Development and Validation of a KAP Questionnaire for Secondary Hypertension: Evaluating a Community Short-Video Intervention in Rural Beijing

Development and Application of a KAP Questionnaire for Secondary Hypertension: Evaluating a Community-Targeted Short-Video Intervention in Suburban Beijing

This is a two-phase, non-randomized clinical trial conducted in eight communities in Miyun District, Beijing. The study first develops and validates a reliable 18-item questionnaire (Knowledge, Attitudes, and Practices [KAP] scale) to assess community residents' understanding, attitudes, and behaviors related to secondary hypertension. Then, we evaluate whether a 1-week community-centered short-video health education intervention (five 1-minute videos delivered via community WeChat groups by local physicians) can improve residents' secondary hypertension-related knowledge, attitudes, and practices. We will compare scores before and after the intervention, and analyze which groups (such as rural residents, people with lower education, older adults) benefit more. This study aims to provide a simple assessment tool and a scalable health education model for secondary hypertension in community settings, especially for rural and low-educated populations.

This is a two-phase, non-randomized, community-based clinical trial carried out in 8 communities in Miyun District, Beijing.

Phase 1: Scale Development and Validation We develop and validate an 18-item Knowledge, Attitudes, and Practices (KAP) scale specifically for secondary hypertension in community residents. Psychometric properties including reliability, internal consistency, and validity are tested using item analysis, exploratory factor analysis, and confirmatory factor analysis.

Phase 2: Intervention Evaluation We enroll hypertensive patients and their family members. All participants receive a 1-week, community-centered targeted short-video intervention delivered through community WeChat groups by trained local physicians. The intervention includes five 1-minute standardized educational videos covering core topics: definition, etiology, clinical manifestations, high-risk groups, and screening methods for secondary hypertension.

Outcomes and Assessments The secondary hypertension KAP scale is administered at baseline (before intervention) and within 24 hours after intervention to measure changes in knowledge, attitudes, and practices. Video engagement (view count, completion rate, viewing duration) is automatically recorded. We compare pre- and post-intervention scores and identify subgroups with greater improvement, including rural residents, those with lower educational attainment, older adults, and patients with hypertension.

The study aims to provide a valid assessment tool and a scalable, community-based health education model to improve secondary hypertension-related awareness and behaviors, especially for rural and low-educated populations.

Inclusion Criteria:

• Permanent residents aged ≥18 years with basic comprehension abilities, capable of completing the online questionnaire independently or with assistance
• Voluntary participation and signed informed consent

For Phase 2 (Intervention Phase) only:

• Individuals with confirmed hypertension or family members cohabiting with hypertensive patients
• Member of a community WeChat group with the ability to receive and view short videos, and to complete online questionnaires independently or with assistance

Exclusion Criteria:

• - Cognitive impairment that would interfere with understanding the questionnaire or video content
• Prior participation in standardized secondary hypertension public education programs
• Inability to use WeChat or access short videos (for Phase 2)