A convergence of health beliefs: An "ethnography of adherence" of African-American rural elders with hypertension

This study assessed the influence of health beliefs on prescribed dietary behaviors in chronic hypertension management among forty-one rural Southern African-Americans age 65+. Despite the overwhelming prevalence of hypertension-related morbidity and mortality, research efforts to determine what accounts for decisions to follow physician's recommendations have been fragmented, interventions inappropriate, and adherence to these recommendations reportedly limited. Adherence was evaluated through a 24-hour dietary recall, food frequency, and physician's consultation. Health beliefs were assessed through various structured questionnaires and unstructured interviews. Results indicate that the influence of health beliefs on the decision to follow treatment recommendations is complex, as study members tend to maintain both "traditional" and biomedical health orientations and practices. The author concludes by making substantive recommendations to researchers, providers and planners designed to improve health outcomes.