article · BMC Public Health
A study of 360 adults living with hypertension in Mampong Municipality, Ghana, examined how digital health literacy and personal self-efficacy relate to blood pressure control. Uncontrolled blood pressure was highly prevalent, affecting 74.2 percent of participants. Analyses revealed that individuals with greater digital health literacy and higher self-efficacy for self-management had significantly lower odds of uncontrolled blood pressure. Conversely, factors including older age, rural residence, unemployment, lower educational attainment, longer illness duration, presence of comorbidities, and seeking care at health centres were linked to poorer blood pressure control. A predictive model combining these variables achieved an overall classification accuracy of nearly 87 percent. These findings suggest that behavioural capabilities and digital competencies are meaningful factors in hypertension care, pointing towards potential value in developing digital and behavioural support strategies in similar sub-Saharan African settings.
Uncontrolled high blood pressure is a major public health challenge that increases the risk of severe cardiovascular disease. Demonstrating that digital literacy and personal confidence in health management correlate with better blood pressure control suggests that improving digital access and self-care skills could strengthen chronic disease programmes, particularly in resource-limited and rural communities across sub-Saharan Africa.
This early-stage research could inform developers of mobile health applications, digital therapeutics, and behavioural support platforms designed for chronic disease management. Healthcare providers and public health agencies could use these insights to design patient-facing digital interventions. However, as the findings rely on cross-sectional data and require external validation, any resulting commercial tools or clinical prediction algorithms remain at an early concept stage.
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Abstract Background Digital health literacy (DHL) and self-efficacy are increasingly recognized as important behavioural determinants of hypertension management, yet evidence on their combined association with blood pressure control in sub-Saharan Africa remains limited. This study investigated the cross-sectional association between DHL, self-efficacy for hypertension self-management, and blood pressure control among adults living with hypertension in Mampong Municipality. Methods A cross-sectional study was conducted among 360 adults living with hypertension in Mampong Municipality. DHL was measured using the 8-item eHealth Literacy Scale (eHEALS; Cronbach’s α = 0.871), and self-efficacy (SE) using the 8-item Self-Efficacy for Hypertension Self-Management Scale (SE-HTA; α = 0.783). Multivariable logistic regression was used to examine associations between study variables and uncontrolled blood pressure. Model performance was assessed using the Hosmer-Lemeshow test and the area under the receiver operating characteristic curve (AUC). Results Out of the 360 participants, 74.2% had uncontrolled blood pressure. Higher DHL was associated with lower odds of uncontrolled blood pressure (AOR = 0.923 per one-point increase; 95% CI: 0.878–0.971; p = 0.002). Similarly, higher self-efficacy was associated with lower odds of uncontrolled blood pressure (AOR = 0.912 per one-point increase; 95% CI: 0.858–0.968; p = 0.003). Older age, lower educational attainment, unemployment, rural residence, longer duration of hypertension, comorbidity, and attendance at health centres were associated with higher odds of uncontrolled blood pressure (all p < 0.05). The final model demonstrated excellent discrimination (AUC = 0.919; 95% CI: 0.890–0.947) with good calibration (Hosmer-Lemeshow p = 0.709) and an overall classification accuracy of 86.9%. Conclusion Higher digital health literacy and self-efficacy are associated with better blood pressure control among adults living with hypertension in Mampong Municipality. The findings highlight these factors as potentially important considerations in hypertension management and may inform the development of digital and behavioural support strategies in similar settings. However, the cross-sectional design does not establish causality. Longitudinal and interventional studies are needed to determine whether improvements in DHL and self-efficacy lead to better blood pressure control. External validation is also needed before the predictive performance of the model can be generalized to other populations.
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DOI: 10.1186/s12889-026-29346-1
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