Background
death, frustration, Hypertension, hypertension, diabetes improves
HEART FAILURE, DISEASE, HYPERTENSION, HYPERTENSION
Hypertension is considered as a growing health problem and the third cause of death in the world, as about 31% of adults over 18 years old in America suffer from hypertension [One of the main determinants of blood pressure control is self-care behavior, including regular control of blood pressure, reducing salt intake, not using tobacco, physical activity, avoiding stress, healthy nutrition, losing weight, and taking medicines prescribed by the physician timely [Ravansar cohort study in Iran demonstrated that 15.7% of 10,040 people aged 35 to 65 have hypertension and only 53% of them are successful in controlling their disease and 73% of them receive antihypertensive drugs [Inadequate adherence to medication leads to increased morbidity, mortality, and health care costs, as well as frustration among patients and health care providers [Health literacy leads to more awareness of health issues and consequently, better self-care [The American Medical Association (AMA) divided the field of health literacy into the cultural and conceptual knowledge, print health literacy (writing and reading skills), oral health literacy (listening and speaking), and numeracy.Low health literacy makes people unable to find and use the health information and cares they need [Based on the results of the studies, the use of m-health application among patients with heart failure, hypertension, and diabetes improves the efficiency of the health care system, quality of life, and medication adherence and reduces costs [Programmed instruction was introduced by Skinner in America (1954), professor of psychology at Harvard University. Programmed instruction is an individual instruction method, dividing the content into small section and presenting them gradually and in regulated steps. Individuals study these materials step by step and after completing each step and before moving to the next step, they are tested to evaluate their understanding [Considering that hypertension is usually associated with asymptomatic symptoms, the person may forget to take their medicine regularly and perform healthy behaviors. Therefore, the programmed instruction is considered as an appropriate method for these patients, since this issue is partially due to the low health literacy of the patients. In this method, the educational material is taught to the person step by step, and after learning the content of each step, the person moves to the next step. Given that this method may be associated with trial and error, it stabilizes learning in the patient. However, interventions to improve health literacy in different domains, including print health literacy and functional literacy, are challenging [