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

Abstract

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.

“If I am free from diabetes, that itself will be the happiest thing”: A convergent mixed methods study of the lived experiences of young adults with type 2 diabetes in Mysore district, India

“…The belief that diabetes is communicable was particularly prevalent and concerning, leading to experiences of social isolation and discrimination. Researchers in the United States and Ghana have established that lower health literacy coupled with illness perception is associated with lower self-management behaviors in adults living with T2D [28–30]. Medication perception also played a significant role in participants’ experience with T2D.…”

“…States and Ghana have established that lower health literacy coupled with illness perception is associated with lower self-management behaviors in adults living with T2D [28][29][30]. Medication perception also played a significant role in participants' experience with T2D.…”

A cross‐sectional study on social determinants of mental health during COVID‐19 among adults in California

“…While the study showed that Black/African Americans were less likely to experience mental health issues, we think this is due to the stigma associated with mental illness, thus, underreporting of experiences of such events. It is crucial to note that mental illness, such as depression, usually goes undiagnosed and untreated in the Black/African American population with chronic diseases such as type 2 diabetes (Ajuwon & Insel, 2022). Further research is needed to examine the role of stigma in mental health disparities among Black/African Americans to develop strategies to address this phenomenon.…”

Medication Adherence and Its Associated Factors among Patients with Type 2 Diabetes Mellitus Attending Primary Health Centers of Eastern Province, Saudi Arabia

“…Perceptions of illness are mainly concerned with the anxiety and depression levels normally resulting from patients who are suffering from a chronic illness such as DM. Patients with DM usually develop depression and stress, which creates their perception of the disease and certain beliefs about the cause and controllability of the disease [ 9 ]. These perceptions normally affect patients’ medication adherence because patients may perceive the cause of the disease, such as DM, as different from what the doctor prescribed.…”