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Relationships of Depression, Anxiety, and Stress with Adherence to Self-Management Behaviors and Diabetes Measures in African American Adults with Type 2 Diabetes

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Abstract

This study examines the relationships of depression, anxiety, and stress with adherence to self-management behaviors and diabetes measures in 42 African American adults with type 2 diabetes (T2D). Participants were recruited from an outpatient clinic located in an urban area of a midsized city in the southeastern USA. The mean age of the sample was 54.9 years (SD = 9.9) and the majority of the participants were female (73.2%), high school graduates (55.3%), unemployed (70.7%), and publicly insured (77.8%). Each participant completed a demographic survey and the Depression, Anxiety and Stress Scale 21. Adherence to self-management behaviors (physical activity, diet, and medication use) was assessed using surveys and self-reports. Glycated hemoglobin (A1c) and body mass index (BMI) were obtained from participants’ medical records at the time of the participants’ clinic visits. Depression, anxiety, and stress were not significantly correlated with self-management behaviors. Depression (r = 0.38, p = 0.03), anxiety (r = 0.56, p = 0.001), and stress (r = 0.36, p = 0.04) were positively correlated with A1c. The greater the dietary risk assessment score, the higher the A1c (r = 0.34, p = 0.05). Anxiety was the strongest correlate of A1c followed by depression, stress, and dietary risk assessment. Future studies to confirm this study’s findings in a larger sample are warranted. Interventions to mitigate the effects of these correlates should be designed and tested to improve health outcomes in African American adults with T2D.

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Funding

The authors acknowledge the University of Louisville School of Nursing for funding of this study. The authors also thank the staff at the clinic who supported the implementation of this study.

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Authors and Affiliations

  1. University of Louisville School of Nursing, Louisville, KY, 40202, USA

    Diane Orr Chlebowy & Catherine Batscha

  2. University of Louisville School of Medicine, Louisville, KY, 40202, USA

    Nancy Kubiak

  3. Wright State University Departments of Population and Public Health Sciences and Family Medicine, Dayton, OH, 45435, USA

    Timothy Crawford

Authors
  1. Diane Orr Chlebowy
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  2. Catherine Batscha
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  3. Nancy Kubiak
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  4. Timothy Crawford
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Correspondence to Diane Orr Chlebowy.

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Chlebowy, D.O., Batscha, C., Kubiak, N. et al. Relationships of Depression, Anxiety, and Stress with Adherence to Self-Management Behaviors and Diabetes Measures in African American Adults with Type 2 Diabetes. J. Racial and Ethnic Health Disparities 6, 71–76 (2019). https://doi.org/10.1007/s40615-018-0500-3

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