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Improving Adherence in African American Women With Uncontrolled Hypertension

Greer, Danice B. PhD, RN, BC; Ostwald, Sharon K. PhD, RN, FGSA, FAHA

Journal of Cardiovascular Nursing: July/August 2015 - Volume 30 - Issue 4 - p 311–318
doi: 10.1097/JCN.0000000000000152
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Background and Objectives: African American women are disproportionately affected with hypertension (HTN). The aim of this randomized controlled trial was to evaluate the effectiveness of a 6-week culturally tailored educational intervention for 60 African American women with HTN.

Methods: Sixty African American women, 29 to 86 years old (mean ± SD, 57.98 ± 12.37 years), with primary HTN were recruited from 4 rural locations and randomized to intervention (n = 30) and control (n = 30) groups to determine the effectiveness of the intervention on knowledge, attitudes, beliefs, social support, adherence to an HTN regimen, and blood pressure control. Culturally tailored educational classes were provided for 90 minutes once a week for 6 weeks. The control group received usual care.

Results: A significant favorable overall main effect (time) was found for systolic blood pressure (F3,174 = 11.104, P = .000) and diastolic blood pressure (F3,174 = 4.781, P = .003) for both groups. Also for diastolic blood pressure, older age was a significant covariate (F1,56 = 6.798, P = .012). Older participants tended to have increased diastolic blood pressures. There were no significant differences between groups on knowledge, adherence, or attitudes.

Conclusion: The culturally tailored program used the African American church as a basis for recruitment and implementation of the program that retained all participants over a 6-month period. African American women living in rural Texas who participated in a 6-week intervention program demonstrated a significant decrease in blood pressure over a 6-month period regardless of whether they were in the intervention or control group. In general, they had a relatively good knowledge of HTN and reported an average level of adherence. Future studies using a culturally tailored program with a larger sample size are warranted to decrease the high level of HTN-related complications in African American women.

Danice B. Greer, PhD, RN, BC Assistant Professor, College of Nursing & Health Sciences, The University of Texas at Tyler.

Sharon K. Ostwald, PhD, RN, FGSA, FAHA Professor Emerita, School of Nursing, University of Texas at Houston.

The Martel Speros Endowment, Center on Aging, and the Isla Carroll Turner Trust at the University of Texas Health Science Center-Houston supported this study.

This study was conducted in full accordance with the American Psychological Association ethical standards for research in human subjects.

The authors have no conflicts of interest to disclose.

Correspondence Danice B. Greer, PhD, RN, BC, 3900 University Blvd, BRB 1115, Tyler, TX 75799 (dgreer@uttyler.edu).

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved
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