Effects of self-guided e-counseling on health behaviors and blood pressure: Results of a randomized trial.

Sam Liu, Rika Tanaka, Susan Barr, Robert P Nolan

Journal: Patient education and counseling 2020;103(3):635-641

PMID: 31669047

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVE

1) Evaluate the efficacy of e-Counseling vs. Control to promote lifestyle behaviors at 4 and 12-month follow-ups, 2) examine whether these behaviors changes were associated with lower blood pressure (BP), and Framingham Risk Index (FRI) at 12-month.

METHODS

Hypertensive patients (n = 264) were randomized to the e-Counseling or the Control group. Primary trial outcome was BP and secondary outcomes included exercise and diet behaviors. This study presented the results of secondary outcomes. Linear mixed models evaluated treatment effects at 4 and 12-month. Treatment-by-sex exploratory analyses were conducted if no main treatment effect was observed.

RESULTS

Daily steps significantly improved in e-Counseling vs. Controls at 12-month. Urinary sodium at 12-month did not significantly differ between the groups, but treatment-by-sex analysis showed that e-Counseling females lowered urinary sodium relative to Controls at 12 months. Improvements in steps and dietary sodium were significantly associated with improvements in BP and FRI at 12-month.

CONCLUSION

This hypertension e-Counseling protocol can promote long-term lifestyle behavior changes. Adherence to the lifestyle behavior change was associated with BP and FRI reduction at 12-month.

PRACTICE IMPLICATIONS

The hypertension e-counseling protocol has the potential to improve hypertension care and intervention reach.

Address: University of Victoria, School of Exercise Science, Physical and Health Education, Victoria, British Columbia, Canada. Electronic address: [email protected].; Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada.; University of British Columbia, Department of Food, Nutrition & Health, British Columbia, Canada.; Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada; University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada.

DOI: 10.1016/j.pec.2019.10.007

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MeSH Terms: Adult, Blood Pressure, Counselors, Diet, Diet, Sodium-Restricted, Distance Counseling, Double-Blind Method, Female, Health Behavior, Humans, Hypertension, Life Style, Male, Middle Aged, Risk Reduction Behavior, Self Care, Telemedicine, Treatment Outcome