Hypertension Self-Management and Stroke Recovery Among Rural Adults in the Stroke Belt: A Mixed-Methods Study.

PURPOSE: To assess hypertension-related knowledge, self-management behaviors, and post-stroke needs among African American (AA) stroke survivors in rural Alabama.

DESIGN

Cross-sectional, mixed-methods study.

METHODS

Using convenience sampling, we recruited 25 AA stroke survivors aged 50 years or older from three rural counties in Alabama. Quantitative data were collected using the Hypertension Knowledge-Level Scale (HK-LS), hypertension Self-Care Activity Level Effects (H-SCALE), and the Southampton Stroke Self-Management Questionnaire. Fourteen participants completed semi-structured interviews. Descriptive statistics and thematic analysis were used to analyze the data.

RESULTS

Most participants had low hypertension knowledge (56%) and poor adherence with medication (76%), the DASH diet (84%), physical activity (56%), and smoking cessation (72%). Qualitative analysis of participant interviews identified key barriers to hypertension management and post-stroke recovery, including limited hypertension knowledge, poor adherence, gaps in continuity of care, and limited social support.

CLINICAL RELEVANCE: Rehabilitation nurses play a critical role in improving hypertension management and post-stroke recovery through culturally tailored education, reinforcement of self-management behaviors, and improved care coordination. Strengthening patient education and access to community-based resources may reduce recurrent stroke risk and improve outcomes.

CONCLUSIONS

AA stroke survivors in rural settings face significant challenges in hypertension management and recovery. Targeted, culturally responsive, and community-engaged interventions are needed to improve self-management and long-term outcomes.