Abstract

Chronic diseases are leading causes that undermine health and quality of life in older adults, with hypertension and diabetes being the most prevalent and high-risk conditions. As the aging population grows, the need for effective prevention and management strategies for chronic diseases in preparation for a super-aged society has become increasingly important. This study aimed to examine the effectiveness of a manualized behavior-modification program when delivered by paraprofessionals for the management of chronic diseases in older adults. Eleven staff members from public health centers and sub-centers in Gangwon Province were randomly assigned to either the intervention or control group, and the 130 older adults (≥ 60 years) with chronic diseases under their care were allocated to the same groups. The intervention was implemented over a six-month period. Results indicated that, compared to the control group, the intervention group showed significant improvements in disease-management knowledge efficacy and self-management efficacy, as well as a reduction in body mass index (BMI). In contrast, systolic blood pressure and self-management behavior varied depending on the analytic approach, and no significant differences were observed in disease-management knowledge scores, systolic/diastolic blood pressure, or other health behaviors. In addition, treatment fidelity assessment demonstrated that all core elements achieved compliance rates above 80%, confirming that paraprofessionals delivered the program consistently according to the manual. These findings suggest that behavior-modification interventions delivered by paraprofessionals may be effective in enhancing health behaviors and improving certain physical indicators among older adults with chronic diseases.