Introduction: Hypertension is a leading global health concern, yet effective self-management remains difficult. Patients frequently struggle with long-term adherence to medication, lifestyle modifications, and routine monitoring. Interventions typically target the individual, overlooking the broader family system that strongly shapes health behaviours. Research indicates that family support enhances chronic disease management; however, the potential role of children as active partners in care has been rarely examined.
Purpose: This study aimed to test whether strengthening children's health literacy and socioemotional agency within their families can enable them to support hypertensive parents more effectively, thereby improving family-centred management of the condition.
Method: A single-group pre-post intervention design was employed with 181 school-going children (aged 10-15), each living with at least one hypertensive family member. Over six weeks, children participated in structured health literacy sessions that included interactive discussions and the use of a monitoring diary to track health-supportive behaviours. Pre- and post-testing assessed changes in children's knowledge of hypertension, adult family members' blood pressure and self-reported hypertension compliance using paired t-tests. In addition, children's psychological traits influencing their engagement were analysed using structural equation modelling (SEM).
Results: Children showed significant improvements in hypertension knowledge (p < 0.01). Adults demonstrated reductions in blood pressure and reported better adherence to treatment. SEM analyses indicated that specific psychological traits in children predicted the strength of their contribution to family care.
Conclusions: Children can act as meaningful partners in family-centred hypertension management. This work advances SDG 3 (Health and Well-Being), SDG 4 (Quality Education), and SDG 10 (Reduced Inequalities) by building intergenerational health literacy and strengthening equitable family health resources.