Impact of Patient Engagement on Blood Pressure Control Among Older Individuals With Hypertension in a Mobile Health Intervention: Longitudinal Analysis Using Latent Growth Curve Modeling

Abstract

Background: Limited research has investigated the influence of patient engagement on the long-term effects of mobile health (mHealth) interventions, particularly among older adults. Objective: This study aimed to examine the long-term impact of a social media–driven mHealth intervention on blood pressure control among older Chinese individuals with hypertension, through repeated measurements of patient engagement and outcomes at 5 preset time points. Methods: The study included older Chinese individuals with hypertension between 2017 and 2022. Participants received a hypertension self-management program via the WeChat social media app (Tencent Holdings Ltd), which provided clinically based digital coaching. Blood pressure measurements were taken repeatedly using a home blood pressure monitor (HBPM) connected to the app at baseline, 3, 6, 9, and 12 months. Patient engagement was evaluated based on the frequency of completed measurements at corresponding follow-ups. Latent growth curve models (LGCMs) served to assess the impact of patient engagement on blood pressure among older individuals with hypertension across preset points. Results: A total of 1723 patients completed the 12-month follow-up (average age 70.1, SD 6.8 years; 890/1723, 51.7% female; and baseline systolic blood pressure 137.2 mm Hg). LGCMs revealed systolic blood pressure decreased significantly over 1 year, notably at 9 months (131 mm Hg, β9=3.244, P