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Longitudinal Relationship between Depression and Diabetes Self-care in Minorities with Type 2 Diabetes

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posted on 11.06.2014 by Rosalba Hernandez
This study evaluates the longitudinal relationship between depressive symptoms, diabetes-related self-efficacy, and diabetes self-management. The primary aims were: (1) to examine whether diabetes-related self-efficacy mediates the relationship between depression and diabetes self-care in African American and Latino adults with type 2 diabetes; (2) after controlling for intervention assignment, to examine the longitudinal association between depressive symptoms and diabetes self-management (i.e., diabetes self-care performance levels and glycemic control) and to determine if individuals with higher baseline levels of depression are less likely to increase diabetes management (i.e., self-care behaviors and glycemic control) during 6-, 12-, and 18-month follow-up; and (3) to examine biopsychosocial factors that predict change in depressive symptomatology across time, after controlling for intervention assignment. Baseline in-person survey data were collected from African American and Latinos aged greater than or equal to 18 years with type 2 diabetes participating in a diabetes self-management intervention at four primary care clinics (n = 276). The sample (n = 276) had a mean age of 53.2 years; 69% were female; 54% African American and 46% Hispanic; and 74% reported incomes below $20,000. Analyses of baseline data revealed that depression was negatively correlated with the self-care behaviors of general diet, specific diet, physical activity, foot care, and smoking, with higher depression scores associated with lower self-care performance. In the African American subgroup, diabetes-related self-efficacy was an important construct in the relational pathway between depression and diabetes self-care. Longitudinal analyses using generalized estimating equations revealed an inverse association between depressive symptoms and non-disease-specific health behaviors of diet and physical exercise. The longitudinal predictors of depression consisted of two intrapersonal constructs of diabetes-related self-efficacy and diabetes distress. These findings suggest that among Latino and African American adults with type 2 diabetes, depression may adversely affect adherence to non-disease-specific health behaviors across time, but the mutable risk factors of elevated diabetes distress levels and diminished self-efficacy may be targets for public health interventions related to mental well-being.

History

Advisor

Prohaska, Thomas R.

Department

School of Public Health

Degree Grantor

University of Illinois at Chicago

Degree Level

Doctoral

Committee Member

Ruggiero, Laurie Chavez, Noel Peacock, Nadine R. Nouwen, Arie

Submitted date

2012-08

Language

en

Issue date

10/12/2012

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