Hypertension Screening For High School Students And Research On Application Of O2O Health Management Model

Objectives1.To investigate the blood pressure states and detection of hypertension among high school students,and to investigate their physical activity,sleep,mental and health-related behaviors,and to explore the relationship between these factors and hypertension.2.Establish O2O(Online-to-Offline,Online and offline e-commerce)health management model,and explore its comprehensive intervention effects on adolescent hypertension patients in blood pressure,BMI,sleep,mental,physical activity and health-related behaviors.Methods1.The Investigation studyFrom March to April 2019,adopt multi-stage sampling method,select two first-class high school schools in Fuzhou,take classes as the unit,and use the lottery method to randomly select 6 classes from the first and second grades.A total of 517 students were included in the blood pressure screening study.The demographic characteristics,sleep,physical activity,mental and health-related behaviors of high school students were investigated by using the general information questionnaire,pittsburgh sleep index scale,physical activity rating scale,general health questionnaire and chinese adolescent health-related behavior questionnaire.The physical examination included height,weight,heart rate and blood pressure.Univariate and multivariate analysis was used to analyze the influencing factors of adolescent hypertension with Chi-square test and Logistic regression analysis.2.The intervention study40 male patients with hypertension were included in the intervention study based on the inclusion,exclusion criteria,and voluntary principles among the 47 hypertension patients screened in the investigation study.The patients were randomly divided into O2 O intervention group and control group with 20 cases each.The control group received online We Chat health education;the O2 O intervention group added offline medium-intensity aerobic exercise intervention on the basis of the control group,3times/week,40min/time,intervention for 12 weeks.The changes of blood pressure,BMI,waist circumference,physical activity,sleep,mental and health-related behaviors of the two groups of patients before and after intervention were compared.SPSS 24.0 was used for t test,Mann-Whitney U test,Wilcoxon Signed Rank test,Mc Nemar’s test and the ANOVA for repeated measures.Results1.The Investigation studyThe survey population had an average systolic blood pressure(113.06±12.31)mm Hg;an average diastolic blood pressure(69.27±7.62)mm Hg;and an average heart rate(82.70±3.92)times/min.The SBP and DBP of boys are higher than that of girls;the SBP and DBP of high school students are increasing with age;the SBP and DBP of second grade students are higher than those of first grade students;BMI is normal,overweight and obese high school students,the comparison between SBP and DBP was obese>overweight>normal(P<0.05).The detection rates of hypertension at three different time points were 15.3%,10.8%,and 9.1%,respectively.The results of multivariate logistic regression analysis showed that gender,age,BMI,sleep time and extracurricular tutoring were independent influencing factors for hypertension in high school students.There was a negative correlation between female and hypertension in high school students.The 17 years old age group,overweight and obesity,sleep time≤7h/d,and extracurricular tutoring≥2h in the past 7 days were positively correlated with the incidence of hypertension in high school students.2.The intervention study(1)Blood pressure:(1)At the three time points before intervention(weeks 6、4 and2 before intervention)and baseline blood pressure in the group:after the ANOVA for repeated measures,the difference of SBP and DBP between the two groups before the intervention was not statistically significant(P>0.05);the SBP and DBP in both groups changed with the time points(P<0.05);however,with the increase of time,the effect of the groups on both systolic and diastolic blood pressure was not statistically significant(P>0.05);the paired sample t test showed that the baseline blood pressure of the two groups was not statistically significant compared with the blood pressure 2 weeks before the intervention(P>0.05);the results indicated that the changes of systolic and diastolic blood pressure tended to be stable at baseline.(2)Baseline blood pressure and2 time points after intervention(Weeks 8 and 12 after intervention): after the ANOVA for repeated measures,the difference of SBP between the two groups was statistically significant(P<0.05),but the difference of DBP between the two groups was not statistically significant(P>0.05).The SBP and DBP in both groups changed with the time points(P<0.05).The effect of different intervention methods on systolic blood pressure varied with time(P<0.05),but there was no significant effect on diastolic blood pressure(P>0.05).Simple effects analysis showed that there was a significant difference in SBP at each point between the two groups(P<0.05),and the difference in SBP between the two groups was statistically significant at weeks 8 and 12(P<0.05).After the intervention O2 O intervention group SBP((128.6±4.0)mm Hg)significantly lower than the control group((134.1±3.8)mm Hg),the difference was statistically significant(P<0.001).(2)Heart rate: Baseline heart rate and 2 time points after intervention(weeks 8 and12 after intervention):The difference in heart rate between the two groups after intervention was not statistically significant(P>0.05).The difference of heart rate at each time point was not statistically significant(P>0.05),and the effect of different intervention methods on heart rate of the two groups over time was not statistically significant(P>0.05).(3)Other indicators:(1)Before intervention:two groups of age,grade,height,weight,BMI and waist circumference,baseline blood pressure,family history of hypertension and other general information,as well as sleep,physical activity,mental and health related behaviors,there were no statistically significant difference(P>0.05).The baseline data of the two groups were equally comparable;(2)After intervention: the score of physical activity in the O2 O intervention group was significantly higher than that of the control group(P<0.05),while the sleep,mental,BMI,waist circumference and health-related behaviors between the two groups were not statistically significant(P>0.05);(3)Comparison within the group:the physical activity score after intervention in the O2 O intervention group was higher than before intervention(P<0.05);sleep,mental health score and BMI were lower than before intervention(P<0.05);however,the differences in waist circumference and health-related behaviors before and after the intervention in the O2 O intervention group were not statistically significant(P>0.05).The sleep score of the control group after intervention was lower than that before the intervention(P<0.05);however,there was no statistically significant difference in physical activity,mental,BMI,waist circumference and health-related behaviors before and after the intervention(P>0.05).(4)Health-related behaviors:There was no statistically significant difference in health-related behaviors between the two groups before and after intervention(P>0.05).In order to understand the changes of health behaviors of the subjects after online health education,the two groups of subjects were integrated and analyzed.After online health education,the results showed that high school students with hypertension had improvement in the frequency of drinking soft beverages,frequency of drinking milk/soy milk,exercise for losing weight,diet control for losing weight,days of exercising ≥1h per day,time of playing games(P<0.05).Conclusions1.The Investigation study(1)The variation of blood pressure in adolescents is large,and blood pressure should be measured at three different time points on different days before the diagnosis of hypertension.The detection rate of hypertension in the survey population is 9.1%,which is at a low level compared with the reports of hypertension among children and teenagers in many places in China.(2)The influencing factors of adolescent hypertension include age,gender,overweight,obesity,sleep time≤7h and extracurricular tutoring≥2h.Therefore,it is important to carry out school and community-based health education for the risk factors of adolescent hypertension.2.The intervention studyThe O2 O health management model constructed in this study can effectively reduce the systolic blood pressure of male high school students with hypertension and improve their level of physical activity.However,it still needs further research and verification in improving the sleep,mental health level and reducing BMI.In addition,online We Chat health education has also played a positive role in reducing systolic blood pressure and promoting the formation of healthy behaviors among male high school students with hypertension.