Higher Motivation for Weight Loss in African American than Caucasian Rural Patients with Hypertension and/or Diabetes.

Abstract

To examine the relationship between race/ethnicity and motivation for weight loss and motivation for exercise among patients with chronic disease. Cross-sectional. Our study took place within a network of federally qualified health centers (FQHCs) in the rural southern United States. 463 active FQHC patients with diabetes and/or hypertension identifying as African American, White Hispanic, or non-Hispanic White participated in our study. Primary outcomes were assessed using standardized measures of motivation for a) weight loss; and b) hypertension per the Transtheoretical Model. Multivariate logistic regression revealed that, when controlling for age, sex, education status, employment status, poverty, comorbidity, and weight status, there were no significant differences in motivation for exercise among the different racial/ethnic groups (P=.361). However, when controlling for the same factors, there was a significant difference in motivation for weight loss, with African American participants more than twice as likely as non-Hispanic White participants to be motivated to lose weight (ORADJ = 2.430, P=.002). Our study suggests that, among rural patients with obesity-related chronic disease, there is a significant variation in motivation to lose weight between racial/ethnic groups. This underscores the importance of culturally tailoring interventions and in considering motivation for change when promoting weight loss behaviors. Additional implications for intervention development and delivery are discussed.