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Background: This study explores the effect of brain and heart health manager (BHHM)-led stroke secondary prevention on blood pressure, and in improving the self-management ability of stroke patients.The BHHM has not been reported.Methods: A total of 200 stroke patients, who were discharged from our hospital, were randomized into two groups at a 1:1 ratio: intervention group and control group. Patients in the control group were followed up for six months via telephone, while patients in the experimental group were followed up for six months using the BHHM-led mHealth follow-up. The primary outcomes were systolic blood pressure (BP) and selfmanagement ability at 3, 6, 9 and 12 months, while the secondary outcomes included medication adherence, the body mass index (BMI), and blood low-density lipoprotein. Results:The systolic BP between these two groups at four time points (F time =8.734, F group =172.075, and F interaction =11.363) was statistically significant (P<0.05). The self-health management ability at four time points during follow-up period (F time =115.09, F group =1,185.50, and F interaction =108.22) was also significantly different between these two groups. Furthermore, there was a statistically significant difference in compliance with medication at six months (χ 2 =37.616, P=0.000). However, after one year, there were no significant differences in BMI (t=0.214, P=0.644), total cholesterol (t=0.56, P=0.837), and low-density lipoprotein (t=0.042, P=0.455). Conclusions:The BHHM-led mHealth follow-up is an effective method for managing BP and improving the self-care ability. Furthermore, this approach has no obvious effect on the management of BMI and blood low-density lipoprotein. A potential signal of efficacy with the intervention was observed.

Background: With the continuous large-scale development of the COVID-19 vaccine, the acceptance of vaccination and its influencing factors at the individual level have become crucial to stemming the pandemic. This study aims to explore the factors that influence the acceptance of the COVID-19 vaccine among international college students. Methods: The target population constituted international students pursuing various degrees in Jiangsu Province through an online cross-sectional study. A cluster random sampling was performed using a self-administered questionnaire. The Health Belief Model and Knowledge, Attitude/Beliefs, and Practice Theory served as the underlying theories to understanding the factors that influence vaccine acceptance. Results: We received 330 responses. About 36.4% intended to accept the vaccine. The acceptance varied across respondents’ place of residence, program of study, continent of origin, knowledge, susceptibility, severity, benefits, and cues to action (p < 0.05). A multivariable logistics regression revealed cues to action (p < 0.001), the perception of COVID-19 vaccination benefits (p = 0.002), and the perception of barriers (p < 0.001) that were associated with vaccine acceptance. Conclusions: The acceptance of the COVID-19 vaccine was low among international students. The correct and comprehensive beliefs of the target groups regarding the benefits and barriers of the vaccination must be raised. Various effective social strategies must be adopted to trigger the intention of COVID-19 vaccination. The study findings will inform the decisions of public health campaigners, aimed at reducing vaccine hesitation when the COVID-19 vaccine is widely available.

Empirical evidence has suggested that social support from family can help patients take their medicines correctly. This study aims to evaluate the role of a family member-based supervision package in the management of hypertension using a cluster randomized trial in rural China. We recruited patients with hypertension from four villages in Yangzhong and randomly allocated them to the control group (n=288) and the intervention group (n=266). A family member-based supervision package was applied to the intervention group, while the usual service was applied to the controls. Patients were followed for 12 months and completed face-to-face interviews at the end of 6 and 12 months. The primary outcomes were patients' medication adherence and frequency of blood pressure measurement. Secondary outcomes included changes in blood pressure, altered risk behaviours and occurrence of hypertension-related complications. To control for the effects of cluster randomization, multilevel mixed-effects regression models were used to compare group changes. We observed that the intervention improved patients' blood pressure measurement frequency (OR: 9.00, 95% CI: 4.52–17.91) and adherence to antihypertensive treatment (OR: 1.74, 95% CI: 0.91–3.32). Its effect on the blood pressure control rate was significant at the mid-term investigation (OR: 0.67, 95% CI: 0.40–0.93), but the long-term effect was not significant (OR: 0.89, 95% CI: 0.64–1.26). After 6 months of intervention, either systolic or diastolic blood pressure was significantly decreased in the intervention group. However, this difference was not significant at the final investigation. Findings from this study revealed that the family member-based supervised therapy may have positive effects on patients' adherence to blood monitoring and hypertensive medications.