Examining the Relationship Among Social Cognitive Theory-Based Constructs, Physical Activity, and Blood Pressure in Young- and Middle-Aged Adults Living With Hypertension

BACKGROUND: Psychosocial factors significantly influence lifestyle changes in adults with hypertension. However, research focusing specifically on these factors in young- and middle-aged adults-especially those newly diagnosed within the first 5 years-is limited. PURPOSE: This cross-sectional study aimed to examine the relationship between psychosocial factors guided by Social Cognitive Theory (perceived stress, self-efficacy, outcome expectancy, and functional and workplace support), physical activity, and blood pressure in young- and middle-aged Thai adults with hypertension. METHODS: = 47.98 years; SD = 7.66), with nearly 60% being female from 25 primary care settings in a Thai province. Confirmatory factor analysis validated latent variables, followed by structural equation modeling with maximum likelihood and robust standard errors to analyze direct and indirect effects on physical activity and blood pressure. RESULTS: Findings highlight self-efficacy in physical activity as a significant predictor of moderate-to-vigorous physical activity, while functional support correlated with reduced systolic blood pressure. Moderate-to-vigorous physical activity mediated the relationship between self-efficacy or functional support and systolic blood pressure. Hypertension duration (diagnosis ≤12 months vs >12 months) moderated the relationship between moderate-to-vigorous physical activity or functional support and diastolic blood pressure. CONCLUSIONS: Our research presents a new, theory-driven perspective on how psychosocial factors could affect blood pressure levels through physical activity among younger adults newly diagnosed with hypertension. Nurses can leverage this insight by providing education to enhance confidence and engage patients' social networks in supporting their participation in physical activity, thereby improving blood pressure management.