The Effectiveness of a Self-Management and Multifactorial Program for Blood Pressure Control Among Older Home-Based Workers in Urban Bangkok, Thailand

Older adults aged between 50-65 years old have a high risk of hypertension. With the growing numbers of home-based workers among adults and older adults in Thailand, this study aimed to evaluate the effectiveness of self-management with a multifactorial program to control blood pressure among older adults. A randomized controlled trial was conducted. Participants who worked as home-based workers aged between 50-65 years old were recruited from a community in the western area of Bangkok. Approximately 70 participants were randomly and equally assigned to the intervention and control groups (35 participants in each group). Participants in the intervention group received the program that consisted of education regarding food selection, work time management and arm swinging; a practical protocol, an exercise program, a heart rate monitor, a recorded book for facilitating participants’ progress to ensure their safety and efficiency in a health professional manner for a week/month. While those in the control group received usual care. A Knowledge Attitude Practice questionnaire was utilized to assess their knowledge, attitude, and practice, which demonstrated a content validity index and Cronbach alpha of 0.80, respectively. The Citizen CH-403C was utilized to measure blood pressure and heart rate. Two-way Repeated Measures ANOVA was employed to analyze the differences in outcome scores at baseline, 3-month after program, and 6-month follow up. The results showed a significant increase in participant’s knowledge, attitudes, and behaviors toward hypertension and a decrease in blood pressure to nearly normal after 3months following the completion of the program and 6-month follow-up. Therefore, the self-management and multifactorial program could be an effective preventive intervention for older adults with pre-hypertension conditions to offer them valuable knowledge on work-life balance as well as to help prevent hypertension, and related stroke complications.