Comorbid Diabetes and Depression in African Americans: Implications for the Health Care Provider

Chlebowy, Diane Orr; Coty, Mary-Beth; Fu, Liyan; Hines‐Martin, Vicki

doi:10.1007/s40615-017-0349-x

Cited by 10 publications

(4 citation statements)

References 36 publications

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“…Finding an inverse association between depression and medication adherence, suggesting that participants who had higher levels of depression had poorer self-management behavior, is consistent with previous studies (Ajuwon & Love, 2020; Chlebowy et al, 2018). Depression is a common comorbidity in individuals with diabetes (Ajuwon & Love, 2020; Gonzalez Heredia et al, 2021), and having depression complicates the management of T2DM, adversely affecting self-management behaviors and consequently leading to poor health outcomes (Al Sayah et al, 2015).…”

Section: Discussionsupporting

confidence: 91%

“…African Americans, as compared with non-Hispanic Whites, are estimated to be 2.2 times more likely to die from diabetes because of poor self-management of diabetes (Lynch et al, 2019; Pena-Purcell et al, 2015). Other long-term complications of poorly controlled T2DM include retinopathy, nephropathy, peripheral nerve damage, cardiovascular disease, and amputation (American Diabetes Association, 2018; Chlebowy et al, 2018). Intensive self-management of T2DM requires lifestyle behaviors involving meticulous blood glucose monitoring, healthy eating, physical activity, and medication adherence (Gomes et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Health literacy, illness perception, depression, and self-management among African Americans with type 2 diabetes

Ajuwon

Insel

2022

J Am Assoc Nurse Pract

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Background: Type 2 diabetes mellitus (T2DM) causes significant morbidity and mortality. Compared with non-Hispanic Whites, African Americans are more likely to suffer and die from T2DM.Purpose: This study examines the associations between health literacy, illness perception, depression, working memory, executive function, and self-management among African Americans (18-65 years) with T2DM.Methodology: A descriptive cross-sectional design was used. Data were collected through Research Electronic Data Capture and transferred to the Statistical Package for the Social Sciences software version 26 for statistical analysis. Fifty-three participants met study eligibility criteria.Results: Health literacy was associated with depression (r = 20.433, p = .003), more concerns about illness (r = 20.357, p = .02), and better medication adherence (r = 0.487, p = .001). Higher levels of depression were inversely associated with medication adherence (r = 20.449, p = .002; r = 0.449, p = .003). Higher concern about illness was associated with lower medication adherence (r = 20.414, p = .005).Conclusions: Lower health literacy coupled with illness perception and depression is associated with lower selfmanagement behaviors among African Americans which can lead to complications of T2DM. More studies are needed to examine the association of cognitive factors with self-management activities among African Americans with T2DM.Implications: Limited health literacy is associated with lower medication adherence among African Americans with T2DM. Illness perception is a significant factor that influences self-management of T2DM among African Americans. Using screening tools that assess health literacy and illness perception may address underlying concerns regarding adherence to T2DM treatment regimens in African Americans.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Health literacy, illness perception, depression, and self-management among African Americans with type 2 diabetes

Ajuwon

Insel

2022

J Am Assoc Nurse Pract

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“…Available literature also posits that the clinical presentation and somatization of mental health disorders differs for African Americans. Elevated depressive symptoms for African American adults have been associated with more severe negative mental and physical health outcomes including cardiovascular disease mortality (Lewis et al, 2011; Newcomer, 2007), increased risk for diabetes (Chlebowy, Coty, Fu, & Hines-Martin, 2018; Lankarani & Assari, 2015), and increased risk of hypertension (Pickering, 2000). Other studies have attributed these more disabling and chronic symptoms of depression to low treatment rates among African Americans, which is influenced by reduced access to mental health facilities (e.g., Carrington, 2006) and cultural mistrust toward mental health professionals (e.g., Whaley, 2004).…”

Section: Overview Of Depression Research For African Americansmentioning

confidence: 99%

The moderating effect of dispositional forgiveness on perceived racial discrimination and depression for African American adults.

