title: Correlates of elevated depressive symptoms among rural African American adults with type 2 diabetes.
abstract: OBJECTIVE
  The study objective was to examine the health-related and sociocontextual correlates of elevated depressive symptoms among rural African American adults with type 2 diabetes mellitus.
  
  
  METHODS
  Cross sectional, observational study.
  
  
  METHODS
  Rural communities in central Georgia, United States.
  
  
  METHODS
  African American patients with type 2 diabetes mellitus (N = 200) were recruited from eight rural counties in Georgia by using community-based procedures.
  
  
  METHODS
  Participants were assessed on demographics (age, sex, and education), diabetes-related characteristics (health status, time since diagnosis, blood glucose control problems, and hemoglobin A1C level), and psychosocial variables (financial stress, community disadvantage, community support, social support, and patient-healthcare provider relationship quality). Elevated depressive symptoms, as assessed via the Center for Epidemiologic Studies-Depression scale, constituted the dependent variable.
  
  
  RESULTS
  Elevated depressive symptoms were present in 30% of the sample. Multiple logistic analysis of the contributors to depression predicted 57% of the variability in depression. Sex, neighborhood disadvantage, health status, hyperglycemic symptoms, social support, and patient-healthcare provider relationship quality predicted depression in multivariate analyses.
  
  
  CONCLUSIONS
  Both health-related and psychosocial stressors contribute to depressive symptoms among rural African Americans. Problems in patient-healthcare provider relationships may impede identification of depressive symptoms among these patients. Providers require training and support to identify and treat depression among rural African Americans.
authors.affiliation: Center for Family Research, University of Georgia, Athens, Georgia, USA. smkogan@uga.edu
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kogan
authors.forename: Gene H
authors.initials: GH
authors.lastname: Brody
authors.forename: Connie
authors.initials: C
authors.lastname: Crawley
authors.forename: Patricia
authors.initials: P
authors.lastname: Logan
authors.forename: Velma McBride
authors.initials: VM
authors.lastname: Murry
mesh_terms: D001741:Black or African American; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000208:ethnology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology*; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012424:Rural Population; D013315:Stress, Psychological / Q000453:epidemiology