JMIR Publications

ABSTRACT

Background:

Despite Chinese immigrants having a higher or comparable proportion of hypertension [HTN] to non-Hispanic Whites and Hispanics, there are no effective technology-based intervention studies that target HTN management in Chinese immigrants the United States.

Objective:

To develop and pilot test the efficacy of a culturally and linguistically sensitive, social media-based (WeChat) intervention for Chinese immigrants to improve blood pressure and antihypertensive medication adherence.

Methods:

The study was conducted in 2020 with a pre and posttest design (n = 20). A WeChat-based intervention was implemented using one 20-minute video presentation plus one 20-minute nurse counseling session via WeChat at the baseline; followed by four bi-weekly 20-minute nurse counseling sessions via WeChat calls. The outcomes (blood pressure [BP] control, medication adherence, self-efficacy in HTN management) were measured at baseline, 3 months and 6 months.

Results:

The participants’ mean age was 68.9 (±10.2) (range: 51-86). About half were male (52%), less than high school degree (59%), married (59%), religious (52%), and not employed (52%). The results showed that the baseline systolic BP was 131.43 (±9.61) mmHg and the diastolic BP was 79.79 (±9.62) mmHg. The 6-month outcome showed a reduction of systolic BP (-0.74±9.18 mmHg, p < =0.05) and diastolic BP (-0.96±6.92 mmHg, p < 0.01). The mean score for medication adherence at baseline was 4.50 (±1.70) and significantly improved at 3.65 (±1.18) at 6 months (reversely scored - possible range was 1-5, with 1 being the best score) (p < 0.01). Self-efficacy in HTN management had a trend in reduction from a baseline at 8.28 (±1.25) to 7.93 (±1.48) at 6 months with a mean difference of 0.34±2.02, with a score of 0 meaning the least self-efficient, and a score of 10 being the most self-efficient.

Conclusions:

Our WeChat-based hypertension management program showed a significant improvement in diastolic blood pressure and medication adherence and a trend of reduction for systolic blood pressure and self-efficacy in managing HTN in Chinese immigrants. Since the proposed WeChat-based HTN management program is considered as low cost and easy to establish, further investigation is recommended to generate more robust results. Clinical Trial: I have communicated with managing editor, Amanda, and she commented this is not required for a non-RCT. Please see below for her detailed comments. Thanks. "I discussed this further with my colleagues today as when reviewing the information on our journal site re trial registration it seemed confusing to me. We therefore came to the conclusion that JMIR's policy does not require trial registration for non-RCT's, I would however recommend checking with your funding agency and institution about specific registration requirements for non-randomized clinical trials to ensure you are compliant. I hope this helps and saves some effort on your part? Thanks Amanda