The burden of hypertension: mental representations of African American women

A qualitative study using focus groups to explore African American women's mental representations of hypertension was conducted with 47 participants. The ability of participants to select and perform rational procedures for threat management also was explored. Leventhal's Self-Regulation Process Model was used to guide the development of the study. African American women (mean age 50.11 years) were recruited from community settings to participate in focus groups. Transcripts from the focus groups were coded and analyzed using comparative analysis. Four themes were generated from the women's mental representations: (1) Vulnerability and Inevitability, (2) Biobehavioral Assaults, (3) Barriers to Effective Management, and (4) Culturally Relevant Remedies. Hypertension was perceived as a significant disease threat; causality was associated with risk factors interacting within the context of psychological stress. Acquiring a clear perspective of how African American women perceive hypertension and their ability to reduce risk factors can assist in developing a model for stimulating the use of health promotive behavior.