Evaluating a Community-Based Lifestyle Redesign Programme for Hypertension Management in Older Adults within Durban's Informal Settlements

Hypertension is a leading cause of morbidity and mortality among older adults in South Africa. Residents of informal settlements face significant barriers to effective management. The potential of occupational therapy in lifestyle redesign for chronic disease management is under-explored in this setting. This study evaluated the feasibility and preliminary effectiveness of a community-based lifestyle redesign programme for hypertension management in adults aged 50 and over in Durban’s informal settlements. The programme was co-developed with local community health workers. A mixed-methods, quasi-experimental pre-test/post-test design was employed. Participants (n=42) were recruited from two settlements and enrolled in an 8-week group programme. The programme focused on activity analysis, salt reduction strategies, stress management, and increasing purposeful physical activity. Data were collected via pre- and post-programme blood pressure measurements, the Health Education Impact Questionnaire (heiQ), and post-programme focus group discussions. Post-intervention, a clinically significant mean reduction in systolic blood pressure of 12.4 mmHg was observed. Questionnaire data indicated statistically significant improvements in self-monitoring and health service navigation. Qualitative analysis revealed a key theme of increased perceived self-efficacy in managing daily activities to support health. The community-based lifestyle redesign programme demonstrated feasibility and preliminary effectiveness in improving both biomedical and self-reported outcomes for hypertension management in this high-risk population. Programme integration into primary healthcare outreach services, supported by task-shifting to trained community health workers, is recommended. Further research with a larger sample and longer follow-up period is warranted to confirm sustained impact. occupational therapy, hypertension, lifestyle redesign, community-based participatory research, older adults, informal settlements, South Africa This study provides evidence for the role of occupation-focused, community-driven interventions in managing non-communicable diseases within low-resource settings. It highlights a feasible model for occupational therapy engagement in primary healthcare.