Intergenerational transmission of chronic illness self-care: results from the caring for hypertension in African American families study.
OBJECTIVE
African Americans often experience early onset of hypertension that can result in generations of adults managing high blood pressure concurrently. Using a model based on the Theory of Interdependence, this study examined whether intergenerational transmission of hypertension knowledge and self-efficacy would affect hypertension self-care of older parents and their adult children.


METHODS
We recruited 95 African American older parent-adult child dyads with hypertension. We constructed separate logistic regression models for older parents and adult children with medication adherence as the outcome. Each model included individual demographic and health characteristics, the partner's knowledge, and self-efficacy to manage hypertension and dyad-related characteristics.


RESULTS
Parents were more adherent with medication than adult children (67.4% vs. 49.5%, p < .012). There were no significant factors associated with parent medication adherence. In adjusted models for adult children, medication adherence was associated with child's gender (odds ratio [OR] = 3.29, 95% confidence interval [CI] = 1.26-8.59), parent beliefs that the child had better hypertension self-care (OR = 4.36, 95% CI = 1.34-14.17), and child reports that the dyad conversed about hypertension (OR = 3.48, 95% CI = 1.18-10.29). Parental knowledge of hypertension and parent's self-efficacy were weakly associated with adult children's medication adherence (OR = 1.35, 95% CI = 0.99-1.84 and OR = 2.59, 95% CI = 0.94-7.12, respectively).


CONCLUSIONS
Interventions should consider targeting African American older adults to increase self-care knowledge and empower them as a primary influencer of hypertension self-care within the family.
Warren-Findlow
Jan
J
Department of Public Health Sciences, The University of North Carolina, Charlotte, NC 28223, USA. jwarren1@uncc.edu
Seymour
Rachel B
RB
Shenk
Dena
D
D000328:Adult; D032721:Adult Children; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000208:ethnology* / Q000628:therapy; D016901:Intergenerational Relations; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D008962:Models, Theoretical; D010287:Parent-Child Relations; D012648:Self Care; D020377:Self Efficacy; D012944:Social Support; D055815:Young Adult