文章基本信息

标题：Trust, Medication Adherence, and Hypertension Control in Southern African American Men
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作者：Keith Elder ; Zo Ramamonjiarivelo ; Jacqueline Wiltshire 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2012
卷号：102
期号：12
页码：2242-2245
DOI：10.2105/AJPH.2012.300777
语种：English
出版社：American Public Health Association
摘要：We examined the relationship between trust in the medical system, medication adherence, and hypertension control in Southern African American men. The sample included 235 African American men aged 18 years and older with hypertension. African American men with higher general trust in the medical system were more likely to report better medication adherence (odds ratio [OR] = 1.06), and those with higher self-efficacy were more likely to report better medication adherence and hypertension control (OR = 1.08 and OR = 1.06, respectively). Trust remains an important issue with African Americans (AAs), particularly in the South where its history of mistreatment and racial discrimination at times were highly prevalent. 1 Racial and ethnic minorities are more prone than are Whites to distrust the health care establishment, and historically, minority men have had less access to culturally competent providers. 2–4 Southern AAs are more likely than are Whites to report perceived racial barriers to care, 5 and AA men are more likely than are AA women to report perceived discrimination. 6–10 Perceived discrimination and mistreatment are associated with poorer medical adherence and delays in seeking health care. 11–14 In addition, higher levels of trust in the health care system are associated with better adherence to recommended care, greater patient satisfaction, and better outcomes. 15–18 This has significant implications considering that AA men develop hypertension (HTN) at an earlier age, have higher rates of advanced (stage 3) HTN, are more likely to experience HTN complications, and are less likely to achieve HTN-control compared with White men. 19–21 The rates of HTN are even higher in the South for AA men, accounting, in part, for higher stroke (80% higher) and cardiovascular mortality (50% higher) in this subpopulation compared with other groups in other regions. 21–23 The goal of this brief study was to assess the relationship between trust in the medical, medication adherence, 24 and HTN control 25 among Southern AA men. Other covariates were perceived discrimination, perceived racism, self-efficacy, and participation in medical decision-making. This study is based on the Race and Health Outcomes Model developed by Williams et al. 26