Effect of health literacy interventions with the stages of change on Kazakh-Chinese hypertension patients

Abstract

Objective To evaluate the effect of the intervention combined the high blood pressure health literacy(HBP-HL) with the stages of change on waist circumference(WC), body mass index(BMI) and physiological-biochemical indexes among the Kazakh-Chinese hypertensive patients. Methods The interventional plan was built based on the Stages of Change of Transtheoretical Model . This randomized controlled trial study was carried out from July 2014 to January 2016, and Kazakh hypertension patients from qianjin and small canal pastoral areas were sampled using stratified cluster sampling method, with 74 patients from each place. The general health management combined with High Blood Pressure Health Education handbook was applied in the control group. The intervention group was given the 12-month intervention combined the HBP-HL with the stages of change based on the control group. Meanwhile, WC, BMI and other data were collected at the first, twelfth and eighteenth months. Results Repeated variance analysis showed interaction effects between time and group (F=14.396, 15.214, P<0.05), indicating that the effect of intervention factors on WC and BMI would increase over time when intervention existed. The total cholesterol ((5.69±0.93)mol/L), low density lipoprotein ((3.74±0.86)mol/L) and serum creatinine ((65.46±13.45)mol/L) of hypertension patients in intervention group were lower than those before intervention (t=3.998, 4.581, 2.574, P<0.05). After intervention, the scores of total health literacy (t=5.157) , understanding ability (t=6.504), the latest vital signs (t=11.583) and avoiding food allergy (t=3.778) of the intervention group were higher than those of the control group, and the differences were statistically significant (P<0.05). Conclusions The intervention strategy of health literacy-behavioral change stage is feasible and effective. It can significantly reduce WC, BMI, total cholesterol, low density lipoprotein and serum creatinine in Kazakh hypertension patients in pastoral areas, and the short-term maintenance effect of the intervention is acceptable. Key words: Kazakh; Hypertension; Health literacy; Stages of change; Waist circumference; Body mass index