Date of Award

Winter 2-24-2021

Degree Type

Dissertation

Degree Name

PhD Health Sciences

Department

Health and Medical Sciences

Advisor

Deborah DeLuca, J.D.

Committee Member

Paul Franco, Ph.D.

Committee Member

Fortunato Battaglia, Ph.D.

Keywords

High blood pressure, African Americans, United States, Alternative Medicine, Home Remedies, Health Belief Model

Abstract

ABSTRACT

Understanding African Americans’ Beliefs, Knowledge, Attitudes and Behaviors Regarding High Blood Pressure and Their Use of Home Remedies as Treatment

Elisa E. Douglas

Seton Hall University, 2021

Dissertation Chair: Dr. Deborah DeLuca, J.D., MS

Background and Purpose of the Study: African Americans have the highest prevalence of high blood pressure (HBP) in the United States but the lowest blood pressure (BP) control rates of any major race/ ethnic group. Only about 45% of those who use drugs to treat the condition have been able to attain BP control. Over 40% of African Americans are affected by HBP. African Americans are more likely to use home remedies as a complement to prescription medicine, with an estimated complementary and alternative medicine (CAM) use of 67.6-71.3%. The purposes of this study were to examine the beliefs, knowledge, attitudes and behaviors of African Americans regarding HBP and their use of home remedies as treatment using a novel survey instrument and to test the reliability of the instrument in the population of interest.

Participants completed the Beliefs about Hypertension Survey (BHS), which has 47 items, via SurveyMonkey. Validity and reliability of the BHS were established using the Delphi Technique, Cronbach’s Alpha, and Exploratory Factor Analysis. Participants were solicited via Facebook and WhatsApp. The results were analyzed using Multivariate Analysis of Variance (MANOVA), follow-up univariate Analyses of Variance (ANOVAs), Pearson’s and Spearman’s correlation, and using the inductive approach to create themes for the qualitative data.

Methods: This was a mixed-methods study that utilized a descriptive, exploratory, cross-sectional and correlational research design. A sample of 254 African Americans with and without HBP participated in this study.

Results: Reliability for the BHS representing all four dependent variables was good (Cronbach’s alpha α = .848). Individually, for each factor of the BHS, the reliability ranged from poor to good: Attitudes (α = .503), Knowledge (α =.608), Behaviors (α = .678) and Beliefs (α = .824). It was found that African Americans with HBP were more willing to use home remedies as treatment than as a preventative measure against diagnosis. However, 77% of participants stated that they would use home remedies to treat their HBP if their doctors recommended it, while 58% of participants who have HBP said they currently use home remedies to treat the condition. The results indicated that 91% of participants were somewhat knowledgeable about HBP, however, over 71% believed that HBP can be cured. Results of the MANOVA test indicated statistical significance (p = .000) only for the behavior variable (α = .05), with no significant differences found between African Americans with HBP and those without the condition with respect to knowledge, beliefs and attitudes.

Conclusion: The results indicate that diagnosis of HBP increases African Americans’ willingness to use home remedies. The results indicate that more focus is needed on educating African Americans in general about the effects of HBP and what they can do to lower their risk of diagnosis. It is recommended that health care professionals receive formal education about holistic approaches to treating HBP during medical training. Further evidence-based studies will also help to increase knowledge and acceptance of home remedies as a treatment option for HBP.

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