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

Michael P. Richardson, Molly E. Waring, Monica L. Wang, Lisa Nobel, Yendelela Cuffee, Sharina D. Person, Sandral Hullett, Catarina I. Kiefe, Jeroan J. Allison

Research output: Contribution to journalArticle

7 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)162-168
Number of pages7
JournalEthnicity and Disease
Volume24
Issue number2
StatePublished - Jan 1 2014

All Science Journal Classification (ASJC) codes

  • Epidemiology

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    Richardson, M. P., Waring, M. E., Wang, M. L., Nobel, L., Cuffee, Y., Person, S. D., Hullett, S., Kiefe, C. I., & Allison, J. J. (2014). Weight-based discrimination and medication adherence among low-income African Americans with hypertension: How much of the association is mediated by self-efficacy? Ethnicity and Disease, 24(2), 162-168.