Study protocol for the Healthy Family Program on population blood pressure: a multicenter, parallel group, cluster randomized, controlled trial in rural China.

Abstract

Background: We aim to determine the effectiveness of a community-based, health instructor led, multifaceted family intervention, as compared with usual care, on blood pressure (BP) management among Chinese rural residents, with or without hypertension.

Methods/design: The Healthy Family Program is a cluster randomized controlled trial being undertaken in 80 villages (each with approximately 100 residents) with a target to enroll a total of 8000 older adults (aged 40-80 years). Villages were randomly assigned in a 1:1 ratio to either an intervention group to receive multifaceted strategies or a control group to continue with usual standard of care. The main components of the multifaceted intervention strategies include: 1) Establishing a BP management team led by family health instructors, with team members including family leaders and village doctors, and 2) Implementing an intervention that focused on six areas: education for a healthy lifestyle, free provision of sodium substitute, weight management, physical exercise, BP monitoring, and appropriate antihypertensive treatment for individuals with hypertension. The primary outcome is change in systolic BP from baseline to 6 months in all participants, reported as the absolute difference between intervention and control groups. After the 6-month intervention, support from the study coordination center and the distribution of low-sodium salt will be withdrawn, and all participants will be followed up until 12 months. As of December 31, 2024, 24 villages in the intervention group have completed the 6-month intervention.

Conclusion: The Healthy Family Program will provide critically important data on the effectiveness of a novel BP management strategy in rural China.

Trial registration: The study is registered at ClinicalTrials.gov (NCT06427096).