Knowledge, attitude, practice of home blood pressure monitoring among rural residents: a mixed-methods study

Objective This mixed-methods study investigated knowledge, attitude and practice (KAP) of home blood pressure monitoring among rural residents and urban-rural disparities.Methods From February 1 to September 1, 2025, a self-developed questionnaire assessed residents’ KAP, and semi-structured interviews with village doctors explored contextual factors.Results Of 1600 contacted residents, 948 valid responses were analyzed. Urban residents had higher knowledge, attitude, practice and total KAP scores than rural residents (all P < 0.001). Among rural residents, higher education was positively associated with KAP scores (β = 9.11, 95% CI: 3.19 to 15.04, P = 0.003), whereas smoking status was negatively associated with KAP scores (β = −3.69, 95% CI: −6.55 to −0.82, P = 0.010). Interviews identified structural barriers related to resource constraints, limited resident awareness and trust, and weak institutional support.Conclusion Our findings suggest that improving rural residents’ knowledge of home blood pressure monitoring may be important, but effective implementation may require coordinated interventions addressing cultural beliefs, economic barriers, provider incentives and primary-care infrastructure.