Effectiveness of a Home Visit Program Integrated With Primary Health Care in Improving Physical Activity of the Elderly With Hypertension: A Randomized Controlled Trial

Introduction: The prevalence of hypertension (HTN) increases with age. This study evaluated the effectiveness of a home visit program integrated with primary health care (PHC) in improving physical activities in the elderly with HTN. Methods: This randomized controlled trial was conducted on 108 hypertensive elderly participants in Khorramabad from May to October 2023. They were selected using stratified, multi-stage cluster sampling, and the intervention was designed based on the Health Belief Model. The primary outcome was the change in physical activity, measured by the Physical Activity Scale for the Elderly. The data were analyzed by SPSS 19 using an independent t-test, the Mann-Whitney test, ANOVA, and the generalized estimating equations model. Results: In the final analysis of 90 individuals, the integrated home visit program within the PHC structure could significantly increase the likelihood of engaging in overall physical activity (OR=1.84; 95% CI: 1.27-2.66; P=0.001) and leisure-time physical activity (OR=1.81; 95% CI: 1.15-2.85; P=0.01) compared to the control group. Based on the analysis of factors associated with the primary outcome, higher education (OR=1.85, 95% CI: 1.3-3.4, P=0.012), home ownership (OR=6.9, 95% CI: 2.88.1-16.73, P=0.001), and having health insurance (OR=1.75, 95% CI: 1.26-2.42, P=0.001) were independently associated with increased odds of achieving a clinically considerable improvement in leisure-time activity. Conclusion: Overall, integrating a home visiting program into the PHC structure noticeably improved overall physical activity levels among older adults with HTN. Therefore, it is suggested that this model be used to improve physical activity in this population. Trial Registration: Identifier: IRCT20180721040540N4; https://irct.behdasht.gov.ir/user/ trial/45393/view (Registration date 2020-05-21).