Initiation of Health Behavior Change and Its Psychological Determinants in Prehypertensive People: An Exploratory Study

Objective: This study explored the relationship of risk perception with change in health behaviors and social cognitive theory (SCT) constructs. Additionally, this study evaluated the feasibility, utility, and practice of self blood pressure monitoring (SBPM). Design: Adults with prehypertension, ages 45-62 (N = 23) completed the Risk Perception Survey for Developing Hypertension (RPS-DH) and Health Belief Survey (HBS) during the screening portion of Dash-2-Wellness (D2W), a lifestyle modification intervention. Participants were randomized into one of two treatment groups, Dash-2-Wellness Plus (D2W Plus) or Dash-2-Wellness Only (D2W Only). Both groups were given dietary counseling regarding the DASH diet and encouraged to monitor their physical activity using a pedometer. The D2W Plus group also engaged in SBPM. Results: Moderate correlations were found between composite risk perception and change in step count (r = -.47, p = .03), and change in systolic blood pressure (r = .42, p = .04). Baseline risk perception was not related to SCT variables, with few exceptions. High levels of compliance (M = 90.36%, SD = 12.62) were reported for SBPM. Conclusions: Findings indicate that risk perception may play a limited role in motivating change in continuous health behaviors, particularly in asymptomatic conditions. Additionally, the nature of the risk reduction offered by the behavior may also influence its association with risk perception as a motivator for change. Findings suggest that SBPM is a feasible and useful behavior. Reports regarding positive affect and ease of machine use in regards to this behavior may increase the likelihood of regular compliance.