Electronic Theses and Dissertations



Document Type


Degree Name

Doctor of Philosophy



Committee Chair

Annapoorna Mary

Committee Member

Sohye Lee

Committee Member

Fawaz Mzayak

Committee Member

Christy Woodbury-Moore


Background: African American (AA) women are disproportionately affected by hypertension and are less likely to adhere to their medication regimen when compared to White and Hispanic women. Very little is known about social factors associated with medication adherence among AA women. Spiritual well-being (SWB), religious well-being (RWB), and social determinants of health (SDOH) may be associated with self-efficacy for appropriate medication use (SEAM). Purpose: The purpose of the study is to: (1) examine the relationships among SDOH, namely age, education level, household income, and marital and insurance status, and SWB and RWB; (2) examine the relationships between SDOH and SEAM; and (3) assess the potential associations of SWB and RWB with SEAM. Methods: The study employed a cross-sectional correlational design. An online survey was used to collect data. A purposive sample of 187 AA women with hypertension diagnosis over 1 year was recruited. SWB and RWB were measured using the Spiritual Well-Being Scale, and SEAM was measured using the Self-Efficacy for Appropriate Medication Use Scale. SDOH were adopted from Healthy People 2030. Linear regression analysis was conducted to assess the adjusted association of SWB and RWB with SEAM, and p < .05 was considered significant. Results: The women of the study were middle aged (M = 57.34 years, SD = 12.89) and had moderate SWB and RWB scores. Only age and education were positively associated with SEAM (p < .001 and p = .025, respectively). There was no association of SWB or RWB with SEAM. Discussion and Conclusion: SWB and RWB scores did not predict SEAM in this sample of AA women with hypertension. However, this could be due to lack of power due to a small sample size. Older age and higher education level were associated with higher self-efficacy. Interventions to improve adherence to antihypertension drug treatments aimed at younger AA women with lower educational attainment could help in improving care and reducing disparities in health outcomes for this population.


Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest


Open Access