Social Cognitive Theory-based Interventions on Healthy Lifestyles for Hypertensive Patients: A Systematic Review

Abstract

Effective strategies to promote a long-term healthy lifestyle among hypertensive patients remain unclear. Social cognitive theory (SCT)-based interventions have demonstrated some effectiveness in promoting sustainable lifestyle change in this population. This systematic review aims to synthesize randomized controlled trials (RCTs) examining the effect of SCT-based interventions on healthy lifestyles, including physical activity [PA] and/or diet adherence [DA], in hypertensive patients. Four electronic databases (CINAHL, PubMed, Scopus, and Web of Science) were searched to identify RCTs that: 1) targeted hypertensive patients; 2) reported PA and/or DA as proximal outcomes; and 3) included an intervention guided by the SCT. Narrative and tabulation synthesis were conducted to present the effects of the SCT-based interventions. Fifteen studies were included in this systematic review with 3,388 hypertensive patients (mean age = 52.21, 68.70% female). Findings were inconsistent for the SCT-based interventions targeting multiple behaviors, including DA and PA. Multiple-component interventions, including PA training and identification of PA barriers through group discussion, had a greater effect size on PA improvement (d = .93–.99) than interventions without these components (d = .29–.44). Interventions with a longer duration (> 12 weeks), greater length of time for sessions (150 minutes/session), and higher session frequency (2 days/week) were more effective on DA change (d = .65) than interventions with a shorter duration (< 12 weeks), shorter session length (60–90 minutes), or lesser session frequency (monthly meeting) (d = .09–.51). Keywords: Social cognitive theory, Hypertension, Physical activity, Diet adherence