{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T21:27:01Z","timestamp":1793568421472,"version":"4.5.0"},"reference-count":66,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hisp Health Care Int"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There is evidence of the relationship between psychosocial distress and elevated blood glucose levels. However, data in the Dominican Republic is limited. The study aims to measure the prevalence of four types of psychosocial distress, assess their associations with A1c levels and stratify these associations by gender among rural Dominican adults with diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between June-July 2023, 501 diabetes patients participated in a cross-sectional survey measuring psychosocial distress (e.g., diabetes distress, depressive symptoms, acute stress, anxiety). Descriptive analyses were conducted to determine prevalence of psychosocial distress, linear regression was run on psychosocial distress and A1c levels, and logistic regression was run to examine psychosocial distress levels by gender.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants reported mild-to-moderate levels of psychosocial distress. Almost a fifth of participants reported high levels of depressive symptoms (20.2%) and acute stress (22.0%). Only diabetes distress was significantly associated with A1c levels (b\u2009=\u20090.037, SE\u2009=\u20090.009, p\u2009=\u20090.001). Men were significantly less likely to report moderate-to-severe depressive symptoms (OR:2.35; CI:1.51\u20133.66), anxiety (OR:3.07; CI:1.52\u20136.19), and acute stress (OR:2.13; CI:1.51\u20133.66) than women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prevalence of psychosocial distress varies by type, and severity varies by gender. Diabetes distress is associated with diabetes outcomes. Findings highlight the importance of addressing psychological distress and mental health in the context of diabetes care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15404153261417251","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T18:33:34Z","timestamp":1770662014000},"page":"229-238","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychosocial Distress and Type 2 Diabetes among Adults in Rural Dominican Republic: A Descriptive Study"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1300-6957","authenticated-orcid":false,"given":"Deshira D.","family":"Wallace","sequence":"first","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quetzabel","family":"Benavides Navarrete","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana","family":"Aguilar","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin","family":"Hiciano","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafaela","family":"Drake","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lourdes Josefina","family":"Est\u00e9vez","sequence":"additional","affiliation":[{"name":"Institute for Latin American Concern, Carretera Duarte Km. 7 \u00bd Licey al Medio, Santiago, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"P\u00e9rez Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Institute for Latin American Concern, Carretera Duarte Km. 7 \u00bd Licey al Medio, Santiago, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Dethlefs","sequence":"additional","affiliation":[{"name":"Chronic Care International, 12370 Rose Lane, Omaha, NE 68154, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Barrington","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2015.06.007"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14405-0"},{"issue":"1","key":"e_1_3_3_4_1","article-title":"2. 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