Weight-based discrimination and medication adherence among low-income African Americans with hypertension: how much of the association is mediated by self-efficacy?
School of Medicine; Department of Quantitative Health Sciences; Department of Medicine, Division of Preventive and Behavioral Medicine
Behavior and Behavior Mechanisms | Cardiovascular Diseases | Clinical Epidemiology | Community Health and Preventive Medicine | Epidemiology | Health Services Administration | Health Services Research | Preventive Medicine
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.
Ethnicity and disease
Richardson, Michael P.; Waring, Molly E.; Wang, Monica L.; Nobel, Lisa; Cuffee, Yendelela L.; Person, Sharina D.; Hullett, Sandral; Kiefe, Catarina I.; and Allison, Jeroan J., "Weight-based discrimination and medication adherence among low-income African Americans with hypertension: how much of the association is mediated by self-efficacy?" (2014). Quantitative Health Sciences Publications and Presentations. 1129.