complications and A1c, with higher family conflict associated with higher A1c (r=.23) and more ED visits (r=.18). For caregivers, low health literacy (r=.17), inconsistent discipline practices (r=.20), and high parental stress related to low adolescent achievement (r=.26), were significantly (p<.05) associated with acute complications, as was youth report of low social support (r=-.20, p<.01). Positive family-medical team relationship was strongly related to lower A1c (r=-.30, p<.01). Discussion: Given these findings, screening and intervention efforts should emphasize targeting multiple systems and relationships with this population of youth, potentially with increased focus on the family-medical team relationship. Disclosure D.V.Wagner: None. L.Yglecias: None. J.Flores garcia: None. A.Torres sanchez: None. A.Bonilla ospina: None. J.Raymond: None. M.A.Harris: None. M.Perry: None. M.A.Clements: Consultant; Glooko, Inc., Research Support; Dexcom, Inc., Abbott Diabetes. J.C.Wong: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc. D.Naranjo: None. A.Reed: None. C.Jenisch: None. C.Cruz: None. S.Mitchell: None. Funding JDRF