Association Between Body Mass Index And Depression On Hbaic Control Among Veterans

Association Between Body Mass Index and Depression on HBA1C Control Among Veterans by Opokua Osei-Yeboah MSN, St Xavier University, 2012 BSN, Framingham State University, 2006 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Public Health Public Health Walden University November 2018 Abstract The study investigated the association between body mass index (BMI) and depression based upon glycated hemoglobin levels (HBA1C) among United States veterans. Based on Bandura’s social cognitive theory, a cross-sectional analysis examined the associationThe study investigated the association between body mass index (BMI) and depression based upon glycated hemoglobin levels (HBA1C) among United States veterans. Based on Bandura’s social cognitive theory, a cross-sectional analysis examined the association between BMI and depression on HBA1C regulation, and if the interaction between BMI and depression affects HBAIC regulation among veterans. Multiple regression analysis was used to test the multivariate associations between depression and BMI on the outcome variable of HBA1C. Linearity, normality, and homoscedasticity were assessed using normal probability plots and residual analysis. Durbin-Watson statistics were used to test for autocorrelations, and variance inflation factor was used to check for multicollinearity. There was not a statistically significant difference between those who were depressed (Mdn = 32.76, IQR = 7.8) and those who were not depressed (Mdn = 33.27, IQR = 5.0) in terms of BMI (U = 774.0, p = 0.47). When depression, BMI, an interaction term for depression*BMI, and other predictor variables were entered into the regression model, these variables did not account for a significant increase in shared variance in A1C (ΔR2 = 0.17, F (14, 74) = 0.17, p = 0.37). Social change implications generated from this study include better resource utilization, improved quality of care, increased veteran satisfaction and improved veteran experience across the healthcare system. The findings from the study can be used to expand access to specialized services for chronically ill veterans, coordinate resources, better outcomes and facilitate seamless care coordination between mental health and primary care providers. Association Between Body Mass Index and Depression on HbA1C Control Among Veterans by Opokua Osei-Yeboah MSN, Saint Xavier University, 2012 BSN, Framingham State University, 2006 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Public Health Public Health Walden University November 2018 Dedication I dedicate my research to my dear husband, Fred Osei-Yeboah and my four lads, Jared Bernard Addo, Kwesi Yeboah, Kwabena Osei-Yeboah, and Kofi Osei-Yeboah. To my siblings, Akosua McDonald and Nyantakyiwa Buotu for your encouragement, during the times I wanted to quit you encouraged me to press on, letting me know I can accomplish this goal. Also to my aging parents, Benjamin and Matilda Asare Buotu, both of whom have been waiting to see me graduate, through the emotional ups and downs, you assured me to rely my strength onto God, for he will see me through and he did! This journey was accomplished with the support and encouragement from all of you. I owe this accomplishment to all of you from the bottom of my heart. Acknowledgments The journey to this great accomplishment seemed never-ending, with mixed feelings on how to survive the stress of school. Many days I felt like this was not achievable due to the amount of commitment needed to balance school, family life, and work. But I know God’s ways are the best, and his plans for us never fail. The very first thank you goes to God Almighty. With God all things are possible, and without his protection, this milestone would have been impossible to complete. The book of Philippians 4:13 says “I can do all things through Christ who strengthens me. ” May his name be glorified? I give him all the thanks, praise, and adoration. Second, I salute my husband Mr. Fred Osei-Yeboah who is my number fan, I wouldn’t have made it without his help and support. His words always echoed “you are almost at the end you can do this! ” Balancing four active boys who are involved in sports could not have been more challenging. However, my husband stepped in and ensured things get done promptly. Third, my dissertation committee chair, Dr. Egondu Onyejekwe, for sharing her knowledge and expertise in helping me narrow my research question and guiding me through each step. Dr. Xiaban Li, first committee chair member, for reviewing the data analysis multiple times to ensure accuracy, Dr. Donna Clews, University Research Reviewer for her guidance, Dr. Tammy Root, Academic Research Coordinator for her support, and Dr. Rea, Program Director for words of encouragement. Also, to Dr. Howard Gordon at the Department of Veterans Affairs for being a mentor and helping me obtain the study database. Finally, to Pastor Pokoo at Lifetouch Worship Center, for his prayers and kind words of encouragement throughout the school year.