JMIR Publications

ABSTRACT

Background:

Some common modified vascular risk factors remain poorly controlled among stroke survivors, and educational programs may help improve these conditions.

Objective:

This study aimed to evaluate the effect of planned online educational intervention based on the health belief model (HBM) for promoting secondary prevention in ischemic stroke patients.

Methods:

An evaluation-blinded quasi-experimental trial with a historical control group was conducted. The control group received routine health management. The intervention group received six additional sessions within 3 months after discharge. The primary outcomes were changes in blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), haemoglobin A1c (HbA1c), and the proportion of patients achieving the treatment target. The secondary outcomes were medication adherence and disability.

Results:

In total, 315 first-ever stroke patients were analyzed. More patients in the intervention group had controlled BP (41.9% vs. 28.4%, adjusted odds ratio [aOR]: 1.93, P = 0.012), LDL-C (83.1% vs. 67.7%, aOR: 2.66, P = 0.001), and HbA1c (91.9% vs. 83.9%, aOR: 3.37, P = 0.035), and a significant decrease post-intervention in the systolic BP (adjusted β = -3.94, P = 0.021), LDL-C (adjusted β = -0.21, P = 0.008), and HbA1c (adjusted β = -0.27, P < 0.001) compared with control groups. Significant between-group differences were observed in medication adherence (79.4% vs. 63.2%, aOR: 2.31, P = 0.002), but not in favourable functional outcomes.

Conclusions:

An online education program based on HBM may be more effective than the current methods used to educate stroke patients on optimal vascular risk factors and medication adherence. Clinical Trial: The study protocol was registered in the Chinese Clinical Trial Registry (ChiCTR2000040804).