Association of Resilience and Stress with Health Behaviors Among American Indian and Alaska Native Adults

Abstract

Abstract Objectives Literature suggests stress and resilience (i.e., perceived ability to cope with stress) are associated with health behaviors. American Indian and Alaska Native (AIAN) adults have increased risk for stress due to historical trauma, discrimination, and higher odds of living in poverty. Despite this, they have not been included in prior quantitative investigations of the association of stress and resilience with health behaviors. The objectives of this work are to describe resilience and stress levels of AIANs and evaluate the associations of resilience and stress with diet and physical activity. Methods Cross-sectional surveys were collected from adults who self-identified as AIAN at three pow wows that took place in Oklahoma and Washington state in 2018. Surveys included: Cohen's 10-item Perceived Stress Scale that ranges from 0–40 in which higher scores indicate higher stress; the Brief Resilience Scale with scores that range from 1–5 and higher scores indicative of higher resilience; one item on quality of eating habits (10-point scale from ‘poor’ to ‘excellent’); two items estimating hours of sedentary activities; and two items estimating hours of physical activity. T-tests and chi-squared tests assessed bivariate differences in health behaviors by high or low stress and resilience, based on scoring above or below the median. Results The mean age of 636 respondents was 45.6 years and 62% identified as female. The median score was 16 for stress was 16 and 3.5 for resilience. High self-reported stress was associated with lower perceived diet quality (5.3 vs. 5.7; P = 0.02). Respondents reporting higher stress levels also reported engaging in more hours of sedentary behaviors on the weekend (P < 0.001). In contrast, high resilience was related to fewer hours of sedentary activities during weekdays and weekends (both P = 0.04). Stress and resilience were not related to moderate or vigorous physical activity. Conclusions Compared with prior studies, AIAN adults in this study reported high levels of both stress and resilience. This cross-sectional study further supports a possible relationship between health behaviors, stress, and resilience. Future investigations should account for other factors related to stress and health behaviors, such as age, income, education, and living situation. Funding Sources N/A.