Health-promotion interventions enhance and maintain self-efficacy for adults at cardiometabolic risk: A randomized controlled trial.

OBJECTIVES

To investigate whether a community-based intervention program, based on self-efficacy theory, might improve older adults' self-care behaviors as well as health outcomes related to hypertension and dyslipidemia.

METHODS

This randomized controlled trial was conducted in Taipei, Taiwan, From October 16, 2011 to July 31, 2014. Residents identified during community screening for the over 50 s were invited to participate if their blood pressure was 120-139/80-89 mmHg, high-density lipoprotein cholesterol was <40 mg/dL (men) or <50 mg/dL (women), or low-density lipoprotein cholesterol was 130-159 mg/dL. The intervention group participated in a special health promotion program; the control group received conventional health education. Participants' demographic and anthropometric data were recorded, and each completed semi-structured questionnaires about hypertension and cholesterol management, and gave blood samples for biochemical analyses before the intervention and 6 months after it ended.

RESULTS

From 90/98 eligible subjects who enrolled, 84 completed the study: 41/43 and 43/47 respectively in intervention and control groups. Body mass index, blood pressure, hyperglycemia, and high-density lipoprotein cholesterol in the intervention group improved significantly from baseline. The Self-Efficacy Scale (P = 0.020), Self-Care Activities Questionnaire (P = 0.014) and Perceived Therapeutic Efficacy Scale (P = 0.023) scores improved significantly.

CONCLUSION

This health promotion intervention program enhanced self-efficacy among older adults, with sustained effect through 6-months' follow-up. These findings are consistent with studies that evaluated the effect of a diabetes education program on self-efficacy. The beneficial effect on a population at high-risk for hypertension and hypercholesterolemia, may serve as a model for developing and implementing such interventions.