Effectiveness of a Surveillance and Prevention Program for Stroke in Patients with Uncontrolled Hypertension in Khok Thai Sub-district, Si Mahosot District, Prachin Buri Province

Abstract

Stroke is the third leading cause of death worldwide, with hypertension as a major risk factor. This quasi-experimental two-group pretest–posttest study evaluated the effectiveness of a surveillance and stroke prevention program for patients with uncontrolled hypertension. Using G*Power, the required sample size was 28 per group, increased to 34 to allow for attrition. The experimental group received a program integrating 4E measures with the Knowledge–Attitude–Practice model over 10 sessions in 5 weeks, followed by 12 weeks of monitoring. Research instruments consisted of the intervention program and questionnaires assessing knowledge, attitudes, and practices related to stroke surveillance and prevention. Content validity was confirmed (CVI = 1). Reliability testing yielded a KR-20 of 0.68, and Cronbach’s alpha values of 0.88 and 0.83 for the attitude and practice scales. Data were analyzed using t-tests, repeated measures ANOVA, and ANCOVA. The results showed that the experimental group had significant improvements in knowledge, attitudes, and practices, along with reductions in systolic and diastolic blood pressure, body mass index, body weight, and waist circumference (p < 0.05). No significant changes were observed in the comparison group. The program was demonstrated to be effective in enhancing stroke prevention behaviors and improving key health indicators among patients with uncontrolled hypertension. Public health personnel may apply this program as a guideline for stroke surveillance and prevention, supported by continuous monitoring through village health volunteers using the LINE application. Development of a practical manual for broader implementation is recommended.