Title

Weight-based discrimination and medication adherence among low-income African Americans with hypertension: how much of the association is mediated by self-efficacy?

UMMS Affiliation

School of Medicine; Department of Quantitative Health Sciences; Department of Medicine, Division of Preventive and Behavioral Medicine

Date

5-9-2014

Document Type

Article

Disciplines

Behavior and Behavior Mechanisms | Cardiovascular Diseases | Clinical Epidemiology | Community Health and Preventive Medicine | Epidemiology | Health Services Administration | Health Services Research | Preventive Medicine

Abstract

OBJECTIVES: Much of the excessive morbidity and mortality from cardiovascular disease among African Americans results from low adherence to anti-hypertensive medications. Therefore, we examined the association between weight-based discrimination and medication adherence.

METHODS: We used cross-sectional data from low-income African Americans with hypertension. Ordinal logistic regression estimated the odds of medication non-adherence in relation to weight-based discrimination adjusted for age, sex, education, income, and weight.

RESULTS: Of all participants (n = 780), the mean (SD) age was 53.7 (9.9) years and the mean (SD) weight was 210.1 (52.8) lbs. Reports of weight-based discrimination were frequent (28.2%). Weight-based discrimination (but not weight itself) was associated with medication non-adherence (OR: 1.94; 95% CI: 1.41-2.67). A substantial portion 38.9% (95% CI: 19.0%-79.0%) of the association between weight-based discrimination and medication non-adherence was mediated by medication self-efficacy.

CONCLUSION: Self-efficacy is a potential explanatory factor for the association between reported weight-based discrimination and medication non-adherence. Future research should develop and test interventions to prevent weight-based discrimination at the societal, provider, and institutional levels.

Comments

Citation: Richardson MP, Waring ME, Wang ML, Nobel L, Cuffee Y, Person SD, Hullett S, Kiefe CI, Allison JJ. Weight-based discrimination and medication adherence among low-income African Americans with hypertension: how much of the association is mediated by self-efficacy? Ethn Dis. 2014 Spring;24(2):162-8. Link to abstract on publisher's website

First author Michael P. Richardson is a medical student in the School of Medicine at UMass Medical School. Co-author Yendelela L. Cuffee is a doctoral student in the Clinical and Population Health Research Program in the Graduate School of Biomedical Sciences (GSBS) at UMass Medical School.

Related Resources

Link to article in PubMed

Keywords

UMCCTS funding

PubMed ID

24804361