Brooks¹,

Hong²,

Madubata³

et al. 2021

Cultural Diversity & Ethnic Minority Psychology

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Objectives: Perceived racial discrimination is associated with depressive symptoms for African American adults; however, insight to protective factors for racism and depression in African Americans is limited. While current research suggests that dispositional forgiveness is an important factor in how people perceive and cope with interpersonal transgressions, few studies have examined its role in the context of racial discrimination. The purpose of this study was to examine the moderating effect of forgiveness (beyond broader internalized religiosity) on the association between perceived racial discrimination and depressive symptoms in African American adults. Method: Sample included 101 African American adults (60.2% female; M age ϭ 21.90 years, SD ϭ 4.93 years) who endorsed experiences of racial discrimination. Participants completed a questionnaire battery consisting of self-report measures of perceived experiences of racial discrimination, depression, dispositional forgiveness, and intrinsic religiosity. Results: Regression analyses showed dispositional forgiveness moderated the association between perceived racial discrimination and symptoms of depression above and beyond intrinsic religiosity (␤ ϭ Ϫ.05, 95% CI [Ϫ.10, Ϫ.05], p Ͻ .05), such that the racial discrimination-depression association was significant for participants who reported low levels of dispositional forgiveness, but not for individuals who reported higher levels of dispositional forgiveness. Conclusions: These findings provide insight into the role of dispositional forgiveness in experiences of racial discrimination and suggest that cognitive flexibility serves as an adaptive coping strategy to experiencing discrimination. Public Significance StatementIt has been suggested that the utilization of internal coping strategies is vital for marginalized populations that experience daily forms of overt racial discrimination. The results of this study suggest that dispositional forgiveness, a robust internal coping mechanism, can serve as an adaptive coping strategy associated with fewer depressive symptoms for African American adults who have experienced racial discrimination; this is true even after controlling for religious beliefs.

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“…Type 2 diabetes mellitus (T2DM) disproportionately affects minoritized groups in the United States ( Centers for Disease Control and Prevention [CDC], 2019 ). For instance, Black or African Americans are twice as likely to have diabetes and two to four times as likely to experience diabetes complications, such as kidney failure, amputation, and blindness, compared with non-Hispanic Whites ( Chlebowy et al, 2018 ). For Asian Americans, diabetes is the fifth leading cause of death.…”

mentioning

confidence: 99%

Filipino Americans’ Social and Cultural Experiences of Type 2 Diabetes Management: Cultural Paradox, Ownership, and Success Definition

Tolentino,

Brynes

2023

J Transcult Nurs

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Background: Although type 2 diabetes mellitus (T2DM) disproportionately affects Filipino Americans, they have not received much attention in the literature. Focusing on how Filipino Americans’ social and cultural contextual experiences affect their self-management is critical. This study examined T2DM self-management among Filipino Americans by describing their sociocultural experiences, strategies, and significance of self-management. Method: An interpretive descriptive qualitative design was used. Data were analyzed using thematic analysis. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Results: Filipino Americans ( n = 19) with T2DM were interviewed. Three themes emerged: (a) cultural paradox of being Filipino American, (b) movement from invisibility to ownership of T2DM, and (c) definition of successful management of T2DM. Conclusion: Results contribute to a greater understanding of Filipino Americans’ T2DM self-management experiences. Implications include the provision of culturally congruent health care, being aware of Filipino Americans’ sociocultural experiences, and involvement of family/community.

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Comorbid Diabetes and Depression in African Americans: Implications for the Health Care Provider

Cited by 10 publications

References 36 publications

Health literacy, illness perception, depression, and self-management among African Americans with type 2 diabetes

Health literacy, illness perception, depression, and self-management among African Americans with type 2 diabetes

The moderating effect of dispositional forgiveness on perceived racial discrimination and depression for African American adults.

Filipino Americans’ Social and Cultural Experiences of Type 2 Diabetes Management: Cultural Paradox, Ownership, and Success Definition

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