Health literacy, illness perception, depression, and self-management among African Americans with type 2 diabetes

Abidemi M. Ajuwon, Kathleen Insel

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background:Type 2 diabetes mellitus (T2DM) causes significant morbidity and mortality. Compared with non-Hispanic Whites, African Americans are more likely to suffer and die from T2DM.Purpose:This study examines the associations between health literacy, illness perception, depression, working memory, executive function, and self-management among African Americans (18-65 years) with T2DM.Methodology:A descriptive cross-sectional design was used. Data were collected through Research Electronic Data Capture and transferred to the Statistical Package for the Social Sciences software version 26 for statistical analysis. Fifty-three participants met study eligibility criteria.Results:Health literacy was associated with depression (r = -0.433, p =.003), more concerns about illness (r = -0.357, p =.02), and better medication adherence (r = 0.487, p =.001). Higher levels of depression were inversely associated with medication adherence (r = -0.449, p =.002; r = 0.449, p =.003). Higher concern about illness was associated with lower medication adherence (r = -0.414, p =.005).Conclusions:Lower health literacy coupled with illness perception and depression is associated with lower self-management behaviors among African Americans which can lead to complications of T2DM. More studies are needed to examine the association of cognitive factors with self-management activities among African Americans with T2DM.Implications:Limited health literacy is associated with lower medication adherence among African Americans with T2DM. Illness perception is a significant factor that influences self-management of T2DM among African Americans. Using screening tools that assess health literacy and illness perception may address underlying concerns regarding adherence to T2DM treatment regimens in African Americans.

Original languageEnglish (US)
Pages (from-to)1066-1074
Number of pages9
JournalJournal of the American Association of Nurse Practitioners
Issue number9
StatePublished - Sep 9 2022
Externally publishedYes


  • African Americans
  • cognitive function
  • depression
  • illness perception
  • self-management
  • type 2 diabetes

ASJC Scopus subject areas

  • General Nursing


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