title: Ethnic differences in psychological outcomes among people with diabetes: USA results from the second Diabetes Attitudes, Wishes, and Needs (DAWN2) study.
abstract: OBJECTIVE
  To assess differences in psychological outcomes as well as risk and protective factors for these outcomes among several USA ethnic groups and identify correlates of these psychological outcomes among adults with diabetes in the second Diabetes Attitudes, Wishes and Needs (DAWN2 * ) study.
  
  
  METHODS
  The core USA DAWN2 sample was supplemented by independent samples of specific ethnic minority groups, yielding a total of 447 White non-Hispanics, 241 African Americans, 194 Hispanics, and 173 Chinese Americans (n = 1055). Multivariate analysis examined ethnic differences in psychological outcomes and risk/protective factors (disease, demographic and socioeconomic factors, health status and healthcare access/utilization, subjective burden of diabetes and social support/burden). Separate analyses were performed on each group to determine whether risk/protective factors differed across ethnic groups.
  
  
  METHODS
  Psychological outcomes include well-being, quality of life, impact of diabetes on life domains, diabetes distress, and diabetes empowerment.
  
  
  BACKGROUND
  NCT01507116.
  
  
  RESULTS
  Ethnic minorities tended to have better psychological outcomes than White non-Hispanics, although their diabetes distress was higher. Levels of most risk and protective factors differed significantly across ethnic groups; adjustment for these factors reduced ethnic group differences in psychological outcomes. Health status and modifiable diabetes-specific risk/protective factors (healthcare access/utilization, subjective diabetes burden, social support/burden) had strong associations with psychological outcomes, especially diabetes distress and empowerment. Numerous interactions between ethnicity and other correlates of psychological outcomes suggest that ethnic groups are differentially sensitive to various risk/protective factors. Potential limitations are the sample sizes and representativeness.
  
  
  CONCLUSIONS
  Ethnic groups differ in their psychological outcomes. The risk/protective factors for psychological outcomes differ across ethnic groups and different ethnic groups are more/less sensitive to their influence. These findings can aid the development of strategies to overcome the most prominent and influential psychosocial barriers to optimal diabetes care within each ethnic group.
authors: Loyola University Maryland , Baltimore, MD , USA.
authors: Mark
authors: M
authors: Peyrot
authors: Leonard E
authors: LE
authors: Egede
authors: Carlos
authors: C
authors: Campos
authors: Anthony J
authors: AJ
authors: Cannon
authors: Martha M
authors: MM
authors: Funnell
authors: William C
authors: WC
authors: Hsu
authors: Laurie
authors: L
authors: Ruggiero
authors: Linda M
authors: LM
authors: Siminerio
authors: Heather L
authors: HL
authors: Stuckey
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000523:psychology*; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D012959:Socioeconomic Factors; D044465:White People / Q000523:psychology*
keywords: DAWN2; Ethnic disparities; Psychological outcomes; Quality of life; Well-being