The Effects of a Health Literacy Promotion Program on Health Behaviors and Blood Pressure Levels Among Uncontrolled Hypertensive Patients: A Quasi-Experimental Study.

INTRODUCTION: Uncontrolled hypertension is a leading global public health concern, contributing significantly to cardiovascular disease burden and premature mortality. Crucially, insufficient patient health literacy often underlies poor blood pressure management. Enhancing health literacy therefore offers substantial potential to empower patients, foster beneficial health behaviors, and ultimately achieve effective blood pressure control. OBJECTIVE: To evaluate the effects of a health literacy promotion program on health behaviors and systolic and diastolic blood pressure levels in patients with uncontrolled hypertension. METHODS: This quasi-experimental study employed a 2-group pretest-posttest design with 50 patients diagnosed with uncontrolled hypertension. It was conducted at a subdistrict health promoting hospital in Phayao Province, Thailand. Participants were randomly assigned to either an experimental or a control group, with 25 individuals in each. The control group received usual care, while the experimental group participated in a 12-week health literacy promotion program. This intervention comprised small-group activities incorporating the Teach-back method, Ask Me 3, and motivational interviewing, supplemented by home-based phone calls. The program aimed to develop 6 key health literacy skills. Data were analyzed using descriptive statistics, chi-square test, Fisher's exact test, Mann-Whitney U test, paired t-test, independent t-test, and ANCOVA. RESULTS: The experimental group showed a significant increase in health behavior scores by 8.72 points post-program (95% CI: 6.61, 10.82; P < .001). This increase was 9.52 points greater than that observed in the control group (95% CI: 6.46, 12.58; P < .001; Cohen d = 1.77). Systolic blood pressure decreased by 14.00 mmHg post-program (95% CI: -17.82, -10.18; P < .001). The between-group difference in reduction was -6.97 mmHg (95% CI: -13.33, -0.60; P = .033, Partial η2 = 0.094), indicating a significantly larger reduction in the experimental group. Although diastolic blood pressure decreased by 10.24 mmHg post-program (95% CI: -13.72, -6.76; P < .001), this change did not significantly differ from the control group (P = .387). CONCLUSIONS: The health literacy promotion program significantly improved health behaviors and reduced systolic blood pressure, suggesting its feasibility for implementation in primary care settings. Future research should employ larger sample sizes and extended follow-up periods to thoroughly examine the program's long-term effectiveness across diverse populations.