Acculturative Stress and Hypertension Control in Filipino Americans

Felicitas A. Dela Cruz, RN, DNSc, FAANP, School of Nursing, Azusa Pacific University, Azusa, CA, USA and Carmen Galang, RN, DNSc, School of Nursing, California State University at Long Beach, Long Beach, CA, USA.

Background: Studies have shown that the incidence of HTN among immigrants is related to the stress resulting from their acculturation to the receiving country. Since 1965, FAs have been one of the fastest growing Asian groups in the U.S. Studies have shown that FAs have the highest rate of uncontrolled HTN among Asians, closely approximating that of African Americans, leading to more cardiovascular disease and deaths than found in the general population. Despite their growing numbers, FAs have remained a “hidden minority”; sparse information exists on the acculturative stress they experience in the U.S.

Methods: This qualitative study is part of a larger study designed to discover the factors involved in HTN control among diagnosed FAs. Two separate focus group interviews of men (n=10) and 2 separate groups of women (n=17) were conducted by a male and female moderator, respectively. Each group completed a sociodemographic form and A Short Acculturation Scale for Filipino Americans (ASASFA). The interviews were tape-recorded, transcribed, coded and analyzed for themes. This study incorporated member checks, peer debriefing, and an audit trail to ensure trustworthiness.

Results: All born in the Philippines, the participants (N=27) ranged in age from 42 to 73, and have resided in the U.S. for an average of 25 years. Their mean ASASFA scores indicated that they were becoming bicultural. They identified acculturative stress as a major cause of uncontrolled HTN, stemming from tensions between the collectivist Filipino and individualistic American values and cultural practices.

Conclusion: Acculturative stress emerged as an important reason for uncontrolled HTN in FAs. This information suggests the need for culturally-appropriate interventions to alleviate the acculturative stress experienced by hypertensive FAs, leading to improved HTN control.

Learning Objective #1: define acculturative stress.
Learning Objective #2: discuss the nature of acculturative stress experienced by Filipino Americans with hypertension in the U.S.