Associations between changes in depressive symptoms and social support and diabetes management among low-income, predominantly hispanic patients in patient-centered care

This study examined whether changes in depressive symptoms and social support prospectively predicted diabetes management among Hispanic patients with probable depression in patient-centered medical homes at safety-net clinics in East Los Angeles, CA. RESEARCH DESIGN AND METHODS Data were collected from 251 patients enrolled in a randomized clinical trial testing the effectiveness of a self-management intervention assisted by a promotora (Hispanic communityhealthworker).Cross-laggedanalysesexaminedassociationsbetweenchanges in depression symptoms and social support between baseline and 6-month follow-up and self-efficacy and adherence to diabetesmanagement at the 6- and 12-month follow-ups. RESULTS Changes in depressive symptoms predicted self-efficacy and level of adherence at the 6- and 12-month follow-ups. Changes in total social support and emotional social support were correlated only with self-efficacy regarding diabetes management at 6-month follow-up. CONCLUSIONS Decline in depressive symptoms is a reliable predictor of improvement in self-efficacy and adherence to diabetes management. Further studies are recommended to study psychosocialmechanismsrelatedtosocial relationships other thansocial support that affect diabetes management.