The goal of the proposed study is to examine the influence of acculturation, social relationships, and socioeconomic status (SES) on hypertension self-care behaviors across generations of African American families. African Americans have a high prevalence of hypertension and frequently experience the onset of chronic illness in early adulthood. This can result in multiple generations of a family concurrently having to manage hypertension for several decades. The underlying conceptual model for this study uses the concepts of relationship interdependence (as measured by dyadic relationship characteristics) and shared outcomes (self- care practices) from Interdependence Theory, in addition to the construct of acculturation, and variables relating to socioeconomic status. Ninety dyads (n=180) will be enrolled, with each dyad consisting of an African American older adult and an adult child each of whom will have hypertension. Participants will be interviewed separately about their: chronic illness self-care practices, health care utilization, general health status and other chronic conditions, level of acculturation, relationship characteristics, and socioeconomic status. The specific hypotheses are to test if, 1) generations of chronically ill African Americans share similar self-care practices;2) whether having similar self-care practices is the result of shared levels of acculturation;or 3) from sharing a close familial relationship;and 4) if older parent-adult child self-care practices are dissimilar is this predicted by differences in SES. Analyses will be conducted in 3 stages: 1) at the individual level to examine the influence of acculturation and SES on self-care practices, 2) then based on the participant's dyadic role (older parent or adult child), and 3) in a multilevel analysis by dyad using multi-level modeling, to assess the association between dyadic variables (proximity, frequency, intensity, reciprocity, and multiplexity), acculturation, SES and self-care practices. The results of this study will provide important information related to the design and implementation of chronic disease self-management programs (CDSMP). This study will increase our understanding of African American cultural beliefs, family structure, and self-care practices, which are critical to the development of salient and effective interventions to improve the health status of African American families.
The health disparities experienced by African Americans related to prevalence and outcomes of chronic illness are a critical public health issue. This study examines the role of acculturation, socioeconomic status, and family interdependence, as possible contributing factors to hypertension self-management in African American families. The findings will aid in the development and implementation of more effective chronic illness self- management programs for African Americans.
| Warren-Findlow, Jan; Seymour, Rachel B; Brunner Huber, Larissa R (2012) The association between self-efficacy and hypertension self-care activities among African American adults. J Community Health 37:15-24 |
| Warren-Findlow, Jan; Seymour, Rachel B; Shenk, Dena (2011) Intergenerational transmission of chronic illness self-care: results from the caring for hypertension in African American families study. Gerontologist 51:64-75 |
| Warren-Findlow, Jan; Seymour, Rachel B (2011) Prevalence rates of hypertension self-care activities among African Americans. J Natl Med Assoc 103:503-12 |
