文化适应性叙事干预与说教干预对改善越南高血压控制效果的比较：一项整群随机对照可行性试验
Culturally adaptive storytelling intervention versus didactic intervention to improve hypertension control in Vietnam: a cluster-randomized controlled feasibility trial.
作者信息
Nguyen Hoa L, Allison Jeroan J, Ha Duc A, Chiriboga Germán, Ly Ha N, Tran Hanh T, Nguyen Cuong K, Dang Diem M, Phan Ngoc T, Vu Nguyen C, Nguyen Quang P, Goldberg Robert J
机构信息
Institute of Population, Health and Development, 18 Alley 132, Hoa Bang Street, Cau giay District, Hanoi, Vietnam.
Department of Quantitative Sciences, Baylor Scott &White Health, Dallas, Texas USA.
出版信息
Pilot Feasibility Stud. 2017 May 1;3:22. doi: 10.1186/s40814-017-0136-9. eCollection 2017.
BACKGROUND
Vietnam 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.
METHODS
The 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.
RESULTS
The 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.
CONCLUSIONS
Both 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 REGISTRATION
ClinicalTrials.gov, NCT02483780.
背景
越南正经历流行病学转变，非传染性疾病患病率不断上升。越南需要新颖、大规模、有效且可持续的高血压控制干预措施。我们报告了在越南兴安省进行的一项为期3个月随访的整群随机可行性试验结果，该试验旨在评估两种基于社区的改善高血压控制干预措施的可行性和可接受性：一种“讲故事”干预措施“我们谈论高血压”，以及一种说教式干预措施。
方法
“讲故事”干预措施包括患者用自己的话讲述应对高血压策略的故事，以及关于健康生活方式行为（包括减少盐摄入和锻炼）重要性的说教内容。说教式干预措施仅包含说教内容。“讲故事”干预措施通过两张DVD每隔3个月发放一次；说教式干预措施仅发放一期。该试验在四个公社进行，随机分为两种干预措施组。
结果
160名研究患者的平均年龄为66岁，54%为男性。大多数参与者表示两种干预措施都易于理解、信息丰富且具有激励作用。在基线至3个月期间，“讲故事”组的平均收缩压下降了8.2 mmHg（95%置信区间4.1 - 12.2），说教式组下降了5.5 mmHg（95%置信区间1.4 - 9.5）。“讲故事”组还报告高血压药物依从性显著提高。
结论
两种干预措施在几个农村社区都得到了很好的接受，并显示出在降低血压方面可能有效。需要进行大规模随机试验来比较两种干预措施在控制高血压方面的有效性。
试验注册
ClinicalTrials.gov，NCT02483780。
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