Mobile health technology (WeChat) for the hierarchical management of community hypertension: protocol for a cluster randomized controlled trial
Received 17 May 2019
Accepted for publication 19 July 2019
Published 9 August 2019 Volume 2019:13 Pages 1339—1352
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 3
Editor who approved publication: Dr Naifeng Liu
Tong Li,1 Weiwei Ding,1 Xiaowen Li,1 Aihua Lin1,2
1Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Department of Health Service and Management, Xinhua College of Sun Yat-sen University, Guangzhou, People’s Republic of China
Purpose: The prevalence of hypertension continues to increase worldwide, raising an urgent need for novel and efficient methods for controlling hypertension. As the Internet and smartphones become more popular, their multiple functions and large user base make mobile health (mHealth) technology a potential tool for hypertension management. We aim to evaluate the use of mHealth technology to improve blood pressure and self-management behavior in people with hypertension and prehypertension.
Intervention: The mHealth intervention measures include health education, behavior promotion, group chatting and long-term blood pressure monitoring hierarchically delivered via WeChat application among 242 participants. The frequency, intensity and content of the hierarchical intervention are determined based on the cardiovascular risk stratification of the intervention subjects.
Study design: This cluster randomized controlled trial was carried out in two subdistricts in Guangzhou, China, among 492 smartphone users with hypertension or prehypertension, from August 2018 to September 2019. The intervention group received hierarchical intervention through WeChat for six months, while the control group received usual care in the community healthcare center during this period. Indicators are measured at three time points for each group, and a telephone follow-up is planned for two years after the intervention. The primary outcome is systolic blood pressure; secondary outcomes include BMI, CPAT score, improvements in behavior and diet, score of self-efficacy and self-management. Feasibility is evaluated by intervention participation. The cost-effectiveness is evaluated by ICER.
Conclusion: This study aims to evaluate the effect of the WeChat-based hierarchical management mode on improving blood pressure and self-management behavior in population with hypertension and prehypertension, based on health-related knowledge, self-efficacy and medication adherence. If successful, the management mode will serve as a feasible, economical and efficient hypertension management mode suitable for the community.
Clinical trial identifier: ChiCTR1900023002
Keywords: chronic disease, mHealth, self-management, self-efficacy, China
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