BACKGROUND: Misperceptions detract from effective disease management in a number of conditions but the nature of underlying illness beliefs and their relative consistency in @entity1 with chronic @entity101 (cHTN) who present to the @entity341 ( @entity341 ) with poor blood pressure control is not known. OBJECTIVES: 1) To explore disease knowledge in @entity341 @entity1 with cHTN using explanatory modelling; and 2) to compare gaps in cHTN knowledge across racially similar but geographically divergent @entity341 @entity1 . METHODS: Emergency department @entity1 of African origin with cHTN were recruited from three sites: Detroit Receiving Hospital (DRH - Detroit, MI), the Tanzanian Training Center for International Health (TTCIH - Ifakara, TZ) and the University Hospital of the West Indies (UHWI - Kingston, JA). Demographic and baseline data were collected along with open-ended responses to a series of questions related to cHTN. Qualitative responses were coded into predefined, disease-relevant quantitative domains by two separate, blinded reviewers and multilevel comparisons were performed using Kruskal-Wallis or analysis of variance (ANOVA) tests, where appropriate. RESULTS: One hundred and ninety-seven @entity1 were enrolled; mean age (50.5 years vs 51.6 years vs 50.8 years; p = 0.86) and gender distribution (% male: 49.5 vs 44 vs 40; p = 0.53) were similar across sites but @entity1 at DRH (vs TTCIH vs UHWI) were more @entity101 at presentation (mean systolic BP in mmHg: 166.8 vs 153 vs 152.7; p = 0.003), had a longer mean duration of cHTN (12.1 years vs 4.6 years vs 9.1; p < 0.0001), and were less likely to be on antihypertensive therapy (84.5% vs 92% vs 100%, p = 0.001). Explanatory models revealed limited recognition of cHTN as a "disease" (19.6% vs 28% vs 16%; p = 0.31) and consistency in the belief that cHTN was curable (44.3% vs 36% vs 42%; p = 0.62). Stress (48.4% vs 60% vs 50%; p = 0.31) and, especially at DRH, diet (62.2% vs 22% vs 36%); p < 0.0001) were identified most frequently as causes of cHTN and an association with symptoms was common (83.5% vs 98% vs 78%; p = 0.15). Clear differences existed for perceived benefits of treatment and consequences of poor control by site but in general, both were under-appreciated. CONCLUSIONS: Misperceptions related to cHTN are common in @entity341 @entity1 . While specific areas of disconnect exist by geographic region, failure to recognize cHTN as a dire and fixed disease state is consistent, suggesting that a uniform educational intervention may be of benefit in this setting.

Differences and Similarities in Explanatory Models of XXXX in the United States of America, Tanzania and Jamaica.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity341 :: ('MESH:D004630', 'Disease') :: ['ED', 'Emergency Department'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension', 'hypertensive']
@entity101 :: (MESH:D006973,Disease) :: ['Hypertension']
