title: Medication adherence beliefs of community-dwelling hypertensive African Americans.
abstract: OBJECTIVE
  Medication adherence is low among hypertensive patients regardless of ethnic background. However, the prevalence of nonadherence is higher among African Americans when compared with their white American counterparts. Recognizing African American perspectives about their adherence to antihypertensive medications is necessary for the development of successful interventions aimed at improving adherence to prescribed regimens. The purpose of this qualitative study was to explore community-dwelling hypertensive African American behavioral, normative, and control beliefs regarding their adherence to antihypertensive medications.
  
  
  METHODS
  A community and academic partnership was formed to conduct 3 audio-taped focus groups with 40 hypertensive and low-income African American adults aged 18 years and older. Interview questions were based on the theory of planned behavior. All transcripts from the tapes were analyzed using thematic analysis.
  
  
  CONCLUSIONS
  Behavioral beliefs associated with medication adherence identified both positive and negative outcomes. Family, friends, neighbors, and God were associated with normative beliefs. Limited financial resources, neighborhood violence, and distrust of healthcare professionals were key control beliefs. Although these results cannot be generalized, they do provide significant insight into the contextual factors associated with the lives of community-dwelling hypertensive African Americans who fit a similar demographic profile. These findings are important because they can be used to tailor interventions to increase their medication adherence.
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, PA 19104-6096, USA. lisml@nursing.upenn.edu
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Lewis
authors.forename: Pheobe
authors.initials: P
authors.lastname: Askie
authors.forename: Shirley
authors.initials: S
authors.lastname: Randleman
authors.forename: Brenda
authors.initials: B
authors.lastname: Shelton-Dunston
mesh_terms: D000328:Adult; D001741:Black or African American / Q000193:education / Q000208:ethnology* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D005190:Family / Q000208:ethnology; D005260:Female; D017144:Focus Groups; D033062:Friends / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000208:ethnology*; D007389:Internal-External Control; D008297:Male; D055118:Medication Adherence / Q000208:ethnology*; D008875:Middle Aged; D015404:Nursing Methodology Research; D015143:Philadelphia / Q000453:epidemiology; D011369:Professional-Patient Relations; D011582:Psychological Theory; D036301:Qualitative Research; D012069:Religion and Psychology; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D035502:Trust / Q000523:psychology; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data; D016903:Drug Monitoring