Abstract 9818: Self-Care Self-Efficacy and Perception of Income Adequacy Influence Self-Care Among African Immigrants with Chronic Disease

Abstract

Introduction: Self-care is vital in chronic illness management. Little is known about the self-care behaviors of African immigrants living in the US. Objectives: I) Describe the self-care behaviors of adult African immigrants in the US living with hypertension, diabetes, or other chronic illness. II) Identify significant determinants of self-care. Methods: Using a cross-sectional design and purposive sampling, 88 African immigrants to the US were enrolled if they self-identified as sub-Saharan African immigrants, were ≥35 years of age, had a symptomatic chronic illness, and could speak and understand English. Self-care was measured with the Self Care of Chronic Illness Inventory and the Self-Care Self-Efficacy scale. Scores are standardized 0-100 with scores >70 considered adequate. Acculturation was measured using a modified standardized acculturation instrument and predefined acculturation proxies (e.g., duration of residency and age at immigration). General linear modeling with backward elimination was used to identify potential determinants of self-care. Results: The 88 participants were between 35 and 78 years, most were married (67%) and reported either diabetes (18%) or hypertension (50%) as their major illness. Self-care scores were adequate (mean 78.6, 77.9, 75.6 for self-care maintenance, monitoring and management). Specific self-care behaviors low in this population were eating a special diet and monitoring for medication side-effects and fatigue. In response to symptoms, few modified their diet or called a healthcare provider. Most (56.8%) were acculturated and acculturation was not associated with self-care. Self-care self-efficacy was high (81.3) and a strong determinant of self-care maintenance (p<0.0001), monitoring (p<0.0001) and management (p<0.0001). Perceived inadequacy of income was a significant determinant of poor self-care management (p= 0.03). Conclusions: In this sample of African immigrants with primarily diabetes and hypertension, self-care was adequate. Self-care self-efficacy and perceived income adequacy were determinants of self-care. These factors can be used to inform culturally concordant interventions to promote self-care.