Publication Date
7-14-2025
Document Type
Article
Organizational Units
Graduate School of Social Work
Keywords
Diabetes mellitus, Mental health and psychiatry, Depression, Diabetes diagnosis and management, Eyes, Gestational diabetes, Health insurance, Behavior
Abstract
Objective
This study examined the association between diagnosis of depressive disorder, the number of bad mental health days per month, and diabetes management behaviors among American Indian/Alaska Native (AI/AN) adults with diabetes.
Research design and methods
Data were drawn from the Behavioral Risk Factor Surveillance System (2018–2021), including 2,272 self-identified non-Hispanic AI/AN adults diagnosed with non-gestational diabetes. Key variables included a self-reported prior diagnosis of depressive disorder and the number of bad mental health days in the past month. Outcome variables were seven diabetes management behaviors, such as taking a diabetes management class and performing daily foot checks. Statistical analyses included descriptive statistics, chi-squared tests, ANOVA, and logistic regression models.
Results
Among the participants, 24.8% were diagnosed with depressive disorder, and 19.5% reported at least 14 bad mental health days in the past month. Logistic regression models show that those reporting depressive disorders were significantly less likely to check their feet daily (adjusted odds ratio (AOR) = 0.56, 95% CI: 0.34–0.92). Individuals with at least 14 bad mental health days were significantly less likely to have ever taken a diabetes management class (AOR = 0.59, 95% CI: 0.36–0.99) and check their feet daily (AOR = 0.37, 95% CI: 0.21–0.65) than those reporting no bad mental health days.
Conclusions
Depressive disorders and frequent bad mental health days were associated with lower odds of diabetes management behaviors among AI/AN adults. These findings suggest that enhancing mental health support within diabetes management programs may help address disparities in diabetes care among AI/AN adults.
Copyright Date
6-23-2025
Copyright Statement / License for Reuse
This work is licensed under a Creative Commons Attribution 4.0 International License.
Rights Holder
Kaipeng Wang, Luohua Jiang, Jie Zhu, and Spero M. Manson
Provenance
Received from PLoS
File Format
application/pdf
Language
English (eng)
Extent
15 pgs
File Size
528 KB
Publication Statement
Copyright is held by the Authors. User is responsible for all copyright compliance. This article was originally published as
Wang, K., Jiang, L., Zhu, J., and Manson, S.M. (2025). Depressive Disorders, Bad Mental Health Days, and Diabetes Management Behaviors Among Non-Hispanic American Indian/Alaska Native Adults: Findings from the Behavioral Risk Factor Surveillance System. PLoS One 20(7), e0327870. https://doi.org/10.1371/journal.pone.0327870
Publication Title
PLoS One
Volume
20
Issue
7
First Page
e0327870
ISSN
1932-6203
PubMed ID
40658702
Recommended Citation
Wang, Kaipeng; Jiang, Luohua; Zhu, Jie; and Manson, Spero M., "Depressive Disorders, Bad Mental Health Days, and Diabetes Management Behaviors Among Non-Hispanic American Indian/Alaska Native Adults: Findings from the Behavioral Risk Factor Surveillance System" (2025). Graduate School of Social Work: Faculty Scholarship. 166.
https://digitalcommons.du.edu/gssw_facultyscholarship/166
https://doi.org/10.1371/journal.pone.0327870
Included in
Behavior and Behavior Mechanisms Commons, Endocrinology, Diabetes, and Metabolism Commons, Indigenous Studies Commons, Native American Studies Commons, Population Health Commons, Psychiatric and Mental Health Commons, Social Work Commons