A Proposed New Model of Hypertensive Treatment Behavior in African Americans

African Americans have poorer levels of hypertensive control than their white counterparts in the US population. Multiple studies have examined the factors that contribute to this discrepancy, but no literature review has yet attempted to place these findings within the framework of health behavior theory. The Health Belief Model (HBM) and social cognitive theory (SCT) are 2 complementary models of health behavior theory that provide a unifying structure to interpret this broad body of literature. Inaccurate lay public understanding of hypertensive illness and its consequences contributes to decreased perceived severity and susceptibility to hypertension; lower rates of compliance with lifestyle recommendations reflect several common perceived barriers along with low self-efficacy and outcome efficacy regarding hypertensive treatments. Public health workers and health care providers must understand these factors within a socioecological perspective if they are to design effective interventions to assist African Americans in meeting antihy-pertensive treatment goals.