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Racial and ethnic minorities in the United States have higher rates of hypertension than European Americans. In this ethnographic study, 30 Nigerian immigrant health care workers with hypertension described their self-efficacy management of the disease to ascertain the relationship between health-related hardiness, individual attitudes on compliance, and medication adherence self-efficacy. Using a mixed methods designs comprised of survey tools and focus-group questionnaires, the research questions were focused on understanding attitudes and health practices within Nigerian culture that support self-efficacy management. The theoretical framework for this study is the social learning theory and the social cognitive theory postulated by Bandura. Content analysis of the focus group transcript revealed that all participants agreed that culture directly influences their self-efficacy practices. Interview responses generated 4 major themes in which the study participants expressed positive attitude towards adopted values including culture practices, faith, enculturation, and fear of medication effects. Cross tabulations of data from the survey tools showed no relationship between self-care management, attitude, and medication adherence. Factor analysis of the Health Related Hardiness (HRH) scale identified 6 constructs with a cumulative variance of 64.9%. Implication for positive social change include culturally specific health intervention programs that focus on the impact of culture on hypertension self-efficacy practices and self-care management.