The Effects of a Self‑Management Program Based on the 5 A’s Model on Self‑Efficacy among Older Men with Hypertension

Document Type : Original Article


Background: Aging population is progressively increasing. Older adults suffer from the different chronic health conditions such as hypertension. Behavior change is a key strategy for effective hypertension management. Successful behavior change necessitates the adequate self‑efficacy. Objectives: This study aimed to evaluate the effects of a self‑management program based on the 5 A’s model on self‑efficacy among the older men with hypertension. Methods: This randomized controlled trial was conducted in 2016–2017 on older men with hypertension in Ramsar, Iran. In total, 60 eligible participants were randomly allocated to an intervention and a control group. The participants in the intervention group were offered a self‑management program based on the 5 A’s behavior change model. Data were collected using a demographic questionnaire, a hypertension assessment form, the Self‑Efficacy for Managing Chronic Disease Scale, and the hypertension Self‑Efficacy Scale. Self‑efficacy scales were completed for participants both before and 12 weeks after the intervention onset. The paired‑ and independent‑sample t, Wilcoxon signed‑rank, Mann–Whitney U, and Chi‑square tests were used in the data analysis. Results: The pretest mean scores of hypertension self‑efficacy in the intervention and the control groups were, respectively, 48.62 ± 11.71 and 44.65 ± 15.4, which significantly increased to 79 ± 13.13 and 62.06 ± 15.38 at posttest (P < 0.001). Moreover, the pretest mean scores of chronic disease management self‑efficacy in these groups significantly increased from, respectively, 5.64 ± 1.28 and 5.35 ± 1.40 at pretest to 8.05 ± 1.29 and 6.12 ± 1.48 at posttest (P < 0.001). The pretest–posttest mean differences of the mean scores of both types of self‑efficacy in the intervention group were significantly greater than the control group (P < 0.001). Conclusion: The self‑management program based on the 5 A’s model is effective in significantly improving the self‑efficacy among older men with hypertension.