Background: Hypertension is a global public health challenge affecting approximately 60 million nationally and more than 1 billion individuals globally. It is one of the most common and important modifiable risk factors for coronary artery disease, stroke, congestive heart failure, chronic kidney disease, and peripheral vascular disease. The rate of hypertension among persons in the Caribbean is three times that of persons living in the United States. The United States Virgin Islands (USVI) is an unincorporated territory of the United States located in the Caribbean. Cultural norms are preconceived belief systems that have various kinds of impact on how treatment modalities are accepted and executed and can greatly influence patient care overall. The cultural influences of this population complex and it stems from both the Caribbean and US influence. The rate of hypertension among the American Citizen from US Virgin Islands is disquieting when equated to that of American citizen living on the US mainland. Population-sensitive assessments of health care practices are essential to improve global healthcare initiatives. Researchers have examined various factors that may deter adherence some explore these factors globally, some by ethnicity others by social structure. There have been no studies that explore the cultural impact of hypertension management among persons from the United States Virgin Islands.
Purpose: The purpose of this presentation is to report on the critical factors that influence the usage of herbal supplementation and its impact on therapeutic hypertensive management adherence among persons from the United States Virgin Islands.
Philosophical Underpinnings: Grounded Theory is based in the Naturalist Constructivist paradigm and is informed by the philosophical constraints of symbolic interactionism and pragmatism.
Method: The research approach was qualitative. Grounded theory methodology uncovered a substantive theory that articulates the critical factors influencing adherence to therapeutic medical management among the hypertensive population residing in the United States Virgin Islands.
Design: Strauss and Corbin’s Grounded Theory method guided the data collection and analysis of this study. Purposive, snowball and theoretical sampling were utilized respectively in this study. Data was collected through semi-structured interviews. Interviews were conducted with twenty-one individual participants and then with a focus group of four participants.
Results: The United States Virgin Islander has several influences that constitute his/her culture, and these have significant impact on the way they view health care and illness in general. The health- related cultural beliefs and practices embraced by this population served as proponents for, and deterrence of, adherence behaviors among hypertensive persons in this population. The perceptual benefits of herbal products, cultural cooking practices, perceptions of illness and spirituality are the most prominent cultural practices embraced by the population that impact adherence practices in this population. The strongest proponent of non-adherence, however, is the use of herbal products to manage blood pressure.
Conclusion: The factors that affect adherence delineated in this study were substantive and yielded evidence that conceptualized the impact of cultural norms on medical decision making among this population. Ethno-cultural effective care is an essential component of efficacious disease management. This study provides insights that could be useful in informing care initiatives for the population from the United States Virgin Islands and other similar populations. The results also provide a basis for future research into herbal supplementation and its efficacy in hypertensive management.
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