Prenatal Depressive Symptoms, Self-Rated Health, and Diabetes Self-Efficacy: A Moderated Mediation Analysis

Sandraluz Lara-Cinisomo (), Julio Ricardo Loret de Mola, Kendra Flores-Carter, Karen M. Tabb and Kristina Roloff
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Sandraluz Lara-Cinisomo: Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, 1206 S. Fourth Street, Champaign, IL 61820, USA
Julio Ricardo Loret de Mola: Department of Obstetrics and Gynecology, Southern Illinois University School of Medicine, 415 N. 9th St. Suite 6W100, Springfield, IL 62794, USA
Kendra Flores-Carter: Department of Social Work, College of Behavioral and Social Sciences, California Baptist University, 8432 Magnolia Avenue, Riverside, CA 92504, USA
Karen M. Tabb: School of Social Work, University of Illinois Urbana-Champaign, 1010 W. Nevada St., Urbana, IL 61801, USA
Kristina Roloff: Department of Women’s Health, Arrowhead Regional Medical Center, 400 N. Pepper Avenue, Colton, CA 92324, USA

IJERPH, 2022, vol. 19, issue 20, 1-11

Abstract: Background: Diabetes leads to risk for pregnant persons and their fetuses and requires behavioral changes that can be compromised by poor mental health. Poor self-rated health (SRH), a reliable predictor of morbidity and mortality, has been associated with depressive symptoms and lower self-efficacy in patients with diabetes. However, it is unclear whether SRH mediates the association between depressive symptoms and self-efficacy in pregnant patients with diabetes and whether the healthcare site moderates the mediation. Thus, we sought to test these associations in a racially and ethnically diverse sample of pregnant individuals diagnosed with diabetes from two clinical settings. Materials and methods: This was an observational, cross-sectional study of 137 pregnant individuals diagnosed with diabetes at two clinical study sites. Participants self-administered a demographic questionnaire and measures designed to assess depressive symptoms, SRH in pregnancy, and diabetes self-efficacy. A moderated mediation model tested whether these indirect effects were moderated by the site. Results: The results show that SRH mediated the association between depressive symptoms and diabetes self-efficacy. The results also showed the site moderated the mediating effect of SRH on depressive symptoms and diabetes self-efficacy. Conclusions: Understanding the role of clinical care settings can help inform when and how SRH mediates that association between prenatal depressive symptoms and self-efficacy in diabetic patients.

Keywords: diabetes; self-efficacy; depressive symptoms; self-rated health; pregnant persons (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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