Optimizing blood pressure reduction: Predicting success in the home environment

Transferring skills to non-clinic contexts remains a challenge for clinical psychologists. Research is needed that investigates strategies of transfer ring clinic skills as well as factors that are associated with successful t ransfer. This paper presents research that involved training clients to red uce blood pressure (BP) in the home environment and isolating factors relat ed to successful BP reduction. Subjects diagnosed with mild hypertension pa rticipated in a controlled trial investigating the efficacy of continuous B P feedback in helping to reduce systolic BP in the clinic and home environm ent. While the benefits of learning BP feedback in the clinic was not shown to be beneficial over a control, training in the home environment was show n to reduce BP significantly in comparison to controls. Factors shown to be associated consistently and reliably with reduction of BP in the home were those that involved beliefs or expectations of self-control. Expectations (self-efficacy) and an internal locus of control consistently predicted the ability to reduce both systolic and diastolic BP in the home environment. Implications for the behavioural treatment of hypertension are discussed. C opyright (C) 2001 John Wiley & Sons, Ltd.