Recognizing Limitations to Blood Pressure Management By Latinos With Hypertension: A Primary Focus Group Study

Background: Latinos in the United States—the largest and the fastest increasing ethnic minority group in the country—are experiencing increasing incidences of high blood pressure (HBP) that is often uncontrolled. Self-management of HBP is a determining factor for BP control yet, it is unclear what barriers and facilitators exist in relation to HBP management from the emic perspective.

Purposes: 1) to explore barriers and facilitators of HBP self-management among Latino individuals residing in an urban area on the East cost of the United States, and 2) to identify potential intervention approaches to BP control preferred by the target population.  

Methods: Four focus groups of 2 to 8 participants were held in varying community locations. Focus group samples included Latino patients with HBP (n=7), health educators (n=8), and community health workers (n=3). Trained bilingual research assistants conducted interviews in Spanish or English. Using an inductive content analytic approach, focus group data were analyzed. Two trained research assistants worked independently to identify common themes across focus groups.

Results: Seven themes emerged in relation to barriers to HBP self-management: Not wanting to take HBP medicine, recognized need for care but not acting on it, lack of knowledge/understanding, lack of self-control, limited access to care, lack of understanding from providers, and dissatisfaction with healthcare. The themes related to facilitators included: For the family and to feel good. Focus group participants suggested that in addition to basic disease knowledge, future interventions focus on addressing HBP in the context of promoting quality of life, consider using text messages, and build on the Latino community infrastructure such as ethnic churches or schools (for better trust).  

Conclusions: Results show that multilevel stakeholders should be involved in the care of individuals with HBP. The data from this focus group study will be used to inform culturally-tailored intervention to lower BP among this target population. Further, the study will help inform health care approaches in other addressing barriers, such as health literacy.