Abstract
Hypertension, particularly among African Americans, has been increasing in importance in the past 10 years. One aspect of this problem is poor disease management. This study examined illness beliefs, behaviors, and hypertension control among 102 African American outpatients. Participants were interviewed about their commonsense beliefs concerning hypertension and its management in accordance with Leventhal’s commonsense model of self-regulation (CSM). Also assessed were medication adherence, stress-reducing behaviors, and lifestyle behaviors recommended for blood pressure control. Blood pressure was measured at about the time of interviewing. Results indicated that endorsement of a medical belief model of hypertension (i.e., caused and controlled by factors such as diet, age, and weight) was cross-sectionally associated with lower systolic blood pressure, a relationship that was statistically mediated by lifestyle behaviors (e.g., cut down salt, exercise). Endorsement of a stress belief model (i.e., stress is the main factor in hypertension cause and control) was associated with engagement in stress-related behaviors but not with blood pressure. These results further support the utility of the CSM for understanding patients’ disease management behaviors.
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Notes
There were nonsystematic missing data values for some interview items. In these instances, the sample mean for that variable was substituted. If the data were missing for a categorical variable (i.e., the patient’s belief that the disease is chronic, acute, or cyclical) then the subject was dropped from all analyses. All analyses were repeated with the subsample of participants that had complete data, N = 79. The results did not differ from those obtained for the full sample, N = 102.
In initial regression analyses, elapsed time between blood pressure reading and interview was entered in the regression models and it did not influence the results. It was dropped from subsequent analyses.
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This study was funded by a grant from the National Institute of Aging: P20AG012072.
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Hekler, E.B., Lambert, J., Leventhal, E. et al. Commonsense illness beliefs, adherence behaviors, and hypertension control among African Americans. J Behav Med 31, 391–400 (2008). https://doi.org/10.1007/s10865-008-9165-4
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DOI: https://doi.org/10.1007/s10865-008-9165-4