The purpose of this study was to develop and conduct preliminary psychometric assessment of instruments measuring knowledge and self-care practices regarding behaviors needed for blood pressure (BP) control among African Americans. Items were empirically derived and scored on a 7-point, bipolar scale. The instruments were evaluated in a sample of 306 community-dwelling African Americans. Results revealed acceptable reliability and validity of the BP Knowledge Scale. Results for the BP Self-Care Scale were mixed. A structural equation model of these scales, recorded BP, and covariates fit well. There was an unexpected positive correlation between selfcare and BP suggesting a potential bi-directional relationship. The scales demonstrated acceptable psychometric properties and, with minor revisions, may have clinical utility as measures of BP knowledge and self-care.
KeywordsBlood pressure; hypertension; African American; self-care; instrument development Hypertension is a major public health problem affecting over 50 million Americans. Thirty percent of adults have the condition but are unaware of its presence, 40% of persons with hypertension are not being treated, and only one-third of those being treated have their blood pressure (BP) controlled to <140/90 (Chobanian et al., 2003). The risk of death from ischemic heart disease and stroke increases linearly and progressively from BP levels as low as 115 mmHg systolic and 75 mmHg diastolic (Lewington, Clarke, Qizilbash, Peto, & Collins, 2002), and the lifetime risk of developing hypertension is 90% for men and women who are normotensive at age 55 (Vasan et al., 2002). Given these data, it is imperative that efforts be directed at preventing and controlling BP disease. The need for hypertension prevention and control is greatest among African Americans, as their prevalence of hypertension is higher than any other racial or ethnic group in the United States (Centers for Disease Control [CDC,] 2005). Yet, little is known about African Americans' knowledge and practice of the self-care behaviors necessary to prevent and control high BP. Therefore, the purpose of this study was to test the psychometric properties of instruments designed to measure both knowledge and frequency of engaging in the self-care behaviors necessary to control BP in a sample of African American adults.The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7;Chobanian et al. 2003 of causal factors for hypertension, including: reduced physical activity, excess body weight, excess dietary sodium intake, inadequate intake of fruits and vegetables, and excessive alcohol intake. These causal factors can be mitigated through self-care strategies for lifestyle modification (Campbell et al., 1999;Chobanian et al.;Douglas et al., 2003).Many of the disparities noted in the prevalence, morbidity, and mortality of hypertension in African Americans may be attributed to disparities in the presence of the identified causal ris...