Cardiovascular disease is the number one killer of Americans. Among ethnic groups cardiovascular disease is most prevalent within the African American population. Despite the seriousness of this disease, treatment non-adherence rates are high. Interventions have not addressed the issue of adherence and culture adequately. Therefore, culturally-informed interventions should be developed and tested to compile an evidence-based repertoire of interventions.

This study examined the effects of MiStory, a combination of motivational interviewing and narrative therapy, on treatment adherence in non-adherent African American heart failure patients. In particular, it examined the effects of social support, medication self-efficacy, perceived behavioral control, and outcome expectancies on adherence rates. In this study only medication self-efficacy was found to be statistically significant with increased adherence rates. However, trends towards adherence were seen in patients. Implications for future research on improvement of adherence with low-income African-American heart failure patients are discussed.