Abstract P309: Social Network Analysis of Religious Organization Co-Affiliation, Exercise, and Weight in South Asians

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Objective: Religious organizations may influence health behaviors by exerting social influence and reinforcing cultural beliefs. We tested the hypothesis that social influence, constituted by affiliating with or attending religious organizations, was associated with exercise and weight in South Asians.Methods: Multilevel, cross-sectional data were collected from participants in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Participants (n=700) were surveyed about their affiliation/membership in religious organizations (e.g., churches, temples, mosques) where South Asians participate using a comprehensive roster. MASALA participants who reported affiliating with or attending the same religious organization were classified as co-attendees. Body mass index (BMI) was calculated from measured height and weight, and physical activity (PA) was assessed using a validated questionnaire. The dependent variables were BMI categories (normal and overweight/obese), and meeting the minimum recommended amount of exercise (≥500 metabolic-minutes/week of moderate-vigorous PA). The main independent variable was affiliation exposure, a measure of the level of exposure to overweight/obesity and PA level among co-attendees at religious organizations, which is an indicator of social influence. Exponential random graph models were conducted to examine associations between exposure to co-attendees’ overweight/obesity and PA and individuals’ overweight/obesity and PA. Models controlled for individual-level sociodemographic, cultural, and network characteristics.Results: Participants (average age 59 years, SD=9 and 43% female) affiliated with 163 unique religious organizations, and the median number of affiliations was 3 (IQR 2-7). Participants were significantly more likely to be overweight/obese (aOR=2.3, 95% CI=1.1, 4.8) as they were increasingly exposed to other overweight/obese participants through co-affiliation in religious organizations. Individual-level network characteristics (e.g., number of overweight/obese friends/family) were not associated with overweight/obesity. Co-affiliation in religious organizations was not associated with PA; however participants with less traditional South Asian cultural beliefs were more likely to exercise at least 500 met-min/week (aOR=2.5, 95% CI= 1.4, 4.7) than those who held more traditional cultural beliefs.Conclusion: South Asians who were exposed to other overweight/obese South Asians through co-affiliation in religious organizations were more likely to be overweight/obese. These results provide evidence of multilevel social and cultural influences on health. Lifestyle interventions that address social and cultural drivers of behaviors and are implemented in partnership with religious organizations could be effective at reducing CVD risk in South Asians.

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