A Cross-sectional Study of Depressive Symptoms and Diabetes Self-care in African Americans and Hispanics/Latinos With Diabetes: The Role of Self-efficacy.
The purpose of this study is to examine the relationship between depressive symptoms and diabetes self-care in African American and Hispanic/Latino patients with type 2 diabetes and whether the association, if any, is mediated by diabetes-related self-efficacy.



The sample included self-report baseline data of African American and Hispanic/Latino patients with type 2 diabetes who were aged ≥18 years and enrolled in a diabetes self-management intervention study. Depressive symptoms were assessed with the 9-item Patient Health Questionnaire. The Summary of Diabetes Self-care Activities measured engagement in healthy eating, physical activity, blood glucose checking, foot care, and smoking. The Diabetes Empowerment Scale-Short Form assessed diabetes-related psychosocial self-efficacy. Indirect effects were examined with the Baron and Kenny regression technique and Sobel testing.



Sample characteristics (n = 250) were as follows: mean age of 53 years, 68% women, 54% African American, and 74% with income <$20 000. Depressive symptoms showed a significant inverse association with the self-care domains of general diet, specific diet, physical activity, and glucose monitoring in the African American group. In Hispanics/Latinos, depression was inversely associated with specific diet. Self-efficacy served a significant mediational role in the relation between depression and foot care among African Americans.



Self-efficacy mediated the relationship between depression and foot care in the African American group but was not found to be a mediator of any self-care areas within the Hispanic/Latino group. In clinical practice, alleviation of depressive symptoms may improve self-care behavior adherence. Diabetes education may consider inclusion of components to build self-efficacy related to diabetes self-care, especially among African American patients.
School of Social Work, University of Illinois at Urbana-Champaign, Urban, Illinois, USA (Dr Hernandez, Mr Boughton)
Rosalba
R
Hernandez
Institute for Health Research and Policy and Community Health Sciences, School of Public Health at University of Illinois at Chicago, Chicago, Illinois, USA (Dr Ruggiero, Dr Chavez, Dr Zhao)
Laurie
L
Ruggiero
College of Health and Human Services, George Mason University, Fairfax, Virginia, USA (Dr Prohaska)
Thomas R
TR
Prohaska
Institute for Health Research and Policy and Community Health Sciences, School of Public Health at University of Illinois at Chicago, Chicago, Illinois, USA (Dr Ruggiero, Dr Chavez, Dr Zhao)
Noel
N
Chavez
School of Social Work, University of Illinois at Urbana-Champaign, Urban, Illinois, USA (Dr Hernandez, Mr Boughton)
Seth W
SW
Boughton
Community Health Sciences, School of Public Health at University of Illinois at Chicago, Chicago, Illinois, USA (Dr Peacock)
Nadine
N
Peacock
Institute for Health Research and Policy and Community Health Sciences, School of Public Health at University of Illinois at Chicago, Chicago, Illinois, USA (Dr Ruggiero, Dr Chavez, Dr Zhao)
Weihan
W
Zhao
School of Science and Technology, Middlesex University, London, UK (Prof Nouwen)
Arie
A
Nouwen
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D015190:Blood Glucose Self-Monitoring / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000208:ethnology*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy*; D003927:Diet, Diabetic / Q000523:psychology; D015444:Exercise / Q000523:psychology; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy; D057566:Self Report; D012907:Smoking / Q000208:ethnology; D014481:United States