Effects of Self-management Program on Healthy Lifestyle Behaviors among Elderly with Hypertension

Main Article Content

Pitchada Sutipan
Ungsinun Intarakamhang
Wirin Kittipichai
Ann Macaskill


This research aimed to evaluate whether a self-management program promoted healthy lifestyle behaviors (HLBs) and improved health outcomes among Thai elderly with hypertension.  Participants were randomly allocated to either an intervention group (n=20), that received an 8-week self-management program that included home visits, or a control group (n=20).  The data were analyzed by a chi-square analysis, a mixed-model repeated measure MANOVA, and MANCOVAs.  There were significant differences in the mean scores of healthy lifestyle behaviors at posttest and follow-up between the two groups (p <0.01).  Moreover, the experimental participants showed statistically significant decrease in BMI as compared to the control group participants in posttest and follow-up (p <0.001).  There was a statistically significant reduction in blood pressure in the experimental participants, compared with the control participants at follow-up (p <0.001).  Furthermore, healthy lifestyle behaviors increased significantly in the experimental participants compared with the control participants and baseline (p < 0.001).  In addition, BMI and blood pressure decreased in the experimental participants compared with the control participants and baseline (p < 0.001).  The self-management program resulted in improved healthy lifestyle behaviors, and health outcomes among the elderly with hypertension, and has implications for health promotion.


Download data is not yet available.

Article Details

How to Cite
Sutipan, P., Intarakamhang, U., Kittipichai, W., & Macaskill, A. (2018). Effects of Self-management Program on Healthy Lifestyle Behaviors among Elderly with Hypertension. The Journal of Behavioral Science, 13(2), 38–50. Retrieved from https://so06.tci-thaijo.org/index.php/IJBS/article/view/98167
Research Articles


Aekplakorn, W., Abbott-Klafter, J., Khonputsa, P., Tatsanavivat, P., Chongsuvivatwong, V., Chariyalertsak, S., & Lim, S. S. (2008). Prevalence and management of prehypertension and hypertension by geographic regions of Thailand: the Third National Health Examination Survey 2004. Journal of hypertension, 26(2), 191-198. doi: 10.1097/HJH.0b013e3282f09f57

Aspinwall, L. G., & Tedeschi, R. G. (2010). The value of positive psychology for health psychology: Progress and pitfalls in examining the relation of positive phenomena to health. Annals of Behavioral Medicine, 39(1), 4-15. doi: 10.1007/s12160-009-9153-0

Bandura, A. (1991). Social cognitive theory of self-regulation. Organizational Behavior and Human Decision Processes, 50(2), 248-287. doi: 10.1016/0749-5978(91)90022-L

Bandura, A. (2005). The primacy of self‐regulation in health promotion. Applied Psychology, 54(2), 245-254.

Brahmawong, C. (2013). Developmental Testing of Media and Instructional Package. Silapakorn Educational Research Journal, 5(1), 7-20.

Bell, K., Twiggs, J., & Olin, B. R. (2015). Hypertension: The Silent Killer: Updated JNC-8 Guideline Recommendations.

Brady, T. J., Murphy, L., O’Colmain, B. J., Beauchesne, D., Daniels, B., Greenberg, M., House, M. & Chervin, D. (2013). A meta-analysis of health status, health behaviors, and health care utilization outcomes of the chronic disease self-management program. Preventing chronic disease, 10, 1-14. doi: 10.5888/pcd10.120112

Brahmawong, C. (1977). Instructional Media System. Bangkok: Chulalongkorn University.

Brill, J. B. (2011). Lifestyle intervention strategies for the prevention and treatment of hypertension: A review. American Journal of Lifestyle Medicine, 5(4), 346-360. doi:10.1177/1559827610392873

Clark, N. M., Becker, M. H., Janz, N. K., Lorig, K., Rakowski, W., & Anderson, L. (1991). Self-management of chronic disease by older adults: a review and questions for research. Journal of Aging and Health, 3(1), 3-27. doi: 10.1177/089826439100300101

Cornelissen, V. A., & Fagard, R. H. (2005). Effect of resistance training on resting blood pressure: a meta-analysis of randomized controlled trials. Journal of Hypertension, 23(2), 251-259.

Cohen, J. (1988). Statistical power analysis for the behavioural sciences. NY: Academic Press.

