Perceived Discrimination, Retention, and Diabetes Risk Among American Indians and Alaska Natives in a Diabetes Lifestyle Intervention

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 d...

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Bibliographic Details
Published in:Journal of aging and health 2021-08, Vol.33 (7-8_suppl), p.18S-30S
Main Authors: Gonzales, Kelly L., Jiang, Luohua, Garcia-Alexander, Ginny, Jacob, Michelle M., Chang, Jenny, Williams, David R., Bullock, Ann, Manson, Spero M.
Format: Article
Language:English
Subjects:
Alaska Natives - psychology
Alaska Natives - statistics & numerical data
American Indian or Alaska Native - psychology
Diabetes
Diabetes Mellitus, Type 2 - ethnology
Diabetes Mellitus, Type 2 - prevention & control
Discrimination, Psychological
Health Behavior - ethnology
Humans
Indians, North American - psychology
Indians, North American - statistics & numerical data
Life Style
Native North Americans
Retention
Retention in Care
Risk Reduction Behavior
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Summary: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.
ISSN:0898-2643
1552-6887
DOI:10.1177/08982643211013188