Facilitators and barriers to hypertension self-management in urban African Americans: perspectives of patients and family members.

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Date

2013

Authors

Flynn, Sarah J
Ameling, Jessica M
Hill-Briggs, Felicia
Wolff, Jennifer L
Bone, Lee R
Levine, David M
Roter, Debra L
Lewis-Boyer, Lapricia
Fisher, Annette R
Purnell, Leon

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Abstract

INTRODUCTION: We aimed to inform the design of behavioral interventions by identifying patients' and their family members' perceived facilitators and barriers to hypertension self-management. MATERIALS AND METHODS: We conducted focus groups of African American patients with hypertension and their family members to elicit their views about factors influencing patients' hypertension self-management. We recruited African American patients with hypertension (n = 18) and their family members (n = 12) from an urban, community-based clinical practice in Baltimore, Maryland. We conducted four separate 90-minute focus groups among patients with controlled (one group) and uncontrolled (one group) hypertension, as well as their family members (two groups). Trained moderators used open-ended questions to assess participants' perceptions regarding patient, family, clinic, and community-level factors influencing patients' effective hypertension self-management. RESULTS: Patient participants identified several facilitators (including family members' support and positive relationships with doctors) and barriers (including competing health priorities, lack of knowledge about hypertension, and poor access to community resources) that influence their hypertension self-management. Family members also identified several facilitators (including their participation in patients' doctor's visits and discussions with patients' doctors outside of visits) and barriers (including their own limited health knowledge and patients' lack of motivation to sustain hypertension self-management behaviors) that affect their efforts to support patients' hypertension self-management. CONCLUSION: African American patients with hypertension and their family members reported numerous patient, family, clinic, and community-level facilitators and barriers to patients' hypertension self-management. Patients' and their family members' views may help guide efforts to tailor behavioral interventions designed to improve hypertension self-management behaviors and hypertension control in minority populations.

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Journal article

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Subjects

health disparities, hypertension, patient perspective, qualitative research

Citation

Published Version (Please cite this version)

10.2147/PPA.S46517

Publication Info

Flynn, Sarah J, Jessica M Ameling, Felicia Hill-Briggs, Jennifer L Wolff, Lee R Bone, David M Levine, Debra L Roter, Lapricia Lewis-Boyer, et al. (2013). Facilitators and barriers to hypertension self-management in urban African Americans: perspectives of patients and family members. Patient Prefer Adherence, 7. pp. 741–749. 10.2147/PPA.S46517 Retrieved from https://hdl.handle.net/10161/8327.

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Scholars@Duke

Boulware

L. Ebony Boulware

Adjunct Professor in the Department of Medicine

Dr. Boulware is a general internist, physician-scientist and clinical epidemiologist focused on improving health and health equity for individuals and communities affected by chronic health conditions such as kidney disease. A national thought leader in health equity, she has identified patient, clinician, system, and community-level barriers that result in disparate outcomes for Black and other marginalized individuals. Using pragmatic trials, she has developed successful interventions, shaped guidelines, raised physician awareness and changed clinical practice.  Throughout her work, Dr. Boulware has sought to improve transparency and trustworthiness in science and medicine. 

Her research has been continuously funded by the National Institutes for Health, the Patient Centered Outcomes Research Institute, and other organizations throughout her career. She has published over 200 manuscripts, book chapters, and editorials, and she mentors numerous students, residents, fellows, and faculty members.  Dr. Boulware is an elected member of the American Society for Clinical Investigation, the Association of American Physicians, the National Academy of Medicine, and the American Academy of Arts and Sciences.

PubMed Listing Here (Link)

Education

  • A.B. Vassar College, 1991
  • M.D. Duke University, 1995
  • M.P.H. Johns Hopkins Bloomberg School of Public Health, 1999


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