IMB-Guided Health Education Intervention for Medication Adherence and Blood Pressure Control in Non-adherent Hypertensive Patients

This study will evaluate the effectiveness of an Information-Motivation-Behavioral Skills (IMB) Model-guided health literacy intervention among adults with hypertension who are non-adherent to prescribed antihypertensive medication. The study will use a cluster randomized controlled trial design in eight public hospitals in North Ethiopia. Four hospitals will be allocated to the intervention group and four to the usual-care control group. The intervention will address information, motivation, and behavioral skills related to medication adherence and hypertension self-management. Participants in the intervention group will receive the IMB Model-guided health literacy intervention in addition to usual care, while participants in the control group will receive usual care. The primary outcome is medication adherence. Blood pressure control and other specified hypertension self-management outcomes will be assessed as secondary outcomes. In addition, a qualitative component will explore the perceptions, experiences, and contextual barriers of medication non-adherent hypertensive patients regarding the information, motivation, and behavioral skills that influence their medication adherence and hypertension self-care behaviors. The study will test the hypothesis that the IMB Model-guided health literacy intervention will improve medication adherence compared with usual care. The qualitative component will provide contextual information to help explain participants\' experiences and the factors influencing medication-taking behavior and intervention implementation.