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

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.