Procedures
depression, hypertension, WeChat-based, anxiety
HYPERTENSION, RECRUITMENT
The baseline data set, which contained sociodemographic features, behavioral patterns, and past medical histories, was obtained from the multimodal intervention and control groups during the recruitment process. A baseline standardized questionnaire survey, including the self-rating anxiety scale (SAS), self-rating depression scale (SDS), and Pittsburgh Sleep Quality Index (PSQI), was conducted by trained professionals during face-to-face interviews. All patients were provided with information regarding lifestyle modification for hypertension management by physicians, which was in line with the Chinese hypertension management guidelines [Online multimodal health education includes internet and online communication, text-based health education, medical graphic narratives, and animation-supported health education. The purpose of online health education is to make health education easier and more accessible to patients and bridge the existing knowledge gap between clinicians and patients. In the context of online health education, program health education, lifestyle modifications, and modifiable risk factors are fundamental elements, which include how to choose an appropriate diet, expert guidance on exercise patterns and timing, and knowledge regarding the hazards of smoking and drinking, improved sleep patterns, and psychological care. The multimodal intervention group comprises cardiologists who possess extensive expertise in their respective professional domains. They underwent standardized training to ensure the consistent provision of high-quality health education. We employed standardized health education materials to minimize variations among doctors. Further, regular quality control and feedback mechanisms are implemented to ensure the efficacy of the intervention. Involving patients in the digital transformation of health information is a crucial step as it empowers them to better comprehend and manage their health conditions. To guarantee the effectiveness of our intervention, we adopted several strategies: providing detailed guidance and support for patients to correctly use WeChat-based multimodal intervention, regularly monitoring patients’ usage while offering feedback and suggestions, as well as conducting biweekly evaluations on effectiveness to monitor and enhance outcomes.Regarding the follow-up schedule, patients in the multimodal intervention group were followed up online once a week and as outpatients at 3 and 6 months. However, patients in the usual care group presented at baseline and were followed up as outpatients at 3 and 6 months. All patients were scheduled for morning home BP measurements every week and had to provide feedback to the clinical physician during follow-up. Accordingly, the clinical physician modifies the management based on the BP situation. These patients also had to refill the standardized questionnaire at the end of the trial. The principles of low-dose initiation, long-acting medication, combination therapy, and individualization were used according to the Chinese hypertension management guidelines [