title: Correlates of depression at baseline among African Americans enrolled in cardiac rehabilitation.
abstract: OBJECTIVE
  To compare baseline psychosocial characteristics of African Americans entering phase 2 cardiac rehabilitation who have depression symptoms at or above threshold (Center for Epidemiological Studies Depression Scale [CES-D] score >or=16) with those who do not (CES-D score <16).
  
  
  METHODS
  A nonrandom sample of 112 men and women (n = 78 without depression, n = 34 with depression) was recruited through local phase 2 cardiac rehabilitation programs. Data were obtained by a structured interview and brief physical examination using several reliable and valid instruments. Chi-square tests, Kruskal-Wallis 2-sample tests, Spearman rank correlation coefficients, and logistic regression models were used for analyses.
  
  
  RESULTS
  We found that 30% of the participants were above the depression symptom threshold. Demographic characteristics were not significantly different between individuals at or above threshold and those below threshold. However, depressed individuals above threshold were more likely to be dissatisfied with their neighborhoods (P = .01) and had lower optimism scores (P < .0001), higher stress scores (P < .0001), lower adaptive coping scores (P = .05), and higher problematic coping scores (P < .01) than their counterparts who were below threshold. In the logistic regression model, the odds of being above the depression symptom threshold increased with stress (P < .001) and decreased with optimism (P = .03); none of the other psychosocial characteristics had an independent effect on depression symptoms.
  
  
  CONCLUSIONS
  At baseline, African Americans starting phase 2 cardiac rehabilitation with depression symptoms at or above threshold had more stress and fewer stress resilience factors. Assessing depression and stress resilience factors is important and may lead to more active participation in cardiac rehabilitation once enrolled, as well as optimal cardiovascular health outcomes.
authors.affiliation: College of Nursing, Center for Urban and African American Health, Wayne State University, Detroit, Michigan, USA. n.artinian@wayne.edu
authors.forename: Nancy T
authors.initials: NT
authors.lastname: Artinian
authors.forename: Judith
authors.initials: J
authors.lastname: Abrams
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Keteyian
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Franks
authors.forename: Barry
authors.initials: B
authors.lastname: Franklin
authors.forename: Amy
authors.initials: A
authors.lastname: Pienta
authors.forename: Rifky
authors.initials: R
authors.lastname: Tkatch
authors.forename: Linton
authors.initials: L
authors.lastname: Cuff
authors.forename: Pamela
authors.initials: P
authors.lastname: Alexander
authors.forename: Steve
authors.initials: S
authors.lastname: Schwartz
mesh_terms: D000223:Adaptation, Psychological; D001741:Black or African American / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000534:rehabilitation*; D003863:Depression / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011594:Psychometrics; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology