The purpose of this study was to identify religious/spiritual coping behaviors of African American women with hypertension (HTN) and explore how religious/spiritual coping influences adherence to high blood pressure (HBP) therapy in older African American women. A mixed-method research design guided this study. Twenty African American women with primary HTN were enrolled in this study using a mixed methods concurrent triangulation design. Data collection included physiologic, descriptive, and sociodemographic data. Adherence was measured using the Hill-Bone Compliance to High Blood Pressure Therapy scale (Kim, Hill, Bone, & Levine, 2000), and religious/spiritual coping was evaluated with the Brief Religious/Spiritual Coping scale. Qualitative data were obtained by audiotaped interviews using a semi-structured interview guide. Descriptive, physiologic data and data from questionnaires were analyzed. Five themes emerged. (a) Feelings of dizziness, lightheadedness, and feeling sick; (b) Belief in God or a Supreme Being, (c) Prayer as the primary coping mechanism, (d) Adherence conceptualized as obedience to God’s will, and (e) Need for healthcare providers to pray and provide more health information. This study provided insight into the influence of religious/spiritual coping behaviors on adherence to HTN treatment in older African American women with HTN in a rural medically underserved area. Nurses and other healthcare providers are in a key position to influence positive health outcomes in rural settings with limited resources using culturally appropriate strategies.


Religious/Spiritual Coping, Adherence/Compliance, Hypertension, Mixed Method, African American Women

Author Bio(s)

Danice B. Greer, PhD, RN, BC is an Assistant Professor at The University of Texas at Tyler School of Nursing. Her research interest includes hypertension and stroke prevention, adherence, health disparities, chronic illness and health promotion, and the influence of religion and spirituality on coping and health. Correspondence regarding this article can be addressed directly to: dgreer@uttyler.edu.

Willie M. Abel, PhD, RN is an Assistant Professor at The University of North Carolina at Charlotte in the School of Nursing. Her clinical concentration is critical care nursing and her research focuses on improving the health status of Black women with cardiovascular disease, particularly hypertension, heart failure, myocardial infarction, and cardiac risk factors. Correspondence regarding this article can also be addressed directly to: wmabel@uncc.edu.


The authors wish to thank the research assistant and the women who participated in this study.

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