Self-care behavior change and depression among low-income predominantly Hispanic patients in safety-net clinics

This study examined whether changes in self-care behaviors during a 12-month period predicted the likelihood of screening positive for depression concurrently and prospectively among low-income Hispanic patients with diabetes. Secondary analyses were conducted with longitudinal data collected from a randomized controlled trial that had tested effectiveness of collaborative depression care. We examined whether changes in self-care behaviors observed during the 12 months after baseline predicted the likelihood of screening positive for depression at 12-, 18-, and 24-month follow-up. Self-care behaviors included healthy diet, exercise, self-blood glucose monitoring, and foot care, which were measured by a validated self-reported instrument. Logistic regression analyses indicated that patients with more frequent healthy diet during the 12 months after baseline had significantly lower likelihood of depression. Patients with more frequent exercise had a lower likelihood of screening for depression at 18- and 24-month follow-up. No significant association was found with self-blood glucose monitoring and foot care. These findings suggest the importance of integrated care that emphasizes healthy diet and exercise, together with traditional depression treatment, when helping low-income Hispanic patients with diabetes and comorbid depression.