Effectiveness of the Protection Motivation Theory-based Education Program among People at Risk of Stroke: A Randomized Controlled Trial

Abstract

Stroke is a serious health issue that causes mortality and disability in the world’s population. People at risk of stroke need to manage the risk factors of stroke and adherence to stroke prevention, which are the key to success in improving clinical outcomes, particularly blood sugar and blood pressure levels. This randomized controlled trial, with a two-arm preand post-test, aimed to investigate the effectiveness of the Protection Motivation Theory-based Education Program on adherence to prevention and clinical outcomes among people at risk of stroke. The sample consisted of 58 adults visiting diabetes and hypertension clinics at a health-promoting hospital in a province in southern Thailand. They were recruited using multi-stage random sampling and randomly assigned into two arms. The experimental arm received the four-week Protection Motivation Theory-based Education Program (n = 29), and the control arm received only usual care (n = 29). Data were collected using a Demographic Data Form, the Morisky Medication Adherence Scale, the Adherence to Preventive Behavior Scale for Thai persons with prehypertension, a mercury sphygmomanometer, and a laboratory test recording form. Data were analyzed using descriptive statistics, Mixed Model ANOVA, and independent t-test. The results showed that after receiving the program, the experimental arm had higher adherence to stroke prevention, lower blood pressure, and lower HbA1C levels than before receiving the program and the control arm after the program completion. The findings indicate the program’s effectiveness in improving adherence to stroke prevention among people at risk of stroke, which results in better clinical outcomes. Thus, nurses can use this program in clinical practice with further testing in other settings with larger groups before it can be widely used.