Health Literacy, Illness Perception, Depression, and Self-management Among African Americans with Type 2 Diabetes

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 = -0.433, p = .003), more concerns about illness ( r = -0.357, p = .02), and better medication adherence ( r = 0.487, p = .001). Higher levels of depression were inversely associated with medication adherence ( r = -0.449, p = .002; r = 0.449, p = .003). Higher concern about illness was associated with lower medication adherence ( r = -0.414, p = .005).

Conclusions: Lower health literacy coupled with illness perception and depression is associated with lower self-management 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.