African American women, blood pressure control, Hypertension treatment adherence measure



  1. Fongwa, Marie N. PhD, RN, MPH
  2. Nandy, Karabi PhD
  3. Yang, Qing PhD
  4. Hays, Ron D. PhD


Background: Lack of adherence to recommended regimens is a major cause of uncontrolled blood pressure (BP) among African/Black American (AA) women. The national initiative to increase BP control among AAs by 50% makes clear the need for culturally appropriate instruments to assess facilitators of adherence to treatment of hypertension (high BP [HBP]).


Objective: The aim of this study was to develop a culturally sensitive measure of facilitators of and barriers to adherence to hypertension treatment regimens for AA women.


Methods: We developed the Facilitators of and Barriers to Adherence to Hypertension Treatment Scale (FATS) with input from focus groups with 20 AA women. A total of 147 AA women from a federally funded inner-city clinic in Los Angeles were enrolled in the study and 70 (48%) completed the survey. Internal consistency reliability was estimated using Cronbach's [alpha].


Results: Coefficient [alpha] for the 18-item FATS was 78. In a multivariate regression model, controlling for BP stage, the FATS was significantly associated with the Hill-Bone High Blood Pressure Compliance Scale (standardized [beta] = .35; P = .0014), the Enhancing Recovery From Coronary Heart Disease Social Support Inventory ([beta] = .42; P = .001), the and CAGE (cut down on your drinking, annoyed by being criticized for your drinking, guilty about drinking, and eye-opener drink in the morning) alcohol screening instrument ([beta] = -.24; P = .05).


Discussion: The FATS is a culturally sensitive measure for assessing adherence to treatment regimens of HBP in AA women. Further study in other samples of AA women is needed to confirm that the FATS adequately assesses facilitators of adherence to regimens for HBP in AA women.