Effectiveness of a physical literacy intervention program for young and middle-aged adults with hypertension: a mixed-methods quasi-experimental study

Abstract

To examine whether a theoretically grounded, 8-week physical literacy intervention incorporating salutogenic model components (sense of coherence, social support, and self-efficacy) could improve physical activity levels and clinical outcomes in young and middle-aged adults with Grade 1 hypertension, and to explore participants’ subjective experiences of the program. A mixed-methods quasi-experimental study was conducted between August and October 2024. Forty patients aged 18–59 years were recruited from a community healthcare center and allocated to the intervention group (n = 20) or control group (n = 20). The intervention group received a multidimensional physical-literacy program, while the control group received usual care. Five participants were lost to follow-up; 35 (intervention: n = 17; control: n = 18) completed all three assessments: baseline (T0), post-intervention (T1), and one-month follow-up (T2). Quantitative outcomes (SBP, BMI, physical-literacy scores, social support, sense of coherence, self-efficacy, and physical activity) were analyzed using independent t -tests or Mann-Whitney U tests for between-group comparisons and paired t -tests or Wilcoxon signed-rank tests for within-group changes, with significance set at α = 0.05 (two-tailed). Qualitative data from semi-structured interviews were analyzed using inductive content analysis. Of the 40 recruited participants, 35 (87.5%) completed the study. Post-intervention, the intervention group demonstrated significant reductions in systolic blood pressure (SBP), body weight, and BMI compared to baseline (all P  < 0.05). Significant improvements were also observed in PL scores, social support, sense of coherence, and self-efficacy ( P < 0.05). Qualitative findings corroborated these results, highlighting enhanced health literacy and stress alleviation, despite some logistical challenges. The PL intervention is a feasible and effective strategy to improve health outcomes and psychosocial resilience in hypertensive adults, offering a promising approach for community-based chronic disease management.