title: Ethnic differences in family member diabetes involvement and psychological outcomes: results from the second Diabetes Attitudes, Wishes and Needs (DAWN2) study in the USA.
abstract: OBJECTIVE
  To assess differences among USA ethnic groups in psychological status of adult family members (FMs) and their involvement with the diabetes of another adult.
  
  
  METHODS
  Data are from the FM survey of the USA DAWN2 study, including 105 White non-Hispanics, 47 African Americans, 46 Hispanic Americans and 40 Chinese Americans. All FMs lived with and cared for an adult with diabetes. Analysis of covariance controlled for respondent and patient characteristics to assess ethnic group differences (P < 0.05). Multiple regression analyses identified significant (P < 0.05) independent correlates of psychological outcomes.
  
  
  METHODS
  FM psychological outcomes measured include well-being, quality of life (QoL), impact of diabetes on life domains, diabetes distress, and burden.
  
  
  BACKGROUND
  NCT01507116.
  
  
  RESULTS
  White non-Hispanics reported less diabetes burden and distress, more negative life impact, and lower well-being than FMs from ethnic minority groups. African Americans reported the highest well-being and lowest negative life impact, Chinese Americans reported the most diabetes burden, Hispanic Americans reported the highest distress. There were no ethnic group differences in QoL. Ethnic minority FMs reported having more involvement with diabetes, greater support success, and more access to a diabetes support network than White non-Hispanics. Higher FM diabetes involvement was associated with negative psychological outcomes, while diabetes education, support success and diabetes support network size were associated with better psychological outcomes. Potential limitations are the sample sizes and representativeness.
  
  
  CONCLUSIONS
  Minority ethnic FMs experienced both advantages and disadvantages in psychological outcomes relative to each other and to White non-Hispanics. Ethnic minority FMs had more involvement in diabetes care, support success and support from others, with the first associated with worse and the latter two with better psychological outcomes. Additional studies are needed with larger samples and broader representation of ethnic groups to better understand these associations and identify areas for intervention.
authors.affiliation: Loyola University Maryland , Baltimore, MD , USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Peyrot
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
authors.forename: Martha M
authors.initials: MM
authors.lastname: Funnell
authors.forename: William C
authors.initials: WC
authors.lastname: Hsu
authors.forename: Laurie
authors.initials: L
authors.lastname: Ruggiero
authors.forename: Linda M
authors.initials: LM
authors.lastname: Siminerio
authors.forename: Heather L
authors.initials: HL
authors.lastname: Stuckey
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001213:Asian / Q000706:statistics & numerical data; D001290:Attitude; D003920:Diabetes Mellitus / Q000208:ethnology / Q000523:psychology*; D005190:Family / Q000208:ethnology / Q000523:psychology*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011788:Quality of Life; D044465:White People / Q000706:statistics & numerical data
keywords: DAWN2; Ethnic disparities; Psychological outcomes; Quality of life; Well-being