Problem: Black women have been shown to experience higher rates of morbidity and mortality as a result of stroke, cardiovascular disease, hypertension, diabetes and overweight and obesity than women of other races/ethnicities. Creating an understanding of the various factors that impact individual health promotion behaviors to reduce risk, such as health literacy, self-efficacy and readiness to change will support effective interventions to reduce health care disparities in this vulnerable population.
Method: 132 urban Black women in Midtown Manhattan in the service region of an academic medical center with a diverse population was chosen for this descriptive correlative study. Participants completed a questionnaire containing a demographic profile and survey instruments measuring health literacy, self-efficacy and readiness for change, and a detailed report of current health promotion behaviors.
Results: Black urban women between 30 - 64 y (M = 45, SD = 9.72) participated. 72.6% completed high school, 25% had achieved a college degree. Pearson correlation showed positive correlation at the 0.01 level (2-tailed) between health literacy (r2 = .25), self-efficacy (r2 = .31) and readiness for change (r2 = .44) to health promotion behaviors. Self-efficacy was positively related to participation church organizations (r2 = .31) and a high body mass index (BMI) (F=25, p<.001). Participation in church organization was inversely related to high health literacy (r2 = .41). Among women scoring high in self-efficacy and low in health literacy, BMI scores averaged higher (BMI=35.2) than those with high health literacy scores (BMI=30.2). Conditions such as hypertension, diabetes, respiratory disorders and stroke were more prevalent if health literacy scores were low and self-efficacy was high. Women with low health literacy were less likely to seek medical care with a health care provider, take prescribed medications or receive routine preventative health care.
Conclusion: Future research interventions geared to reduce health care disparities in Black women may be more effective in reducing modifiable conditions if performed in collaboration with community church organizations rather than from a health care provider alone.