Using a social ecological model in predicting type 2 diabetes self-care in rural African American women
Kennedy, Kelly Stidham
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Rural African American women in Georgia have a disproportionate prevalence rate of diabetes, which nearly doubled in the past 30 years. Self-care behaviors, such as healthy eating, physical activity, foot care, and monitoring blood glucose levels, are important in the long-term prognosis of the disease. Using a social ecological model and stress coping theory, I examined the pathways in which community disadvantage, social support, and depressive symptoms are linked to type 2 diabetes self-care in women. Specifically, I hypothesized that community disadvantage would affect women’s self-care by increasing depressive symptoms and that social support would ameliorate the influence of community disadvantage on depressive symptoms. Hypotheses were tested with data from 140 rural African American women diagnosed with type 2 diabetes. As hypothesized, community disadvantage was linked to type 2 diabetes self-care and this association was mediated through depressive symptoms. No evidence was found to support the moderating influence of social support on the association between community disadvantage and depressive symptoms. Interventions are needed to decrease depressive symptoms and increase community support for rural African American women with type 2 diabetes.