Year: 2021
Type: dissertation
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Background: Hypertension (HTN) is a major modifiable risk factor and the leading cause of premature deaths globally.The lack of awareness and knowledge have been identified as risk factors in low-and middle-income countries including Bangladesh.Recently, the use of mobile phone SMS text messaging is found to have an important positive impact on HTN management.Objective: The study aimed to develop awareness and knowledge in order to enhance lifestyle behavior changes among individuals with HTN in a rural community of Bangladesh by using health education and mobile health (mHealth) technology (SMS text messaging).Methods: A prospective randomized 5-month intervention, open-label (1:1), parallel-group trial was implemented among the individuals with HTN aged 35 years or older.Both men and women were included.Between August 2018 and July 2019, we enrolled 420 participants, selected from a tertiary level health facility and through door-to-door visits by community health workers.After block randomization, they were assigned to either the intervention group (received SMS text messaging and health education; n=209) or the control group (received only health education; n=211).The primary outcome was the evaluation of self-reported behavior changes (salt intake, fruits and vegetables intake, physical activity, and blood pressure [BP], and body weight monitoring behaviors).The secondary outcomes were measurements of actual salt intake and dietary salt excretion, blood glucose level, BP values, and quality of life (QOL).Results: During the study period, a total of 8 participants were dropped, and the completion rate was 98.0% (412/420).The adherence rates were significantly higher (9%) among the control group regarding salt intake (P=.04) and physical activity behaviors (P<.03), and little differences were observed in other behaviors.In primary outcome, the focused behavior, salt intake less than 6 g/day, showed significant chronological improvement in both groups (P<.001).The fruits intake behavior steadily improved in both groups (P<.001).Participants in both groups had a custom of vegetables intake everyday/week.Physical activity suddenly increased and continued until the study end (P<.001 in both groups).Both BP and body weight monitoring status increased from baseline to 1 month but decreased afterward (P<.001).In case of secondary outcomes, significant chronological changes were observed in food salt concentration and urinary salinity between the groups (P=.01).The mean systolic BP and diastolic BP significantly chronologically decreased in both groups (systolic BP, P=.04; diastolic BP, P=.02.P<.05).All of these supported self-reported behavior changes.For the QOL, both groups showed significant improvement over the study periods (P<.001).
Authors: Jahan, Yasmin, Jahan, Most Yasmin
Institution: Hiroshima University
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7208275931