The Association Between Self-Efficacy and Hypertension Self-Care Activities Among African American Adults

Abstract

Chronic disease management requires the individual to perform varying forms of self-care behaviors. Self-efficacy, a widely used psychosocial concept, is associated with the ability to manage chronic disease. In this study, we examine the association between self-efficacy to manage hypertension and six clinically prescribed hypertension self-care behaviors. We interviewed 190 African Americans with hypertension who resided in the greater metropolitan Charlotte area about their self-efficacy and their hypertension self-care activities. Logistic regression for correlated observations was used to model the relationship between self-efficacy and adherence to hypertension self-care behaviors. Since the hypertension self-care behavior outcomes were not rare occurrences, an odds ratio correction method was used to provide a more reliable measure of the prevalence ratio (PR). Over half (59%) of participants reported having good self-efficacy to manage their hypertension. Good self-efficacy was statistically significantly associated with increased prevalence of adherence to medication (PR = 1.23, 95% CI: 1.08, 1.32), eating a low-salt diet (PR = 1.64, 95% CI: 1.07–2.20), engaging in physical activity (PR = 1.27, 95% CI: 1.08–1.39), not smoking (PR = 1.10, 95% CI: 1.01–1.15), and practicing weight management techniques (PR = 1.63, 95% CI: 1.30–1.87). Hypertension self-efficacy is strongly associated with adherence to five of six prescribed self-care activities among African Americans with hypertension. Ensuring that African Americans feel confident that hypertension is a manageable condition and that they are knowledgeable about appropriate self-care behaviors are important factors in improving hypertension self-care and blood pressure control. Health practitioners should assess individuals’ self-care activities and direct them toward practical techniques to help boost their confidence in managing their blood pressure.

The Survey of Self-Regulation Behaviors and Related Factors in Elderly with Hypertension in South-East of Iran

“…Rakwell suggests that patients with higher level of education have better decision-making powers to adopt health behaviors [20]. Some studies state that some people with low level of education do not understand the instructions correctly and this leads to a lack of self-efficacy in the adoption of these behaviors [27]. In the analysis of other factors, there was a significant relationship between marital status and self-regulation behaviors so that the average self-regulation performance of married individuals was better compared to other groups.…”

Using Insights From Behavioral Economics and Social Psychology to Help Patients Manage Chronic Diseases

“…High selfefficacy is important in achieving chronic disease control, and has been found to predict more successful hypertension self-management in African Americans. 29,30 Behavioral research provides some clues why well-meaning attempts to educate patients or provide them feedback may backfire (see Fig. 1).…”

Control Beliefs and Risk for Death, Stroke and Myocardial Infarction in Middle-aged and Older Adults: An Observational Study

“…We proposed that control beliefs may be relevant in this population, based on previous work showing that condition or task-specific control beliefs were associated with health behaviors and physiologic markers. 8,9,[21][22][23][24] Some evidence also indicated general control beliefs were associated with differences in illness-specific control beliefs. 37 It is possible that we did not detect interaction effects because general control beliefs have diverse effects on health, beyond self-care behaviors solely associated with DM and hypertension.…”

“…studies of those with DM and hypertension indicated that control beliefs may impact clinical outcomes and behavioral change, but only short-term outcomes were evaluated (e.g., dietary adherence, blood pressure and glycemic control). 8,9,[21][22][23][24] We found no investigations addressing the impact of control beliefs on the long-term risk for major cardiovascular events and mortality in DM and hypertension.…”