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Original Research

Effectiveness of a Community-Based Intervention Program to Reduce Hypertension Prevalence Among Adults: Results of a Quasiexperimental Study With Control Group in the Region of Sousse, Tunisia

Authors:

Jihene Sahli,

Department of Epidemiology, University Hospital Farhat Hached, Sousse, TN
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Jihene Maatoug ,

Department of Epidemiology, University Hospital Farhat Hached, Sousse, TN
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Imed Harrabi,

Department of Epidemiology, University Hospital Farhat Hached, Sousse, TN
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Sihem Ben Fredj,

Department of Epidemiology, University Hospital Farhat Hached, Sousse, TN
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Emna Dendana,

Department of Epidemiology, University Hospital Farhat Hached, Sousse, TN
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Hassen Ghannem

Department of Epidemiology, University Hospital Farhat Hached, Sousse, TN
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Abstract

Background: High blood pressure is preventable and is directly related to lifestyle habits such as an unbalanced diet, low levels of physical activity, and tobacco use.

Objectives: This quasiexperimental study aimed to assess the effectiveness of a 3-year community intervention targeting healthy lifestyle promotion in reducing hypertension prevalence among adults.

Methods: A quasiexperimental design was used to evaluate the effectiveness of a 3-year intervention for healthy lifestyle that was implemented between 2010 and 2013 in a community of adults in the region of Sousse in Tunisia. The population study was randomly selected in both intervention and control groups at pre-assessment and post-assessment. After considering a type 1 error a of 5%, a type 2 error b of 20%, and a change in the prevalence of various risk factors of 6% between pre-intervention and post-intervention, the sample size was fixed to 2,000 adults in intervention and control areas.

Results: The intervention group was composed of 940 and 1,001 adults, and the control group was composed of 940 and 976, respectively, at pre-assessment and post-assessment. The prevalence of hypertension decreased in the intervention group globally from 37.3% to 33.7% but not significantly (p = 0.1). In the control group, this proportion increased from 31.1% to 33.4% without significant difference (p = 0.28). In the intervention group, after stratification for age, a significant decrease (p = 0.007) in the prevalence of hypertension was observed for participants younger than 40 years old: it decreased from 22.8% to 16.2%. In the control group, it increased from 14% to 15.4% (p = 0.52). In intervention group, a significant decrease of the hypertension from 31.4% to 26% (p = 0.03) was observed among nonobese participants after stratification for weight status. No significant change was observed in the control group.

Conclusions: This study showed the feasibility and effectiveness of a community-based intervention to reduce the prevalence of hypertension in the context of a developing country.

Highlights

  • This article describes a quasiexperimental community-based intervention (2010 to 2013) in Tunisia.
  • The intervention took place in different settings: neighborhoods, workplace, schools, primary care, and mass media.
  • The intervention effect was negatively associated with hypertension.
  • The feasibility and effectiveness of a community-based intervention in a developing country were determined.
How to Cite: Sahli J, Maatoug J, Harrabi I, Ben Fredj S, Dendana E, Ghannem H. Effectiveness of a Community-Based Intervention Program to Reduce Hypertension Prevalence Among Adults: Results of a Quasiexperimental Study With Control Group in the Region of Sousse, Tunisia. Global Heart. 2016;11(1):131–7. DOI: http://doi.org/10.1016/j.gheart.2016.01.001
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Published on 01 Mar 2016.
Peer Reviewed

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