MHealth provides a new way of promoting hypertension self-management behaviors. However, the acceptance, feasibility, and effectiveness of interventions incorporating mHealth technology have been understudied in African-Americans with hypertension. This study aimed to explore participants' (n = 30) experiences using a community and technology-based intervention to self-manage their hypertension (COACHMAN). Focus groups were conducted with African-Americans living with hypertension. Focus groups were audio-recorded, and the data were transcribed verbatim and analyzed qualitatively using thematic analysis. Regarding the use of mHealth-enabled self-management hypertension interventions to support hypertension control among African-Americans, the thematic analysis produced the following five barrier themes: (a) lack of knowledge regarding how to use technology, (b) resistance to learning new technology, (c) lack of access to technology, (d) privacy and security concerns, and (e) issues with the medication management support features. Facilitator themes that emerged from the thematic analysis were all related to the intervention components, which were: (a) reminders, (b) rewards, and (c) education modules. This study focused on mHealth barriers and facilitators as described by African-Americans living with hypertension. Results provide a starting point for developing a mHealth intervention for African-Americans that incorporates a self-management program.
The purpose of this study was to encourage African-Americans to become active participants in advanced care planning through increased education and awareness. A quasi-experimental design was used in two local churches in Leon County. Thirty participants (N = 30) were African-Americans, 18 years of age and older, English speaking, from all socioeconomical levels, and from all educational backgrounds. The annotated 2003 Minnesota Survey was used to develop pre-survey and post-survey questions regarding advanced care planning. A paired t test was used to analyze the pre-survey and post-survey responses. The significant value was < 0.05, thus demonstrating a statistically significant difference in pre- and post-survey responses. The educational intervention on advanced directives indicated that all 30 participants would consider completing some form of advanced directive or discussing end-of-life care planning with either another person, a healthcare provider, or they would seek legal advice. African-Americans are more prone to chronic diseases. However, a systemic literature review describes how African-Americans were less likely to participate in advanced care planning and were less likely to receive end-of-life care than other ethnic groups. The 30-minute educational intervention encouraged African-Americans to participate in advanced care planning. Because the sample size was small, results cannot be generalized to all African-Americans. With increased educational opportunities, African-Americans may be encouraged to become active participants in advanced care planning. Advanced practice registered nurse providers should provide advanced care planning information to all patients, but especially to African-Americans. This study should be replicated in a wide variety of settings with larger numbers of participants. Further research is needed to discover additional methods of providing advanced care planning education to African-Americans.
African-Americans bear a disproportionate burden of HIV infections in the United States and African-American women make up 64% of new HIV infections. Therefore, this study aimed to explore the predictors of those who are more likely to use Pre-Exposure Prophylaxis (PrEP) among women reporting IPV, depression, and partner risk. This study used secondary data analysis to explore IPV, depression, and increased partner risk as predictors of PrEP use among 768 women (506 African-American women and 262 White women in the United States) who responded to survey questions regarding potential PrEP use and barriers to uptake. The parent data had been collected at Emory University Rollins School of Public Health. Results of the data analysis of the sample (N = 768) indicated that women who reported high levels of partner risk (p < 0.05), depression (p < 0.01), and/or experienced IPV (p < 0.01), were more likely to use PrEP. In addition, younger women aged 20-35 were more likely to use PrEP, compared to women older than 36 years. Furthermore, college educated African-American women were more likely to use PrEP than White women. Despite limitations, findings indicated that IPV, depression, and partner risk are predictors of PrEP use. There is need for a multi-modal approach in addressing these predictors of PrEP use among African-American women in the United States.
This study describes a conceptual model about empowering self-care. Such a model is important because of its potential for influencing health outcomes in chronic conditions, a leading cause of illness and disability. A defining characteristic of chronic illness is the need for effective self-care management. Therefore, a self-care management plan that is collaboratively developed and considers the patient's goals, resources, culture, and lifestyle was proposed. The philosophical perspective of oppression and story theory provided the theoretical lenses used to define the concept empowering self-care. Identified are qualities of empowerment, which stress a non-hierarchical relationship that promote authentic dialoguing and valuing of each individual's contribution. Story theory structures ideas around the nurse-person intentional dialogue. It is especially useful when the nurse is attempting to understand what matters most to someone living with a health challenge. The story was gathered using the story path method to structure the dialogue. A synthesized definition of empowering self-care was created through the lens of Freire (2005) and the story of what matters to a person living with the health challenge of a chronic condition. Empowering self-care can promote increased patient accountability and responsibility for self-care management leading to improved patient outcomes. Health outcomes may improve when nurses actively support patients' efforts to achieve their own goals.
