Associations Between Changes in Depressive Symptoms and Social Support and Diabetes Management Among Low-Income, Predominantly Hispanic Patients in Patient-Centered Care

Oh, Hyunsung; Ell, Kathleen

doi:10.2337/dc17-2000

Cited by 20 publications

(18 citation statements)

References 45 publications

(64 reference statements)

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“…11 This is also the case in the United States, where those of lower socioeconomic status (SES) are particularly vulnerable, but the effects may vary by sociodemographic factors such as age, gender, racial-ethnic group, country of origin, and acculturation. 12-14 Several studies in the United States have linked greater acculturation to increased rates of obesity, diabetes, and other chronic diseases in Hispanic populations. 15-17…”

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confidence: 99%

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Psychosocial Contributors to Depressive Symptoms in Hispanic Patients With Type 2 Diabetes

Mansyur

Rustveld

Nash

et al. 2021

The Science of Diabetes Self-Management and Care

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Purpose The purpose of this study is to identify psychosocial factors associated with depressive symptoms in Hispanic patients with diabetes and explore the extent to which their effects may vary by gender and acculturation. Methods The authors completed a secondary analysis of data from 247 Hispanic adults with type 2 diabetes. Gender and language groups were compared using chi-square and t tests. Hierarchical multiple regression was used to examine associations of depressive symptoms with perceived support, diabetes-related distress, and social and personal factors. Results Women reported less support than men. English speakers reported more depressive symptoms than Spanish speakers. When adjusting for age, gender, and acculturation, psychosocial factors significantly associated with depressive symptoms included less support received, greater emotional burden, and less ability to socialize or pursue normal activities because of diabetes. Conclusions Social support provided by family among less acculturated Hispanics may play an important role in reducing emotional burden and lowering the risk of comorbid depression. The quality of interpersonal relationships and the ability to continue normal activities may also be important. More acculturated Hispanic women with diabetes may be at greater risk for comorbid depression and worse health outcomes. Screening for depression and assessment of support needs is warranted for Hispanic women.

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confidence: 99%

“…3,11,18 However, there is evidence that social support can mitigate the effects. 14,19-22 Many Hispanic groups tend to have strong family ties that provide support, yet this support does not consistently lead to better outcomes. The type of support that is available may be important.…”

mentioning

confidence: 99%

Psychosocial Contributors to Depressive Symptoms in Hispanic Patients With Type 2 Diabetes

Mansyur

Rustveld

Nash

et al. 2021

The Science of Diabetes Self-Management and Care

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“…Mood disorders affect a woman's self-care during pregnancy and beyond, and minority women are more likely to experience postpartum depression (55,56). In low-income Hispanic patients, a decline in depressive symptoms predicted improvement in self-efficacy and compliance with diabetes management (57). This finding suggests that effective GDM care incorporates collaboration with mental health specialists, especially in disadvantaged populations.…”

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confidence: 77%

Bridging Gaps and Understanding Disparities in Gestational Diabetes Mellitus to Improve Perinatal Outcomes

et al. 2019

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G estational diabetes mellitus (GDM), or glucose intolerance after 24 weeks' gestation, affects public health in the United States and worldwide (1). GDM increases maternal and neonatal risks, predisposing women and their children to chronic health problems such as type 2 diabetes, recurrent GDM in subsequent pregnancies, and cardiovascular disease (2). In the United States, GDM affects ~1-18% of pregnancies, with up to 70% of these women developing type 2 diabetes later in life (2-4). Minority women are up to two times more likely than white women to have GDM (2), and U.S. Native Americans, Asians, Hispanics, and African-American women are at higher risk for GDM (3,5-9), with similar patterns seen in Canada (10). Rates of GDM increased in the past 20 years by 10-100% among various ethnic groups (11). Low-income populations often lack affordable and dependable access to medical care and more frequently have concomitant diagnoses of GDM and obesity (12).

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“…The social bonds created among group members addressed mental health issues among participants related to isolation due to financial constraints and provided a space to express their struggles with the chronic disease. Increased social support is a benefit identified in several diabetes self-management interventions that emphasize the role of peers in providing emotional support and dealing with depression [26][27][28]. The intervention through increasing self-efficacy and social support addressed potential psychological complications (related to feelings of isolation and anxiety) associated with diabetes.…”

Section: Discussionmentioning

confidence: 99%

Mental health and diabetes self-management: assessing stakeholder perspectives from health centers in Northern Mexico

Aceves

Ruiz

Ingram

et al. 2021

BMC Health Serv Res

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Background People living with diabetes have an increased risk of developing mental health issues. Mexico has observed a high prevalence of people living with diabetes suffering from mental health issues, such as anxiety and depression. Self-management programs have demonstrated promise in helping participants address and prevent not only physiological health complications but mental health issues as well. This qualitative study aimed to understand the mental health benefits of a diabetes self-management intervention for health centers in Northern Mexico and opportunities for improvement through assessing stakeholder perspectives. Methods Trained research staff used a semi-structured questionnaire guide to conduct all interviews and focus groups from February–May 2018. Individual interviews (n = 16) were conducted face-to-face at four health center sites among all health center directors and key staff located throughout the state of Sonora. One focus group (n = 41) was conducted at each of the four health centers among intervention participants. Directed content analysis was used to establish themes by understanding relationships, identifying similar experiences, and determining patterns across datasets. Results In total 57 health center directors, health center staff, and intervention participants were involved in the interviews and focus groups across the four health centers. Overall the analysis identified four themes throughout the data, two were categorized as benefits and two as improvements. The primary themes for participant benefits were an increase in self-efficacy and social support to manage their chronic conditions. These were evident from not only participant perspectives, but health staff observations. Conversely, increased family involvement, and increased mental health integration and services within diabetes care were identified themes for opportunities to improve the intervention to be more inclusive and holistic. Conclusion All stakeholders observed the benefits for intervention participants and opportunities for more inclusivity of the family and integration as well as an increase in mental health services. The themes identified demonstrated a need to more proactively enhance and utilize diabetes self-management as a means to improve mental health outcomes among people living with diabetes in Mexico. This is an opportunity to employ a more comprehensive approach to diabetes self-management, and integrate mental health services into overall diabetes care. Trial registration www.ClinicalTrials.gov, identifier: NCT02804698. Registered on June 17, 2016.

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Associations Between Changes in Depressive Symptoms and Social Support and Diabetes Management Among Low-Income, Predominantly Hispanic Patients in Patient-Centered Care

Abstract: Decline in depressive symptoms is a reliable predictor of improvement in self-efficacy and adherence to diabetes management. Further studies are recommended to study psychosocial mechanisms related to social relationships other than social support that affect diabetes management.

Cited by 20 publications

References 45 publications

Psychosocial Contributors to Depressive Symptoms in Hispanic Patients With Type 2 Diabetes

Psychosocial Contributors to Depressive Symptoms in Hispanic Patients With Type 2 Diabetes

Bridging Gaps and Understanding Disparities in Gestational Diabetes Mellitus to Improve Perinatal Outcomes

Mental health and diabetes self-management: assessing stakeholder perspectives from health centers in Northern Mexico

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