Leveraging adolescents as health advocates: Evaluating hypertension education’s impact on knowledge retention & family health compliance

Background & objectives Hypertension, traditionally a significant health issue among adults, is now increasingly being observed in the paediatric population posing long-term cardiovascular risks. This study evaluated a school-based hypertension education intervention for adolescents and its impact on their hypertensive family members. Objectives included assessing adolescents' knowledge retention, knowledge transfer to adults, and the effects of child-led monitoring on adult compliance. Methods The study was conducted in two phases. In Phase 1, the study involved adolescents from classes 6-10 (n=423). Phase 1 assessed hypertension knowledge changes post-intervention from baseline scores across 6 interval points through 91 days using hypertension knowledge test (HKT). In Phase 2, adolescents and their hypertensive family members (n=181) were recruited in pairs. Changes in HKT, hypertension compliance (hypertension compliance scale: HyCompS), and mean arterial pressure (MAP) were analysed pre- and post-intervention using paired t-tests. Adolescents tracked adult adherence via daily monitoring diaries, analysed descriptively. Results In Phase 1, adolescents showed significant and sustained improvements in hypertension knowledge despite minor dips on the 35th and 63rd days. In Phase 2, adults' knowledge improved significantly in overall and general awareness domains. Compliance increased, particularly for medication and lifestyle monitoring, with significant reduction in MAP. Children recorded high monitoring adherence-medication (77.6%), exercise (72%), and diet (66%). Interpretation & conclusions Adolescents can effectively serve as health advocates, promoting hypertension awareness and compliance within families. Structured school interventions may improve both adolescent and adult health outcomes. Longitudinal studies with larger samples are recommended.