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Hypertension Knowledge and Teach-Back Education at a Student-Led Clinic in a Medically Underserved Community
Jacobo Nieto1, Ernesto Robinson2, Sofia Gonzalez Higgins2
1Long School of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA. nietoj4@livemail.uthscsa.edu.
Abstract:
Patient knowledge is a key determinant of hypertension self-management and blood pressure control, yet data from underserved, community-based settings remain limited. We evaluated baseline hypertension knowledge in a predominantly Hispanic, rural population and assessed the short-term effectiveness of a brief teach-back educational intervention delivered in a community health setting. A four-item, Spanish-language version of the Hypertension Knowledge-Level Scale, shortened for feasibility in fast-paced outreach settings, was administered before and immediately after a teach-back session at a free community health fair on the U.S.-Mexico border. Among 30 Spanish-speaking participants (73% female; 30% with a prior hypertension diagnosis), the percentages who responded correctly to the three knowledge questions were 51.7%, 34.5%, and 27.6%, respectively, at baseline, increasing to 100% (p < 0.001), 79.3% (p = 0.021), and 93.1% (p = 0.004) after teach-back. The median total knowledge score increased from 1.0 (interquartile range [IQR] = 2.0) to 3.0 (IQR = 0.0). Participants reporting being "very comfortable" interpreting blood pressure readings increased from 29.6% to 55.2% (p < 0.008). Female sex (p = 0.037) and higher educational attainment (p = 0.043) were independently associated with lower diastolic blood pressure values. Overall, substantial hypertension knowledge gaps were identified in this underserved Hispanic population. A brief teach-back educational session may represent a feasible, low-cost strategy for improving hypertension knowledge in resource-limited, community-based settings.
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