JMIR Publications

ABSTRACT

Background:

A growing number of studies indicate that exposure to social stress such as perceived racial discrimination may contribute to poor health, health behaviors, and health disparities. Increased physical activity (PA) may buffer the impact of social stress resulting from racial discrimination. However, data on the relationship between racial discrimination and PA, to date, are mixed. Part of the reason is that the effect of perceived racial discrimination on PA has been examined in mostly cross-sectional studies that captured the retrospective measures of perceived racial discrimination associated with individuals’ current PA outcomes. An association between real-time perceived racial discrimination and PA among African Americans remains an open question.

Objective:

The purposes of the study were to: (1) examine the relationship among demographic, clinical and psychological factors and lifetime racial discrimination, and (2) examine the within- and between-persons associations of racial discrimination on total energy expenditure, sedentary time and moderate-to-vigorous PA patterns measured by accelerometers and a real-time data capture strategy, Ecological momentary assessments (EMA) in healthy African Americans.

Methods:

The current pilot study used an intensive, observational, case-crossover design of community recruited African Americans (n=12). After participants completed baseline surveys, they were asked to wear an accelerometer for seven days to measure their PA levels. EMA were sent to participants 5x/day for seven days to assess daily real-time racial discrimination. Multilevel models were conducted to examine the within- and between-persons associations of daily racial discriminations on PA.

Results:

More EMA-reported daily racial discrimination was associated with younger age (r= .75, p=0.02). Daily EMA-reported microaggression was associated with depressive symptoms (r=0.66, p=0.05), past race-related events (r=0.82, p<0.01), and lifetime discrimination (r=0.78, p=0.01). In the within-person analyses, the day-level association of racial discrimination and sedentary time was significant (B=0.30±0.14, p=0.03), indicating that on occasions when participants reported more racial discrimination than usual, more sedentary time was observed. Between-person associations of racial discrimination (B= -0.30±0.28, p=0.29) or microaggression (B= -0.34±0.36, p=0.34) with total energy expenditure were suggestive but inconclusive.

Conclusions:

Concurrent use of EMA and accelerometers were feasible methods to examine the relationship between racial discrimination and PA in real-time. Examining the daily process within persons has the potential to elucidate mechanisms of action by which racial discrimination may have on health and health behaviors and to provide personalized interventions for increasing PA in racial ethnic minorities. Future studies with a precision health approach, incorporating within- and between-person associations are warranted to elucidate the effect of racial discrimination and PA.