Kelly L Gonzales1, Luohua Jiang2, Ginny Garcia-Alexander3, Michelle M Jacob4, Jenny Chang2, David R Williams5, Ann Bullock6, Spero M Manson7. 1. 143856Oregon Health & Science University-Portland State University joint School of Public Health, Portland, OR, USA. 2. School of Medicine, 8788University of California Irvine, Irvine, CA, USA. 3. 360175Portland State University, Portland, OR, USA. 4. College of Education, 143853University of Oregon, Eugene, OR, USA. 5. Florence Sprague Norman and Laura Smart Norman Professor of Public Health, 1857Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA. 6. Division of Diabetes Treatment and Prevention, 1246Indian Health Service, Rockville, MD, USA. 7. Centers for American Indian and Alaska Native Health, 12219University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Abstract
Objectives: To examine the association of perceived discrimination with participant retention and diabetes risk among American Indians and Alaska Natives. Methods: Data were drawn from the Special Diabetes Program for Indians-Diabetes Prevention Demonstration Project (N = 2553). Results: Perceived discrimination was significantly and negatively associated with short-term and long-term retention and diabetes risk without adjusting. After controlling for socioeconomic characteristics and clinical outcomes, perceived discrimination was not associated with retention but was significantly associated with less improvement in body mass index (BMI) and high-density lipoprotein (HDL) cholesterol. Every unit increase in the perceived discrimination score was associated with 0.14 kg/m2 less BMI reduction (95% CI: [0.02, 0.26], p = 0.0183) and 1.06 mg/dl lower HDL at baseline (95% CI: [0.36, 1.76], p = 0.0028). Discussion: Among racialized groups, improving retention and health in lifestyle interventions may require investigating perceived discrimination and the broader context of structural racism and colonialism.
Objectives: To examine the association of perceived discrimination with participant retention and diabetes risk among American Indians and Alaska Natives. Methods: Data were drawn from the Special Diabetes Program for Indians-Diabetes Prevention Demonstration Project (N = 2553). Results: Perceived discrimination was significantly and negatively associated with short-term and long-term retention and diabetes risk without adjusting. After controlling for socioeconomic characteristics and clinical outcomes, perceived discrimination was not associated with retention but was significantly associated with less improvement in body mass index (BMI) and high-density lipoprotein (HDL) cholesterol. Every unit increase in the perceived discrimination score was associated with 0.14 kg/m2 less BMI reduction (95% CI: [0.02, 0.26], p = 0.0183) and 1.06 mg/dl lower HDL at baseline (95% CI: [0.36, 1.76], p = 0.0028). Discussion: Among racialized groups, improving retention and health in lifestyle interventions may require investigating perceived discrimination and the broader context of structural racism and colonialism.
Authors: Howard H Moffet; Nancy Adler; Dean Schillinger; Ameena T Ahmed; Barbara Laraia; Joe V Selby; Romain Neugebauer; Jennifer Y Liu; Melissa M Parker; Margaret Warton; Andrew J Karter Journal: Int J Epidemiol Date: 2008-03-07 Impact factor: 7.196
Authors: Nicholas J Everage; Annie Gjelsvik; Stephen T McGarvey; Crystal D Linkletter; Eric B Loucks Journal: Ann Epidemiol Date: 2012-03 Impact factor: 3.797
Authors: Richard F Hamman; Rena R Wing; Sharon L Edelstein; John M Lachin; George A Bray; Linda Delahanty; Mary Hoskin; Andrea M Kriska; Elizabeth J Mayer-Davis; Xavier Pi-Sunyer; Judith Regensteiner; Beth Venditti; Judith Wylie-Rosett Journal: Diabetes Care Date: 2006-09 Impact factor: 19.112
Authors: Mary F Dallman; Norman Pecoraro; Susan F Akana; Susanne E La Fleur; Francisca Gomez; Hani Houshyar; M E Bell; Seema Bhatnagar; Kevin D Laugero; Sotara Manalo Journal: Proc Natl Acad Sci U S A Date: 2003-09-15 Impact factor: 11.205
Authors: Thomas P Giordano; Allen L Gifford; A Clinton White; Maria E Suarez-Almazor; Linda Rabeneck; Christine Hartman; Lisa I Backus; Larry A Mole; Robert O Morgan Journal: Clin Infect Dis Date: 2007-04-23 Impact factor: 9.079