In China, a country owning a large number of hypertensive patients, offline management is still a major approach for hypertension prevention and control, but the efficiency and effectiveness of this approach are unsatisfactory. Therefore, it is necessary to develop a closed-loop hypertension management path using online management approaches actively explored based on cognitive-behavioral models.

To assess the effect of cognitive-behavioral change model-based online health education in the management of hypertension.

A total of 122 essential hypertension outpatients and inpatients were recruited from General Practice Department, General Hospital of Medical University of Ningxia Medical University from November 2018 to October 2019, and randomly divided into online management group (n=61) and off-line management group (n=61) . Off-line management group received routine management. Online management group received online health education (including systematic courses and personalized self-management information in line with the five stages of behavior transformation of hypertension patients provided via the WeChat platform for gradually changing their health-related behaviors) based on the cognition-behavioral change model (a model built upon improved knowledge-attitudes-behavior model, health belief model, and transtheoretical model) . Systolic blood pressure (SBP) and health-related behaviors at baseline and 12 weeks after intervention were compared between the groups.

The average SBP levels at baseline demonstrated no significant difference between the groups (P<0.05) . After intervention, the average SBP level decreased significantly in both groups (P<0.05) , and it decreased more significantly in the online management group (P<0.05) . Two groups showed no significant differences in the prevalence of self-monitoring blood pressure, taking medications, eating a diet and exercising as well as taking actions to improve psychological state according to the doctor's advice at baseline (P<0.05) . After intervention, the prevalence of self-monitoring blood pressure according to the doctor's advice was significantly increased in the online management group (P<0.05) although the prevalence of other four of the above-mentioned health-related behaviors was still similar in both groups (P<0.05) .

This hypertension management approach developed based on mobile health technologies and the cognition-behavioral change model could help general practitioners to effectively manage hypertension patients, which will contribute to the improvement of work efficiency of general practitioners, and the achievement of long-term preservation and real-time analysis of patient management data. So this management is worthy of application and promotion.

我国高血压患者基数大，目前开展的高血压预防和管理仍以线下模式为主，存在管理效率不高、管理效果未达预期的问题。因此，积极探索基于线上的高血压患者管理模式，结合认知-行为转变模型构建高血压患者闭环管理路径十分必要。

探讨基于认知-行为转变模型的线上健康教育在高血压患者管理中的应用效果。

选取2018年11月至2019年10月宁夏医科大学总医院全科门诊及病房收治的原发性高血压患者122例，随机分为线上管理组61例和非线上管理组61例。非线上管理组患者由医生给予常规管理；线上管理组患者采用基于认知-行为转变模型的线上健康教育模式，该模式以知识-态度-行为模型（KAPM）、健康信念模型（HBM）、跨理论模型（TTM）及三者的改进为基础，围绕高血压患者行为转变的5个阶段，以微信小程序为载体，采取系统化课程教育与个性化知识推送两种形式，循序渐进地改变患者的行为方式。比较两组患者基线时和干预12周后的收缩压及健康行为改变情况。

管理前，两组患者收缩压比较，差异无统计学意义（P>0.05）；管理后，两组患者的收缩压均低于管理前（P<0.05），且线上管理组患者的收缩压低于非线上管理组（P<0.05）。管理前，两组患者血压自测、服药、饮食、运动、心理方面的指令完成合格率比较，差异无统计学意义（P>0.05）；管理后，线上管理组患者的血压自测的指令完成合格率高于非线上管理组（P<0.05），两组其他健康行为的指令完成合格率比较，差异无统计学意义（P>0.05）。

基于移动医疗技术和认知-行为转变模型设计的高血压患者管理模式，可以帮助全科医生有效管理高血压患者，提高全科医生的工作效率，并可实现患者管理数据的长期保存和实时分析，值得在实践中推广应用。