Exploring spiritual health locus of control and medication adherence among individuals of African descent with hypertension

Introduction: Existing evidence indicates nontraditional factors such as spirituality may influence medication adherence. Spirituality has been linked with lower blood pressure and stress related medical symptoms. We examined factors associated with spirituality and the association between spiritual health locus of control (SLC) and medication adherence (MA) among individuals of African descent with hypertension. Methods: Baseline data were obtained from the ongoing group randomized control trial Faith-based Approaches in the Treatment of Hypertension (FAITH). MA was measured using the Morisky 8-item scale, with a lower score indicating greater adherence. SLC was measured using the Spiritual Health Locus of Control Scale; a higher SLC score indicated a more active approach to his/her healthcare (e.g. God works through doctors to heal us). Ordinal logistic regression was used for bivariate analysis and multivariate analysis which was adjusted for age, gender, employment, education, and income. Results: The study sample consisted of 249 participants with an average age of 62.5 years ± 12.3. The sample was 73% female with 54% reporting an income of less than $39,999, 21% reported perfect adherence to medication. Active SLC was associated with attending college (p=0.010), employment (p=0.048) and age (p=0.022). The mean SLC scores were 27.8 for high adherence 27.8 moderate and 28.6 for low adherence (p=0.532). Discussion: We did not find a statistically significant relationship between SLC and MA at baseline; however participants that were younger, employed, and more educated reported higher SLC. Future work will assess the association between spirituality and medication adherence at six months.