Depression remission, receipt of problem-solving therapy, and self-care behavior frequency among low-income, predominantly Hispanic diabetes patients.
This study explored whether depression remission and problem-solving therapy (PST) receipt are associated with more frequent self-care behaviors via cross-sectional and prospective analyses.



We analyzed data from a randomized clinical trial (N=387) that tested collaborative depression care among predominantly Hispanic patients with diabetes in safety-net clinics. Data at 12-month follow-up, measured with the Patient Health Questionnaire-9 and Hopkins Symptom Checklist-20, were used to define depression remission. PST was provided by a bilingual social worker. Multivariate regression analysis was used to examine associations between predictors and frequency change of each self-care behavior (healthy diet, exercise, self-blood glucose monitoring, and foot care between baseline and 12-month (N=281), 18-month (N=249), and 24-month (N=235) follow-up surveys.



Inconsistent relationships were observed depending on the instrument to identify depression remission, type of self-care behaviors, and time when self-care behavior was measured. Significant associations were more likely to be observed in cross-sectional analyses. PST receipt was not associated with self-care behaviors.



Depression remission or the receipt of PST may not be a reliable antecedent for more frequent self-care behaviors among this group. A few recommendations for studies were offered to enhance existing depression care for diabetes patients.
School of Social Work, Arizona State University. Electronic address: hyunsung@asu.edu.
Hyunsung
H
Oh
School of Social Work, University of Southern California.
Kathleen
K
Ell
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000628:therapy*; D003920:Diabetes Mellitus / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011203:Poverty / Q000523:psychology*; D012074:Remission Induction; D012648:Self Care / Q000523:psychology*
Depression; Diabetes; Problem-solving therapy; Self-care behaviors