Abstract
Behavioral risk factors are among the preventable causes of health disparities, yet long-term change remains elusive. Many interventions are designed to increase self-efficacy, but little is known about the effect on long-term behavior change in older, low-income African Americans, especially when facing more problematic barriers. A cohort of 185 low-income African–Americans with hypertension reported barriers they encountered while undergoing a multiple behavior change trial from 2002 to 2006. The purpose of the present study was to explore the relationships between self-efficacy, barriers, and multiple behavior change over time. Higher self-efficacy seemed to be partially helpful for smoking reduction and increasing physical activity, but not for following a low-sodium diet. Addiction was indirectly associated with less reduction in smoking through lower self-efficacy. Otherwise, different barriers were associated with behavior change than were associated with self-efficacy: being “too busy” directly interfered with physical activity and “traditions” with low-sodium diet; however, they were neither the most frequently reported barriers, nor associated with lower self-efficacy. This suggests that an emphasis on self-efficacy alone may be insufficient for overcoming the most salient barriers encountered by older African Americans. Additionally, the most common perceived barriers may not necessarily be relevant to long-term behavioral outcomes.
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Acknowledgments
The study was supported by grant R01 HL69397 from the National Heart, Lung, and Blood Institute. The first author was supported by National Research Service Award T32 HP10031-12, National Institutes of Health (NIH).
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Mansyur, C.L., Pavlik, V.N., Hyman, D.J. et al. Self-efficacy and barriers to multiple behavior change in low-income African Americans with hypertension. J Behav Med 36, 75–85 (2013). https://doi.org/10.1007/s10865-012-9403-7
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DOI: https://doi.org/10.1007/s10865-012-9403-7