Commonsense illness beliefs, adherence behaviors, and hypertension control among African Americans

• Published in: Journal of behavioral medicine 2008-10, Vol.31 (5), p.391-400
• Main Authors: Hekler, Eric B., Lambert, Jennifer, Leventhal, Elaine, Leventhal, Howard, Jahn, Eric, Contrada, Richard J.
• Format: Article
• Language: English
• Subjects: Adherence; African Americans - psychology; African Americans - statistics & numerical data; Age Factors; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Attitude to Health; Biological and medical sciences; Black American people; Blood and lymphatic vessels; Blood pressure; Body Mass Index; Cardiology. Vascular system; Control Groups; Disease management; Family Medicine; Female; Fundamental and applied biological sciences. Psychology; General Practice; Health Behavior; Health beliefs; Health Knowledge, Attitudes, Practice; Health Psychology; Humans; Hypertension; Hypertension - drug therapy; Hypertension - prevention & control; Hypertension - psychology; Illness and personality; Life Style; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Models, Psychological; Patient Compliance; Personality, behavior and health; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Regression Analysis; Sex Factors; Socioeconomic Factors; Stress, Psychological - prevention & control; Stress, Psychological - psychology
• ISSN: 0160-7715; 1573-3521
• DOI: 10.1007/s10865-008-9165-4

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.