种族歧视的负担：在参加行为体重管理计划的成年初期女性中，检验种族歧视与肥胖变化之间的关联。
The Weight of Racial Discrimination: Examining the Association Between Racial Discrimination and Change in Adiposity Among Emerging Adult Women Enrolled in a Behavioral Weight Loss Program.
机构信息
Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
J Racial Ethn Health Disparities. 2022 Jun;9(3):909-920. doi: 10.1007/s40615-021-01030-7. Epub 2021 Mar 29.
BACKGROUND
Non-Hispanic Black (NHB) emerging adult (EA) women are at disproportionate risk for obesity but experience limited benefit from behavioral weight loss (BWL) programs. Race-related stress could play a role; the goal of this study was to examine the association between racial discrimination (RD) and early (3 months) changes in adiposity, and to explore potential protective factors, among EA in an adapted BWL program.
METHODS
This is an ancillary study of non-Hispanic White (NHW) and NHB EA women enrolled in an adapted BWL trial (N = 49; 55.1% NHB; Age 21.2 (2.1); BMI = 33.0 + 4.3 kg/m). At baseline, group- and personal-level RD (RD-group and RD-personal), racial identity (NHB women only), vigilant coping, and social support were assessed via validated questionnaires. Weight and waist circumference were measured objectively at 0 and 3 months.
RESULTS
NHW women manifested greater reductions in waist circumference relative to NHB women (p = .004). RD-personal did not predict change in waist circumference at 3 months (p = .402); however, the association between RD-group and change in waist circumference was statistically significant (p = .015), such that reporting greater group-level discrimination predicted a smaller decrease in waist circumference; the model explained 22% of the variance. Social support and vigilant coping were not statistically significant in the model. Among NHB women only, higher racial identity-centrality predicted greater reduction in waist circumference (p = .019).
CONCLUSION
Findings suggest racial discrimination could contribute to greater cardiometabolic risk during this developmental period. Future research should examine how experiences of racial discrimination unfold in the daily lives of NHB women to inform mechanistic interventions to enhance health and well-being.
TRIAL REGISTRATION
NCT02736981. Low Intensity Weight Loss for Young Adults.
背景
非西班牙裔黑人（NHB）成年初期女性（EA）肥胖的风险不成比例，但从行为减肥（BWL）计划中获益有限。与种族有关的压力可能起作用；本研究的目的是检查种族歧视（RD）与肥胖早期（3 个月）变化之间的关系，并在适应 BWL 计划的 EA 中探索潜在的保护因素。
方法
这是一项非西班牙裔白人（NHW）和 NHB EA 女性参加适应 BWL 试验的辅助研究（N=49；55.1%NHB；年龄 21.2（2.1）；BMI=33.0+4.3kg/m）。在基线时，通过验证问卷评估了群体和个人层面的 RD（RD-群体和 RD-个人）、种族认同（仅 NHB 女性）、警惕应对和社会支持。在 0 和 3 个月时通过客观测量体重和腰围。
结果
NHW 女性的腰围减少量相对 NHB 女性更大（p=0.004）。RD-个人在 3 个月时并不预测腰围变化（p=0.402）；然而，RD-群体与腰围变化之间的关联具有统计学意义（p=0.015），表明报告更高的群体歧视预测腰围减小幅度较小；该模型解释了 22%的方差。在该模型中，社会支持和警惕应对不具有统计学意义。仅在 NHB 女性中，较高的种族认同中心性预测腰围减少量更大（p=0.019）。
结论
研究结果表明，种族歧视可能会在这一发育期间导致更大的心血管代谢风险。未来的研究应检查 NHB 女性在日常生活中经历种族歧视的方式，为增强健康和幸福感的机制干预措施提供信息。
试验注册
NCT02736981. 年轻人的低强度减肥。
Zotero 插件