Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jul 23, 2025
Date Accepted: Dec 18, 2025
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Self-Management Combined with Digital Health Interventions to Improve Dietary Behavior, Exercise Behavior, Stress Management Behavior, and Blood Pressure among Thais with Uncontrolled Hypertension: An Explanatory Sequential Study Protocol
ABSTRACT
Background:
Uncontrolled hypertension is a major public health issue globally, contributing to high morbidity, mortality, and rising healthcare costs, including in Thailand. While successful pharmacological and non-pharmacological treatments are available and effective, adherence to self-management is critical for minimizing the risk of hypertensive complications. However, long-established self-management approaches involve challenges, including inadequate communication with healthcare providers, delayed management, and insufficient support. Digital health interventions offer a feasible solution for closing these gaps and enhancing hypertension self-management. Little is known about patients’ perspectives and experiences concerning how digital health interventions influence their self-management behavior, raising the need to assess the feasibility of self-management and digital health interventions, and to better understand patient experiences and perceptions.
Objective:
This study aims to determine the effects of a self-management intervention combined with digital health interventions on dietary behavior, exercise behavior, stress management behavior, and blood pressure among Thais with uncontrolled hypertension. The study will explore and compare experiences and perceptions among participants with varying levels of blood pressure control.
Methods:
This study will use an explanatory sequential design performed in two phases comprising (1) a quasi-experimental design with two groups using repeated measures to determine the effects of self-management combined with digital health intervention among 90 participants, and (2) an in-depth interview approach to explore the perceptions and experiences of 24 participants regarding the combination of self-management and digital health interventions after the intervention. The analysis will take into account the effects of the interventions on dietary, exercise, and stress management behaviors, as well as blood pressure, by performing Generalized Estimating Equations and Linear Mixed-Effects Modeling. The study will perform Colaizzi’s method for the qualitative portion of the analysis.
Results:
Funded in December 2024, this study will involve 90 patients with uncontrolled hypertension at the Siriraj Primary Care Unit, Thailand. This study gained ethical approval on May 31, 2025, and the recruitment of participants will begin in August 2025. This study will complete the data collection and data analysis in December 2025. The expected date for the submission of results for publication is January 2026.
Conclusions:
This study has the potential to address the gap between traditional self-management and digital health interventions in improving self-management behavior and reducing blood pressure. The findings may offer practical guidance for nurses tasked with managing uncontrolled hypertension in Thailand and contribute valuable insights for shaping future healthcare policies. Clinical Trial: Trial Registration: The Universal Trial Number (UTN) is U1111-1324-0264. Thai Clinical Trials Registry is TCTR20250722001
Citation
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