Effects of self-guided e-counseling on health behaviors and blood pressure: Results of a randomized trial

Patient Educ Couns. 2020 Mar;103(3):635-641. doi: 10.1016/j.pec.2019.10.007. Epub 2019 Oct 19.


Objective: 1) Evaluate the efficacy of e-Counseling vs. Control to promote lifestyle behaviors at 4 and 12-month follow-ups, 2) examine whether these behaviors changes were associated with lower blood pressure (BP), and Framingham Risk Index (FRI) at 12-month.

Methods: Hypertensive patients (n = 264) were randomized to the e-Counseling or the Control group. Primary trial outcome was BP and secondary outcomes included exercise and diet behaviors. This study presented the results of secondary outcomes. Linear mixed models evaluated treatment effects at 4 and 12-month. Treatment-by-sex exploratory analyses were conducted if no main treatment effect was observed.

Results: Daily steps significantly improved in e-Counseling vs. Controls at 12-month. Urinary sodium at 12-month did not significantly differ between the groups, but treatment-by-sex analysis showed that e-Counseling females lowered urinary sodium relative to Controls at 12 months. Improvements in steps and dietary sodium were significantly associated with improvements in BP and FRI at 12-month.

Conclusion: This hypertension e-Counseling protocol can promote long-term lifestyle behavior changes. Adherence to the lifestyle behavior change was associated with BP and FRI reduction at 12-month.

Practice implications: The hypertension e-counseling protocol has the potential to improve hypertension care and intervention reach.

Trial registration: ClinicalTrials.gov NCT01541540.

Keywords: Counseling; Hypertension; Lifestyle intervention; e-Health.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Pressure / physiology
  • Counselors
  • Diet / psychology
  • Diet, Sodium-Restricted / psychology*
  • Distance Counseling*
  • Double-Blind Method
  • Female
  • Health Behavior*
  • Humans
  • Hypertension / diagnosis
  • Hypertension / psychology
  • Hypertension / therapy*
  • Life Style*
  • Male
  • Middle Aged
  • Risk Reduction Behavior
  • Self Care / methods*
  • Telemedicine / methods*
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT01541540

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