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The theory of planned behavior (TPB) was integrated within the theory of self-care (SCT) to explore the predictive value of extending TPB to measure attitudes and beliefs regarding a behavioral goal, and determine the ability of goal beliefs to predict engagement in the combined, multiple behaviors necessary to control BP. The hypothesized model was evaluated in a sample of 306 community-dwelling African Americans between 21 and 65 years of age. Scales developed for the study achieved acceptable reliability (α = .68-.95). Structural equation modeling analysis resulted in a second-order factor structure with attitude, subjective norm, perceived behavioral control, and intention modeled as indicators of a construct representing goal beliefs related to keeping BP within normal limits. This latent construct was conceptualized within the theory of self-care as "self-care motivation," and predicted 18% of the variance in self-care behaviors necessary for BP control. The model achieved acceptable fit (CMIN/df = 2.32; CFI = .95; RMSEA = .066). Final assessment of fit was done using multi-group SEM and bootstrapping techniques. In this extension of the TPB attitudes and beliefs regarding the goal of keeping BP within normal limits were found to determine one's motivation to engage in the multiple behaviors necessary for BP control.
Keywords: self-care; self-care agency; self-care motivation; theory of planned behavior; structural equation modeling
One in three African Americans has high blood pressure (HBP), a rate that is 45% higher than that of their Caucasian counterparts ( Centers for Disease Control and Prevention [CDC], 2005 ; Fields et al., 2004 ). African Americans develop hypertension at an earlier age of onset, tend to maintain higher BP readings, develop more frequent and severe complications, and are less likely to achieve BP control than other racial groups ( Chobanian et al., 2003 ). The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7; Chobanian) indicates that lifestyle self-care strategies are essential for preventing high blood pressure, and lifestyle modification is an indispensable aspect in the treatment of all stages of hypertensive disease. Yet, little is known about African Americans' attitudes and beliefs regarding the selfcare behaviors and lifestyle modification needed to attain BP control and prevent hypertension. In addition, no research was found that examined...