Health literacy and hypertension prevention and control in a marginalized community in northern India: A mixed-methods study
1
Community Medicine and School of Public Health, Postgraduate institute of medical education and research, CHANDIGARH, India
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Hypertension (HTN) prevalence is high in India, yet awareness, treatment adherence and blood pressure control remain low. Health literacy may play an important role in managing HTN. This study assesses hypertension prevalence in a low-SES labourer community in India. It examines the role of health literacy in HTN management, along with the community's perception and preferences for managing such diseases.
METHODS:
A community-based mixed-methods study was conducted among 510 marginalized adults in Chandigarh, India. Health literacy, behavioural risk factors, medication adherence, follow-up practices, and blood pressure control were assessed. Associations between health literacy and medication adherence were also assessed. Nine focus group discussions with community members (n=76) were conducted and thematic analysis was performed.
RESULTS:
Mostly participants were female (59.2%), 70.3% below 40 years, internal migrants (91.6%), illiterate (35.1%), and unskilled or semi-skilled workers (33.5%). Risk factors prevalence: tobacco (19.8%), alcohol (11.3%), low physical activity (64.5%), and high salt intake (mean 6.9 g/day, SD 2.8). Among hypertensive individuals (35.2%; n=180), 43.8% (n=79) were aware of their condition; 27.9% were not on treatment, and 5.1% were adhering to medication with 10.1% blood pressure control. Medication-adherents had higher scores for navigating healthcare system (mean difference = 0.39; 95% CI: 0.03–0.75; p = 0.036), finding health information (mean difference = 0.73; 95% CI: 0.36–1.11; p < 0.001), and understanding health information (mean difference = 0.53; 95% CI: 0.17–0.89; p = 0.004). FGDs indicated that effective use of health information was shaped by provider communication, affordability, and service availability, with strong preferences for community-driven interpersonal, visual, and mobile messages for management of HTN.
CONCLUSIONS:
Hypertension prevalence is high in marginalised communities, alongside widespread behavioural risk factors, low awareness and poor medication adherence. Health literacy emerges as a key enabler of hypertension self-management. Community-based participatory interventions may support equitable hypertension management.
Hypertension (HTN) prevalence is high in India, yet awareness, treatment adherence and blood pressure control remain low. Health literacy may play an important role in managing HTN. This study assesses hypertension prevalence in a low-SES labourer community in India. It examines the role of health literacy in HTN management, along with the community's perception and preferences for managing such diseases.
METHODS:
A community-based mixed-methods study was conducted among 510 marginalized adults in Chandigarh, India. Health literacy, behavioural risk factors, medication adherence, follow-up practices, and blood pressure control were assessed. Associations between health literacy and medication adherence were also assessed. Nine focus group discussions with community members (n=76) were conducted and thematic analysis was performed.
RESULTS:
Mostly participants were female (59.2%), 70.3% below 40 years, internal migrants (91.6%), illiterate (35.1%), and unskilled or semi-skilled workers (33.5%). Risk factors prevalence: tobacco (19.8%), alcohol (11.3%), low physical activity (64.5%), and high salt intake (mean 6.9 g/day, SD 2.8). Among hypertensive individuals (35.2%; n=180), 43.8% (n=79) were aware of their condition; 27.9% were not on treatment, and 5.1% were adhering to medication with 10.1% blood pressure control. Medication-adherents had higher scores for navigating healthcare system (mean difference = 0.39; 95% CI: 0.03–0.75; p = 0.036), finding health information (mean difference = 0.73; 95% CI: 0.36–1.11; p < 0.001), and understanding health information (mean difference = 0.53; 95% CI: 0.17–0.89; p = 0.004). FGDs indicated that effective use of health information was shaped by provider communication, affordability, and service availability, with strong preferences for community-driven interpersonal, visual, and mobile messages for management of HTN.
CONCLUSIONS:
Hypertension prevalence is high in marginalised communities, alongside widespread behavioural risk factors, low awareness and poor medication adherence. Health literacy emerges as a key enabler of hypertension self-management. Community-based participatory interventions may support equitable hypertension management.
| eISSN: | 2654-1459 |
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