title: Diet and exercise adherence and practices among medically underserved patients with chronic disease: variation across four ethnic groups.
abstract: Many factors interact to create barriers to dietary and exercise plan adherence among medically underserved patients with chronic disease, but aspects related to culture and ethnicity are underexamined in the literature. Using both qualitative (n = 71) and quantitative (n = 297) data collected in a 4-year, multimethod study among patients with hypertension and/or diabetes, the authors explored differences in self-reported adherence to diet and exercise plans and self-reported daily diet and exercise practices across four ethnic groups-Whites, Blacks, Vietnamese, and Latinos-at a primary health care center in Massachusetts. Adherence to diet and exercise plans differed across ethnic groups even after controlling for key sociodemographic variables, with Vietnamese participants reporting the highest adherence. Food and exercise options were shaped by economic constraints as well as ethnic and cultural familiarity with certain foods and types of activity. These findings indicate that health care providers should consider ethnicity and economic status together to increase effectiveness in encouraging diverse populations with chronic disease to make healthy lifestyle changes.
authors.affiliation: Brown University, Providence, RI 02912, USA. kathryn_orzech@brown.edu
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Orzech
authors.forename: James
authors.initials: J
authors.lastname: Vivian
authors.forename: Cristina
authors.initials: C
authors.lastname: Huebner Torres
authors.forename: Julie
authors.initials: J
authors.lastname: Armin
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Shaw
mesh_terms: D044383:Black People / Q000523:psychology / Q000706:statistics & numerical data; D002908:Chronic Disease / Q000208:ethnology* / Q000628:therapy; D003920:Diabetes Mellitus / Q000178:diet therapy / Q000208:ethnology / Q000628:therapy; D004032:Diet / Q000208:ethnology; D004035:Diet Therapy / Q000523:psychology* / Q000592:standards; D015444:Exercise / Q000523:psychology*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000178:diet therapy / Q000208:ethnology / Q000628:therapy; D008297:Male; D008404:Massachusetts; D017057:Medically Uninsured / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D010349:Patient Compliance / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D011446:Prospective Studies; D012959:Socioeconomic Factors; D014744:Vietnam / Q000208:ethnology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D001741:Black or African American