Effects of the preventive hypertension self-management education program for deaf and hard of hearing adults: a randomized controlled trial

Deaf and hard of hearing (DHH) individuals often experience limited access to health information due to communication barriers, increasing their risk for hypertension. This randomized controlled trial evaluated PRE-H-SMILE (PREventive Hypertension Self-Management Intervention using sign LanguagE), an 8-week, sign language-based program for DHH adults without prior hypertension. It was hypothesized that the intervention group would exhibit higher levels of health-promoting behaviors and show a trend toward blood pressure reduction compared with the control group. The program included weekly sign language educational videos and two in-person sessions. A total of 37 participants completed the study (intervention = 20, control = 17). Total health-promoting behavior scores increased significantly in the intervention group (χ2 = 5.530, p = .019), and sedentary time decreased significantly (F = 4.766, p = .039). No significant changes were observed in blood pressure. Findings suggest that PRE-H-SMILE can effectively support healthier behaviors among DHH adults.