African American culture and hypertension prevention

A qualitative study was done to explore attitudes and beliefs of African Americans regarding hypertension-preventive self-care behaviors. Five focus groups, with 34 participants, were held using interview questions loosely based on the Theory of Planned Behavior (TPB). Analysis revealed themes broadly consistent with the TPB and also identified an overarching theme labeled "circle of culture." The circle is a metaphor for ties that bind individuals within the larger African American community and provides boundaries for culturally acceptable behaviors. Three subthemes were identified: One describes how health behaviors are "passed from generation to generation," another reflects a sense of being "accountable" to others within the culture, and the third reflects negative views toward people who are "acting different," moving outside the circle of culture. Findings provide an expanded perspective of the TPB by demonstrating the influence of culture and collective identity on attitude formation and health-related behaviors among African Americans.