title: Role of Depressive Symptoms in Mediating Socioeconomic Disparities in Diabetes Risk Misperception.
abstract: OBJECTIVE
  In the U.S., type 2 diabetes awareness remains low among individuals at risk. Unawareness poses risk of developing comorbidities, commonly depression, which would harm physical and mental health and well-being. This study builds off previous findings identifying significant differences in accurate diabetes perception by race/ethnicity, sex, age, and self-rated health. This study explores depressive symptoms as a mediator and potential explanation for significant associations between determinants of risk and incorrect perception of risk when at risk.
  
  
  METHODS
  This study uses 2011-2012 & 2013-2014 National Health and Nutrition Examination Survey data (NHANES). The sampling frame includes individuals identified with clinical risk of diabetes, who report not perceiving risk (N = 3238). Summary statistics, bivariates by outcome and mediator, unadjusted and adjusted logistic regression were conducted. The Sobel test was used for mediation analysis.
  
  
  RESULTS
  Depressive symptoms, female sex, Mexican American ethnicity or other/multiple race, younger age, or worse self-rated health were independently associated with lower odds of incorrectly perceiving no clinical risk. Depressive symptoms moderated most socioeconomic disparities.
  
  
  CONCLUSIONS
  Findings demonstrate that depressive symptoms explain disparities in incorrectly perceiving no diabetes risk by sex, age, and self-rated health but not race/ethnicity.
authors.affiliation: Research Assistant, Department of Health Policy and Administration, The Pennsylvania State University, State College, PA.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Wilkie
authors.affiliation: Research Assistant, Department of Health Policy and Administration, The Pennsylvania State University, State College, PA.
authors.forename: William K
authors.initials: WK
authors.lastname: Bleser
authors.affiliation: Assistant Professor of Health Policy and Administration and Demography, Department of Health Policy and Administration, The Pennsylvania State University, State College, PA;, Email: pym1@psu.edu.
authors.forename: Patricia Y
authors.initials: PY
authors.lastname: Miranda
authors.affiliation: Associate Professor of Health Policy and Administration; Department of Health Policy and Administration, The Pennsylvania State University, State College, PA.
authors.forename: Rhonda
authors.initials: R
authors.lastname: BeLue
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult