Psychosocial correlates of HbA1c among adult Samoans without diabetes

Understanding psychosocial determinants of health is critical in understudied, high-risk populations, where such knowledge could have a major impact on health outcomes. In Samoa, where diabetes prevalence has rapidly increased over 30 years, associations between psychosocial factors and diabetes remain poorly understood.

The purpose of our study was to identify psychosocial factors associated with HbA1c among Samoan adults while accounting for established correlates of HbA1c including age, body composition, and genetic and behavioral risk factors.

Participants (n = 349 adult Samoans; 53% female) who were not receiving diabetes care were selectively sampled from the Soifua Manuia (2017 - 2019) study. Multiple linear regression with backwards elimination and a bootstrapping stability investigation was used to assess associations between HbA1c and participant demographics, genetics (rs373863828 A allele in CREBRF), biological, behavioral, and psychosocial variables (i.e., self-esteem, self-efficacy, social support, health related quality of life, perceived social conflict, food security).

The rs373863828 genotype and age were statistically significantly associated with HbA1c-more copies of the rs373863828 A allele and younger age were associated with lower HbA1c. While not statistically significant based on confidence intervals, those with greater self-efficacy tended to have lower HbA1c, while those with higher social support tended to have higher HbA1c.

Based on the frequent appearances of psychosocial factors in our models, we advocate for increased awareness and promotion of psychosocial health, and health promoting social support in Samoa. Integrating psychosocial and mental health awareness with standard biomedical protocols and health promotion materials provides an important and empowering means of diabetes prevention and management.