Effectiveness of a community-based health programme on the blood pressure control, adherence and knowledge of adults with hypertension: A PRECEDE-PROCEED model approach.

Abstract

AIMS AND OBJECTIVES\nTo determine the effectiveness of a community-based health programme grounded on the PRECEDE-PROCEED model, on the knowledge, adherence and blood pressure control of community-dwelling adults with hypertension.\n\n\nBACKGROUND\nHypertension has consistently been a leading cause of morbidity and mortality in different countries and has continuously increased in prevalence. Albeit manageable with lifestyle modification and anti-hypertensive medications, adequate knowledge and poor adherence to these treatment regimens are issues that have led to poor blood pressure control.\n\n\nDESIGN\nQuasi-experimental, one-group pretest-post-test design.\n\n\nMETHODS\nThe PRECEDE-PROCEED model was used to develop and evaluate the effectiveness of the community-based health programme. From August to October 2017, a total of 50 community-dwelling adults with hypertension participated in the programme which included blood pressure monitoring, targeted health educations, motivational interviews, individualised lifestyle modification plans and house-to-house visits. Knowledge, adherence and blood pressure were assessed at the start and at the end of the 2-month programme. Gathered data were analysed using descriptive statistics and RM-MANOVA. The TREND checklist was followed in reporting this study (See Appendix S1).\n\n\nRESULTS\nAfter 2\xa0months, the mean adherence, systolic blood pressure and diastolic blood pressure significantly improved, attributing more than 25% of the change. Although knowledge scores were significantly higher after the programme, it only accounted 9% of the improvement.\n\n\nCONCLUSION\nThis study provides evidence on the effectiveness of a community-based health programme grounded on the PRECEDE-PROCEED model on the knowledge, adherence and blood pressure control of community-dwelling adults with hypertension.\n\n\nRELEVANCE TO CLINICAL PRACTICE\nThe community-based health programme is beneficial to community-dwelling adults with hypertension in promoting knowledge and adherence to treatment regimen and improving BP control. This study also provides a framework for developing new or enhancing existing programmes on hypertension in the Philippines.