Abstract Body (Do not enter title and authors here): Background:
Current strategies for blood pressure (BP) control focus primarily on individuals with diagnosed hypertension, yet they have yielded only modest success. Because cardiovascular risk rises continuously with BP, even within the normotensive range, shifting the entire population distribution toward lower levels may prevent more events than targeting high-risk individuals alone. Whether family focused interventions led by trained health instructors can achieve a reduction in BP across populations has not been tested in clinical trials.
Methods:
The Healthy Family Program is a cluster-randomized trial conducted in 80 villages, each comprising 30–50 families. Villages were randomly assigned in a 1:1 ratio to either a family-focused intervention or usual care [ClinicalTrials.gov (NCT06427096)]. All residents aged 40–80 years within participating families were eligible, except those with end-stage diseases or pregnancy plans. The intervention involved training family health instructors in each village and selecting a family leader for every household. Health instructors supervised the family leaders in monitoring BP using a predefined algorithm through a WeChat mini-program, with referral to village doctors for elevated readings. Family health instructors were incentivized based on their performance. Additionally, the program provided free sodium-substitute salt, promoted healthy lifestyle education, supported weight management, and encouraged physical activity. The intervention lasted 6 months, after which study coordination center support, incentives for instructors, and salt distribution were withdrawn. The primary outcome is the change in systolic BP from baseline to 6 months, measured as the absolute difference between the intervention and control groups. Secondary outcomes include the change in systolic BP at 12 months and the difference in diastolic BP between groups at 6 months. The full statistical plan is available at https://www.medrxiv.org/content/10.1101/2025.04.07.25325383v2. Results will be presented at the upcoming conference.
Conclusions:
The outcomes of the Healthy Family Program may provide valuable insights for scaling family focused health initiatives, offering a sustainable approach to improving cardiovascular health in diverse populations. The findings could inform future public health strategies aimed at addressing hypertension, particularly in underserved rural areas.