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.