Self-efficacy and barriers to multiple behavior change in low-income African Americans with hypertension.
Behavioral risk factors are among the preventable causes of health disparities, yet long-term change remains elusive. Many interventions are designed to increase self-efficacy, but little is known about the effect on long-term behavior change in older, low-income African Americans, especially when facing more problematic barriers. A cohort of 185 low-income African-Americans with hypertension reported barriers they encountered while undergoing a multiple behavior change trial from 2002 to 2006. The purpose of the present study was to explore the relationships between self-efficacy, barriers, and multiple behavior change over time. Higher self-efficacy seemed to be partially helpful for smoking reduction and increasing physical activity, but not for following a low-sodium diet. Addiction was indirectly associated with less reduction in smoking through lower self-efficacy. Otherwise, different barriers were associated with behavior change than were associated with self-efficacy: being "too busy" directly interfered with physical activity and "traditions" with low-sodium diet; however, they were neither the most frequently reported barriers, nor associated with lower self-efficacy. This suggests that an emphasis on self-efficacy alone may be insufficient for overcoming the most salient barriers encountered by older African Americans. Additionally, the most common perceived barriers may not necessarily be relevant to long-term behavioral outcomes.
School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, VA 23529, USA. cmansyur@odu.edu
Carol L
CL
Mansyur
Valory N
VN
Pavlik
David J
DJ
Hyman
Wendell C
WC
Taylor
G Kenneth
GK
Goodrick
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D004039:Diet, Sodium-Restricted; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000523:psychology*; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011203:Poverty; D012309:Risk-Taking; D020377:Self Efficacy; D016540:Smoking Cessation / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires