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2015 HSR&D/QUERI National Conference Abstract

3131 — The impact of a stories based educational DVD on patients' intentions to change hypertension management behaviors: A randomized control trial.

Bokhour BG, CHOIR Bedford VAMC; Fix GM, CHOIR Bedford VAMC; Orner M, CHOIR Bedford VAMC; DeLaughter KL, CHOIR Bedford VAMC; Rao S, CHOIR Bedford VAMC; Long JA, CHERP Philadelphia VAMC; Gordon HS, CINCCH JBVAMC; Pope C, Ralph H. Johnson VAMC; Houston TK, CHOIR Bedford VAMC;

Objectives: African-American Veterans have higher rates of hypertension and are more likely to have their hypertension uncontrolled compared to whites. Many didactic educational interventions about behaviors necessary to control hypertension have had limited success. Real life stories of patients who have struggled and later succeeded in managing their blood pressure (BP) may have important lessons for other patients with hypertension and be effective for controlling their BP. We developed and tested an educational DVD consisting of African-American Veterans' success stories of controlling their hypertension.

Methods: 620 African-American Veterans with uncontrolled hypertension at three VAMC's were randomized to receive either a DVD with only didactic information, reflective of typical health messages (control) or a DVD that incorporated videotaped stories told by African-American Veterans who had successfully controlled their hypertension (intervention). Immediately post- DVD viewing, participants completed measures of 1) intellectual and emotional engagement with the DVD and 2) influence of the DVD on intention to change behavior. We computed the mean scores for the two groups and compared them with two-sided t-tests.

Results: On average, patients in the intervention group reported significantly higher emotional engagement (means: 4.3 vs. 3.2; p < 0.0001) than those in the control group. They were also more likely to report intentions to become more physically active (4.6 vs. 4.4; p = 0.018); use salt substitutes (3.9 vs. 3.4; p = 0.0006) and talk openly with their doctor about their HTN (4.6 vs. 4.5; p = 0.049). The stories DVD did not significantly affect intellectual engagement or changes in intentions for other hypertension management behaviors.

Conclusions: Veterans were more emotionally engaged and reported intentions to change behavior when watching DVDs with patient stories of successful hypertension management. Behavioral intentions have been associated with clinical outcomes in prior research. Further important analyses to explore the impact of patient stories on long-term behavioral changes and clinical outcomes are in progress.

Impact: Videotaped patient stories may be more influential than purely informational educational materials to effect patient behavior change. Such videotapes could be shared by clinical staff or in a broader medium, such as on My HealtheVet.