Cross-sectional study on stigma and motivation to adhere to lifestyle modification among vulnerable populations with fatty liver disease

Abstract

Objectives: Adherence to lifestyle modification (diet, exercise, and alcohol cessation) for fatty liver disease (FLD) management remains challenging. The study examined stigma, barriers, and factors associated with motivation to adhere to lifestyle modification in a diverse and vulnerable population with FLD. Methods: From 2/19/2020 to 2/28/2022, 249 FLD patients within San Francisco safety-net hepatology clinics were surveyed along with clinical data taken from medical records. Multivariable modeling assessed factors associated with motivation to adhere to lifestyle modification in a cross-sectional study. Results: Median age was 53 years, 59% female, 59% Hispanic, 25% Asian/Pacific Islander, 9% White, and 2% Black, 79% were non-English speakers, 64% had ≤ high school education, and 82% reported high school (coef 1.41, 95% CI 0.34–2.48), stigma (coef 0.34, 95% CI 0.07–0.62), and depression (coef −1.52, 95% CI -2.79 to −0.26) were associated with motivation. Conclusions: Stigma is commonly reported among FLD patients. Interventions to enhance patient education and mental health support are critical to FLD management, especially in vulnerable populations.