Effects of Intervention Based on Behavioral Change Wheel and Behavioral Change Technologys on the Behavior, Ambulatory Blood Pressure and Quality of Life in Patients with Hypertension

Abstract

Background The control rate for patients with hypertension remains suboptimal, with hypertensive patients experiencing a lower quality of life compared to healthy individuals. Enhancing life quality and lowering blood pressure in patients with hypertension through behavioral interventions is currently a critical area of research. Theoretical-based behavioral interventions are shown to be more effective and sustainable in modifying the behaviors of hypertensive patients. The Behavior Change Wheel (BCW) and Behavior Change Techniques (BCTs) are widely utilized in the management of chronic diseases globally to maximize the exploration of modifiable factors. Nevertheless, in the domestic context, studies on the impact of BCW and BCTs-driven behavioral interventions on the ambulatory blood pressure and quality of life of hypertensive patients are relatively limited, indicating a need for more comprehensive research. Objective This study aims to develop and evaluate the intervention based on BCW and BCTs, focusing on its impact on behavior, ambulatory blood pressure, and quality of life in hypertensive patients. Methods From December 2021 to August 2022, a hundred hypertensive patients who met the inclusion criteria were selected as study participants. They were allocated into an intervention group and a control group using a simple randomization method, with each group comprising fifty participants. Patients in the control group received conventional outpatient medication and health education lifestyle guidance. In contrast, patients in the intervention group was treated with standard medication supplemented by the BCW and BCTs-based intervention guidance.Before and after the intervention, assessments were conducted using the Hypertension Knowledge-Level Scale, the Chinese Version of the 8-item Morisky Medication Adherence Scale, the International Physical Activity Questionnaire-Short, the Patient Health Questionnaire-9, the General Anxiety Disorder-7, ambulatory blood pressure monitoring, and the 12-Item Short-Form Health Survey. The study examined changes in behavioral indicators, results of ambulatory blood pressure monitoring, and quality of life pre- and post-intervention. Results The results indicated that after the intervention, the intervention group exhibited significantly higher levels of hypertension knowledge, medication adherence, quality of life scores, proportions of high medication adherence and engagement in moderate physical activity compared to the control group (P<0.05) . Additionally, the intervention group showed lower average daytime systolic and diastolic blood pressures, nighttime systolic and diastolic blood pressures, morning systolic and diastolic blood pressures, 24-hour systolic and diastolic blood pressures, variability coefficients of 24-hour systolic and diastolic blood pressures, BMI, anxiety scores, depression scores, and lower proportions of individuals with anxiety, depression, high sodium intake, and excessive alcohol consumption compared to the control group (P<0.05) . Conclusion The BCW and BCTs-based intervention model positively impacts behavioral interventions for hypertensive patients. It effectively improves the behaviors of these patients, lowers their blood pressure levels, and elevates their quality of life. This model is recommended for incorporation into the management of hypertension as a chronic disease.

Keywords

• hypertension|behavioral change|health intervention|ambulatory blood pressure|quality of life