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

Publication 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.

Keywords

UMCCTS funding

Journal/Book/Conference Title

Ethnicity and disease

PubMed ID

24804361

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