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UKnowledge > College of Public Health > Journal of Appalachian Health > Vol. 6 (2024) > Iss. 3

 

Corresponding Author

Nancy Schoenberg, nesch@uky.edu

Author Affiliations

  1. Blake DiPaola: University of Kentucky College of Medicine (Lexington KY)
  2. Zoe Taylor, MPH: Administrative support associate, University of Kentucky College of Medicine
  3. Eric Hennemann: Quality improvement coordinator, University of Kentucky College of Medicine
  4. Brittany L. Smalls, PhD, MHSA, MSHPsych: Associate professor, University of Kentucky College of Medicine; ORCiD: https://orcid.org/0000-0003-3727-346X
  5. Philip M. Westgate, PhD: Professor, Department of Biostatistics,University of Kentucky; ORCiD: https://orcid.org/0000-0003-2991-268X
  6. Nancy Schoenberg, PhD: Professor, University of Kentucky College of Medicine; Email: nesch@uky.edu

Author Area of Expertise

Smalls: rural health, chronic disease, aging

Westgate: cluster randomized research design

Schoenberg: rural health, interventions, cultural factors

Abstract

Introduction: Rural Appalachian residents experience higher rates of most chronic diseases, including type 2 diabetes mellitus (T2DM). Stress and sleep deficiency also are common in the region.

Purpose: To better understand these associated health burdens, the relationship among these conditions and psychosocial factors—such as depressive symptoms, distress, empowerment, and social support—was examined among Appalachian residents with T2DM.

Methods: Using data collected from a community-based sample of Appalachian adults with T2DM, the study examined whether psychosocial factors were associated with perceived stress (Cohen Perceived Stress Scale) and self-reported sleep deficiency (Epworth Sleepiness Scale). Multilevel linear mixed effects regression modeling was used to test these associations.

Results: Depressive symptoms, distress, and social support were significantly associated with perceived stress, while diabetes empowerment was not associated with perceived stress. None of these psychosocial factors were found to be associated with sleep.

Implications: To our knowledge, this is the first known study to examine the relationship among psychosocial factors and perceived stress and sleep in rural Appalachian people with T2DM. With a high prevalence of mental distress in Appalachia, the findings highlight the need to further examine depression, diabetes management, and social support in people with T2DM in rural regions like Appalachia.

DOI

https://doi.org/10.13023/jah.0603.05

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Recommended Citation

DiPaola B, Taylor Z, Hennemann E, Smalls BL, Westgate PM, Schoenberg N. Psychosocial factors, stress, and sleep among rural Appalachian Kentucky residents with type 2 diabetes mellitus. J Appalach Health 2024;6(3):50-65. DOI: https://doi.org/10.13023/jah.0603.05

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