Abstract
BackgroundVietnam is experiencing an epidemiologic transition with an increased prevalence of non-communicable diseases. Novel, large-scale, effective, and sustainable interventions to control hypertension in Vietnam are needed. We report the results of a cluster-randomized feasibility trial at 3 months follow-up conducted in Hung Yen province, Vietnam, designed to evaluate the feasibility and acceptability of two community-based interventions to improve hypertension control: a “storytelling” intervention, “We Talk about Our Hypertension,” and a didactic intervention.MethodsThe storytelling intervention included stories about strategies for coping with hypertension, with patients speaking in their own words, and didactic content about the importance of healthy lifestyle behaviors including salt reduction and exercise. The didactic intervention included only didactic content. The storytelling intervention was delivered by two DVDs at 3-month intervals; the didactic intervention included only one installment. The trial was conducted in four communes, equally randomized to the two interventions.ResultsThe mean age of the 160 study patients was 66 years, and 54% were men. Most participants described both interventions as understandable, informative, and motivational. Between baseline and 3 months, mean systolic blood pressure declined by 8.2 mmHg (95% CI 4.1–12.2) in the storytelling group and by 5.5 mmHg (95% CI 1.4–9.5) in the didactic group. The storytelling group also reported a significant increase in hypertension medication adherence.ConclusionsBoth interventions were well accepted in several rural communities and were shown to be potentially effective in lowering blood pressure. A large-scale randomized trial is needed to compare the effectiveness of the two interventions in controlling hypertension.Trial registrationClinicalTrials.gov, NCT02483780
Highlights
Vietnam is experiencing an epidemiologic transition with an increased prevalence of non-communicable diseases
We developed two different strategies to promote engagement in the care of persons diagnosed with hypertension in rural Vietnam: didactic versus storytelling intervention
Based on the ensuing group discussion, we selected five individual “stars” who had successfully controlled their blood pressure during the last year and told compelling stories about how they modified their lifestyle practices for better blood pressure control. For those randomly assigned to the storytelling intervention group, two digital video disc (DVD) were produced (Fig. 1)
Summary
Vietnam is experiencing an epidemiologic transition with an increased prevalence of non-communicable diseases. The. Nguyen et al Pilot and Feasibility Studies (2017) 3:22 prevalence of hypertension was 25% in persons 25 years and older, and the frequency of this condition increased with advancing age. Previously reported disconcerting results from a population-based survey of residents of Thai Nguyen province in 2011 in which only one-third of persons diagnosed with hypertension were aware of their condition. Of those diagnosed with hypertension, only 43% were on treatment; of those being treated for hypertension, only 39% had achieved appropriate control [8]
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