Perceived racial discrimination and adoption of health behaviors in hypertensive Black Americans: the CAATCH trial.

Abstract

Few studies examine psychosocial factors influencing the adoption of healthy behaviors among hypertensive patients. The effect of discrimination on health behaviors remains untested. To examine the influence of discrimination on adoption of healthy behaviors among low-income Black hypertensive patients. Black patients (N = 930) in community-based primary care practices enrolled in the CAATCH trial. Mixed effects regressions examined associations between perceived discrimination and change in medication adherence, diet, and physical activity from baseline to 12 months, controlling for intervention, gender, age, income, and education. Patients were low-income, high-school-educated, with a mean age of 57 years. Greater discrimination was associated with worse diet and lower medication adherence at baseline. Discrimination was associated with greater improvement in healthy eating behaviors over the course of the 12-month trial. Prior exposure to discrimination was associated with unhealthy behaviors at baseline, but did not negatively influence the adoption of health behaviors over time.