229 We found an effect of GoYK on hypertension. Although, we did not find an effect on other clinical parameters, such as eGFR, the most important measure for kidney function. To the best of our knowledge GoYK is the first CKD health literacy intervention to have an effect on a clinical parameter[30], which suggests it has the potential to slow the decline of kidney functioning. This is important as hypertension is among the most important risk factors for developing kidney disease[42], and a potential mediator of the association between LHL and CKD onset and complications[4,43]. Other clinical parameters, such as eGFR, are less responsive to changes in behaviour on the short term. However, GoYK may have an impact on the other clinical parameters, such as eGFR, at a longer follow-up. Our finding on hypertension confirms the theoretic framework of the Intervention Research On Health Literacy among Ageing population (IROHLA) project[44] as shown in Figure 7.3. This framework theorizes that targeting patients’ and HCPs’ competences and their contexts can optimize health outcomes of patients. The effect of GoYK on hypertension shows such an approach holds truth and is promising for health literacy intervention research targeting other patient groups. Figure 7.3 Framework of the project IROHLA - Intervention Research On Health Literacy among Ageing population, explaining how to intervene on health literacy problems Community support Empowerment persons lowhealth literacy Communication clients and professionals Health literacy capacities professionals Reduction access barriers HEALTH LITERACY INTERVENTIONS HEALTHY AGING INTERMEDIATE RESULTS PROFESSIONAL Health system INDIVIDUAL Context HEALTH LITERACY OUTCOMES
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