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NCT Number: NCT07131176

Assessing the Feasibility of Multimedia Interventions to Reduce Blood Pressure in Marginalized Hypertensive Communities of Karachi, Pakistan

This study utilizes the I-Change Model to empower individuals in literacy-limited settings, where the majority of the population is illiterate. By leveraging multimedia tools-such as an educational video and a pictorial infographic-we aim to promote self-care practices among individuals suffering from hypertension. Through these tailored interventions, we seek to enhance awareness, improve hypertension management, and encourage behavioral change, even in low-literacy communities

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Key information

Age range

21 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

This study is grounded in the I-Change Model, a behavioral change framework that emphasizes awareness, motivation, and ability as key drivers for adopting healthier lifestyles. Recognizing the barriers posed by low literacy in many underserved communities, particularly in urban slums, we aim to implement context-sensitive interventions that empower individuals with hypertension to take charge of their health. In these settings, traditional written health education materials often fail to reach or resonate with the population due to widespread illiteracy and limited health literacy. To address this gap, our study introduces two key multimedia tools: an educational video, designed with simple language and culturally relevant visuals to demonstrate self-care techniques; and a pictorial infographic that visually conveys essential information about hypertension management, medication adherence, dietary habits, and physical activity. By combining these tools with physician consultations, we hope to strengthen patient understanding, increase engagement with self-care practices, and ultimately improve blood pressure control. This multimedia-based, patient-centered approach offers a scalable and cost-effective strategy for promoting behavioral change in marginalized, low-literacy populations.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Participants will be hypertension patients with an active primary healthcare clinic registration from eight chosen clinics situated in Karachi, Pakistan's slums.
  • Anyone between the ages of 21 and 70 who has been diagnosed with hypertension at one of SINA's participating clinics in the last 30 days is eligible to participate.
  • Participants will be required to take medicine to control their blood pressure,
  • sign an informed consent form,
  • attend primary healthcare clinic on a regular basis, and
  • have proficiency in five local languages: Urdu, Sindhi, Balochi, Pashto, or Punjabi.

Exclusion criteria

  • a patient's pregnancy or lactation status, a history of cancer that may necessitate medication changes,
  • a blood pressure reading greater than 220/120 mmHg,
  • a disability that prevents the patient from reading, writing, communicating, or watching television, and participation in any other study.

Treatment and study plan

Behavior Change through Education intervention

Other

The I-Change Model We used behavior alteration theory to identify areas of thinking or conduct that might potentially lead to issues in the process of collecting or consuming medicine. Subsequently, we proceeded to create and improve the substance of the message, and we aligned the messages with a standardized classification of evidence-based strategies for modifying behavior.

Unclear or confusing information in infographics and television videos was revised, while information that was deemed unhelpful or insignificant by both patients and clinicians was eliminated. Patients' feedback was used to create fresh material for television videos and infographics.

  • Encourage patients about routine clinic appointments
  • Provide relevant health-related information.
  • Help participants plan and organize various treatment adherence behaviors including medication collection and taking, diet, and exercise
  • Support positive adherence-related behaviors

Primary outcomes

  1. Change in Systolic and/or Diastolic Blood Pressure

    Time frame: 3, 6, 9 months post intervention

    Change in Systolic and/or Diastolic Blood Pressure from baseline to follow-up

Secondary outcomes

  1. Change in hypertension knowledge score

    Time frame: at 3, 6, 9 months post intervention

    From baseline to post intervention, knowledge about self-care among interventional arms

  2. Adherence to antihypertensive medication

    Time frame: at 3, 6, 9 months post intervention

    The Hill bone-scale, comprising 14 items, assesses medication self-efficacy in managing Hypertension (chronic diseases) and appears suitable for individuals with limited literacy skills

  3. Dietary modifications (e.g., reduced salt intake)

    Time frame: at 3, 6, 9 months post intervention

    Dietary modifications (e.g., reduced salt intake)

  4. Number of clinic visits or follow-up consultations

    Time frame: 3, 6, 9 months post intervention

    Number of clinic visits or follow-up consultations

  5. BMI management in Kg/m2

    Time frame: 3,6,9 months post intervention

    weight control according to height in kg/m2

  6. Smoking control (number of cigarettes per day)

    Time frame: 3, 6, 9 months post intervention

    Smoking control starting from reduction in number of cigarettes per day to complete cessation

  7. Physical activity

    Time frame: 3, 6, 9 months intervention

    time in minutes which shows physically active in a day (in term of walking, yoga, exercise)

Study contacts

Contact information is provided by the study sponsor or research team.

Hina Sharif, PharmD,MSPH

CONTACT

[email protected]

03373305666

Sana S Sheikh, MSc. MPH

CONTACT

[email protected]

Sponsors and collaborators

Lead sponsor

SINA Health Education and Welfare Trust

Other

Collaborators

  • Aga Khan University

Registry information

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Aug 20, 2025
Registry last updated
Aug 20, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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