Primary Submission Category: Chronic disease
Psychological Stressors and Diabetes Self-Management: A Community-Engaged Research Approach With Rural African Americans in the Missouri Bootheel
Authors: Idethia Shevon Harvey, Maude Harris, Greta Hermann,
Presenting Author: Idethia Shevon Harvey*
Introduction: Type 2 diabetes management presents significant challenges in rural African American communities due to healthcare access limitations and socioeconomic barriers. Our study uses a community-engaged methodology through the Cooperative Extension Service to examine relationships between psychosocial stressors and diabetes self-management in this underserved population.
Methods: The pilot study engaged 49 African Americans (mean age=65.9 years) with type 2 diabetes (diagnosis age=47.2±13 years) from the Missouri Bootheel. Participants completed validated measures assessing diabetes self-care, depression, stress, relationship strain, diabetes distress, discrimination, and financial wellbeing.
Results: Financial insecurity correlated with depression (r=-.46, p<.01) and emotional burden (r=-.52, p<.01). Parental stress associated with emotional burden (r=.54, p<.01), depression (r=.48, p<.01), and perceived stress (r=.48, p<.01). Perceived stress strongly correlated with diabetes distress (r=.64, p<.001), emotional burden (r=.67, p<.001), interpersonal stress (r=.55, p<.001), regimen-related stress (r=.59, p<.001), and depression (r=.52, p<.001). Discrimination experiences correlated with physician-related distress (r=.44, p<.01).
Discussion: The findings suggest that effective diabetes interventions must address not only clinical management but also psychological stressors including financial insecurity, parental responsibilities, and experience of discrimination. By partnering with Extension Specialists, the study ensures cultural competence through established networks, creating a replicable framework for addressing rural health disparities. While our results are promising, larger-scale studies are needed to validate these findings and develop targeted, culturally-responsive interventions.