The Development of Health Promotion Program for Behavior Modification on Hypertension Control of the Elderly in Phetchaburi Province
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Abstract
This research and development study consisted of three phases. Phase 1 explored the health status of older adults with hypertension and the relationships between ecological factors and health status. Quantitative data were collected from 397 older adults with hypertension using multistage random sampling, while qualitative data were obtained from 16 community stakeholders. Data were analyzed using Pearson's correlation coefficient and content analysis. Phase 2 involved the development of the health promotion program. Phase 3 evaluated the program's effectiveness, feasibility, and implementation process using a two-group pretest–posttest quasi-experimental design. Sixty-six older adults with hypertension and their caregivers were equally assigned to the experimental and control groups. Data were analyzed using descriptive statistics, t-tests, and analysis of covariance. The findings showed that;
1. The overall health status of older adults with hypertension was high (M = 3.89, SD = .48), and ecological factors were positively associated with health status (r = .617, p < .001). Qualitative findings indicated insufficient knowledge and self-care skills, inadequate proactive follow-up, and limited supportive environments for hypertension control.
2. The developed program integrated ecological factors at the individual, interpersonal, organizational, community, and policy levels.
3. The program was effective in improving outcomes among the experimental group. Participants demonstrated significantly higher knowledge scores after the intervention and compared with the control group (t = 2.04, 5.03; p = .046 and < .001, respectively). Both systolic and diastolic blood pressure significantly decreased (t = 4.76, 3.71; p < .001, respectively). Older adults and Caregivers reported a high level of satisfaction with the program (M = 3.89, SD = .48), and caregivers significantly improved their knowledge (t = 6.23, p < .001), whereas their attitudes and supportive behaviors did not significantly change.
The program is effective and feasible for promoting self-management among community-dwelling older adults through collaborative support from families, healthcare providers, and communities.
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