Problem: Significant racial disparities exist in the age of onset, prevalence, and outcomes of hypertension with African Americans bearing a disproportionate burden of disease. African Americans are less likely to sustain lifestyle changes necessary to prevent hypertension, yet almost nothing is known about their beliefs related to these preventive strategies. Framework/Methodology: The Theory of Planned Behavior (TPB) guided the semi-structured interviews used in this qualitative study. Five focus groups were conducted to elicit the emic view regarding hypertension prevention. Participants included 34 African Americans, between 27 and 60 years of age (M=48, Mdn=47) who were fairly evenly distributed by age and education, and with income ranging from <$15,000 (24%) to >$50,000 (31%)/year. Participants viewed themselves as quite healthy, with a perceived low to moderate risk of developing hypertension, kidney disease, stroke, and diabetes. Verbatim transcripts were used for thematic analysis. A loosely constructed a priori coding scheme based on the TBP identified the salient behavioral, normative, and control beliefs influencing behavior. Findings. Themes related to behavioral beliefs revealed participants to be knowledgeable about causes and consequences of hypertension, but having less knowledge regarding prevention options. Participants reported few choices for dealing with chronic stress, and negatively evaluated dietary changes and increasing exercise. Normative belief themes revealed a consistent sense that the participants’ social groups would disapprove of the person engaging in preventive lifestyle strategies, especially changing dietary practices. Data regarding control beliefs indicated that participants had significant concerns regarding external factors (e.g., time, social support) with fewer concerns regarding internal factors (e.g., skill, information). Implications: Findings will assist nurses to conduct more thorough assessments of prevention beliefs and social supports of African Americans at risk for hypertension. Using more group-oriented intervention strategies to increase social support for preventive behaviors may improve outcomes in this population.
Session #1195 - Prevention: Beliefs and Interventions
The 29th Annual MNRS Research Conference (April 1-4, 2005)