D’Amico, E. J., Neilands, T. B., & Zambarano, R. (2001). Behavior Research Methods. Instruments, & Computers, 33(4), 479. doi: 10.3758/BF03195405

Fishbach, A., & Labroo, A. A. (2007). Be better or be merry: How mood affects self-control. Journal of Personality and Social Psychology, 93(2), 158-173. doi:10.1037/0022-3514.93.2.158

Goyal, S., Morita, P., Lewis, G. F., Yu, C., Seto, E., & Cafazzo, J. A. (2016). The Systematic Design of a Behavioural Mobile Health Application for the Self-Management of Type 2 Diabetes. Canadian Journal of Diabetes, 40(1), 95-104. doi:10.1016/j.jcjd.2015. 06.007

Heinrich, E., Schaper, N. C., & Vries, N. K. D. (2010). Self-management interventions for type 2 diabetes: a systematic review. European Diabetes Nursing, 7(2), doi: 10.1002/ edn.160

Huffman, J. C., Millstein, R. A., Mastromauro, C. A., Moore, S. V., Celano, C. M., Bedoya, C. A., & Januzzi, J. L. (2015). A positive psychology intervention for patients with an acute coronary syndrome: treatment development and proof-of-concept trial. Journal of Happiness Studies, 17(5), 1985-2006. doi: 10.1007/s10902-015-9681-1

James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., & Ortiz, E. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the eighth joint national committee (JNC 8). The Journal of the American Medical Association, 311(5), 507-520. doi: 10.1001/jama.2013.284427

Jolly, K., Majothi, S., Sitch, A. J., Heneghan, N. R., Riley, R. D., Moore, D. J., & Singh, S. J. (2016). Self-management of health care behaviors for COPD: a systematic review and meta-analysis. International Journal of Chronic Obstructive Pulmonary Disease, 11, 305-326. doi: 10.2147/COPD.S90812

Ku, P. W., Fox, K. R., & Chen, L. J. (2016). Leisure-time physical activity, sedentary behaviors and subjective well-being in older adults: An eight-year longitudinal research. Social Indicators Research, 127(3), 1349-1361. doi: 10.1007/s11205-015-1005-7

Lyu, J, Lee, S. H., & Kim, H. Y. (2016). Associations between healthy lifestyles and health outcomes among older Koreans. Geriatrics & Gerontology International, 16(6), 663-669. doi: 10.1111/ggi.12531

Melchart, D., Doerfler, W., Eustachi, A., Wellenhofer-Li, Y., & Weidenhammer, W. (2015). The talent study: a multicentre randomized controlled trial assessing the impact of a ‘tailored lifestyle self-management intervention’ (talent) on weight reduction. BMC Obesity, 2(1), 38-44. doi: 10.1186/s40608-015-0069-x

Merrill, R. M., Hyatt, B., Aldana, S.G., & Kinnersley, D. (2011). Lowering employee health care costs through the Healthy Lifestyle Incentive Program. Journal of Public Health Management and Practice, 17(3), 225-232. doi: 10.1097/PHH.0b013e3181f54128

Park, Y. H., Chang, H., Kim, J., & Kwak, J. S. (2012). Patient-tailored self-management intervention for older adults with hypertension in a nursing home. Journal of Clinical Nursing, 22(5-6), 710-722. doi: 10.1111/j.1365-2702.2012.04236.x

Pressman, S., & Cohen, S. (2005). Does positive affect influence health? Psychological Bulletin, 131(6), 925-971. doi: 10.1037/0033-2909.131.6.925

Seligman, M. E. P., Steen, T., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychologist, 60, 410-421.

Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55(1), 5-14.

Sutipan, P., & Intarakamhang, U. (2017). Healthy Lifestyle Behavioral Needs among the Elderly with Hypertension in Chiang Mai, Thailand. International Journal of Behavioral Science, 12(1), 1-12.

Thutsaringkarnsakul, S., Aungsuroch, Y., & Jitpanya, C. (2011). Self-Management Program on Blood Pressure Control in Thai Hypertensive Patients at Risk for Stroke: a Randomized Controlled Trial. Journal of Health Research, 26(5), 243-249.

Torgerson, D. J. (2001). Contamination in trials: is cluster randomisation the answer? British Medical Journal, 322(7282), 355–357. doi: 10.1136/bmj.322.7282.355

World Health Organization. (2016). A global brief on hypertension: silent killer, global public health crisis. Retrieved from http://www.who.int/cardiovascular_diseases/ publications/global_brief_hypertension/en/

World Health Organization. (2000). Obesity: preventing and managing the global epidemic Report of a WHO Consultation (WHO Technical Report Series 894) (pp.221-222). Retrieved from http://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/

Yamaoka, K., & Tango, T. (2012). Effects of lifestyle modification on metabolic syndrome: a systematic review and meta-analysis. BMC Medicine, 10(1), 138-148. doi:10.1186/17 41-7015-10-138