Effects of A Combined Health Literacy Intervention and Web-based Application on the Health Literacy, Health Behaviors, and Blood Pressure of Patients with Hypertension: A Quasi-experimental Study

Saowaluck Sukpattanasrikul; Jirawan  Mala; Budsara Hiransaroj  Jirawisan; Virapun  Wirojratana; Theepapha  Jamkrajang; Jittima  Panyasarawut; Prasert  Assantachai; Varalak  Srinonprasert; Siwaporn  Chainuvati; Naris  Kitnarong; Sukree  Kade; Kantamas  Supamanee

doi:10.64960/srimedj.v41i3.270454

Authors

Saowaluck Sukpattanasrikul Faculty of Nursing, Mahidol University, Bangkok, Thailand 10700
Jirawan Mala Faculty of Nursing, Mahidol University, Bangkok, Thailand 10700
Budsara Hiransaroj Jirawisan Faculty of Nursing, Mahidol University, Bangkok, Thailand 10700
Virapun Wirojratana Faculty of Nursing, Mahidol University, Bangkok, Thailand 10700
Theepapha Jamkrajang Faculty of Nursing, Mahidol University, Bangkok, Thailand 10700
Jittima Panyasarawut Faculty of Nursing, Mahidol University, Bangkok, Thailand 10700
Prasert Assantachai Faculty of Nursing, Mahidol University, Bangkok, Thailand 10700
Varalak Srinonprasert Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand 10700
Siwaporn Chainuvati Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand 10700
Naris Kitnarong Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand 10700
Sukree Kade Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand 10700
Kantamas Supamanee Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand 10700

DOI:

https://doi.org/10.64960/srimedj.v41i3.270454

Keywords:

Blood pressure, Health behaviors, Health literacy, Hypertension, Web-based intervention

Abstract

Background and objective: Hypertension is a leading cause of cardiovascular morbidity and mortality worldwide, yet blood pressure control rates remain suboptimal in several populations. Effective blood pressure control requires individuals to adopt and maintain healthy lifestyle behaviors, which can be challenging when health literacy is limited. Integrating health literacy programs with web-based applications may help patients with hypertension acquire information, appraise health resources, and implement strategies to reduce blood pressure. This study evaluated the effects of a combined health literacy intervention and web-based application on health literacy, health behaviors, and blood pressure.

Methods: A quasi-experimental repeated-measures study was conducted among participants in Bangkok, Thailand, who received either a 12-week intervention integrated with a web-based application or traditional care between April and August 2023. Outcomes included health literacy, health behaviors, and blood pressure. Data were collected at baseline, post-intervention, and follow-up, and analyzed using repeated-measures ANCOVA, adjusted for hypertension duration.

Results: From 58 participants (n=28 experimental, n=30 control), the experimental group demonstrated higher adjusted mean scores across all time points for health literacy (F=44.37; p<0.001; partial η²=0.446) and overall health behavior (F=53.41; p<0.001; partial η²=0.493) compared with the control group. Systolic blood pressure showed a significant main effect of time and group-by-time interaction, with reductions from baseline to post-intervention (mean difference –10.57 mmHg, p<0.001), and baseline to follow-up (mean difference –12.31 mmHg, p<0.001), whereas diastolic blood pressure only showed a significant main effect of time.

Conclusion: The integrated interventions improved health literacy, health behavior domains, and systolic blood pressure, but not diastolic blood pressure, supporting the integration of theory-based health literacy interventions with digital tools.

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