Effects of Pender’s Health Promotion Model-Based Online Education and Telephone Follow-Up on Symptom Burden, Dietary Behaviors, and Medication Adherence in Adults with Heart Failure: A Randomized Controlled Trial

Background/Objectives: Effective heart failure (HF) self-management requires sustained engagement in symptom management, dietary behaviors, and medication adherence. This randomized controlled trial evaluated Pender’s Health Promotion Model (HPM)-informed online education combined with telephone reinforcement in adults with HF. Methods: In this single-center, parallel-group trial, 60 adults were randomized 1:1 to intervention (n = 30) or usual care (n = 30). The intervention comprised individualized synchronous online education and telephone reinforcement at 2 weeks and 1 month. Self-reported dietary behaviors, symptom burden, and medication adherence were assessed at baseline and 2 months. Linear mixed-effect models evaluated group-by-time effects, with Holm adjustment for three prespecified primary outcomes. Age-adjusted sensitivity analyses were conducted. The trial was prospectively registered (NCT07017751). Results: All 60 participants completed follow-up. Group-by-time effects favored the intervention for all outcomes (Holm-adjusted p < 0.001 each). Between-group differences in change were 12.77 points (95% CI, 10.22 to 15.31) for dietary behaviors, −17.27 (95% CI, −24.56 to −9.97) for symptom burden, and −2.33 (95% CI, −3.37 to −1.30) for medication adherence. Findings remained significant after age adjustment. Conclusions: HPM-informed online education combined with telephone reinforcement improved self-reported dietary behaviors and medication adherence and reduced symptom burden compared with usual care over 2 months. Although the unblinded design and reliance on self-report warrant cautious interpretation, these findings support the potential value of this combined nursing intervention for short-term HF self-management. Larger trials with longer follow-up and objective clinical outcomes are needed.