A randomized controlled trial published in the International Journal of Cardiology Cardiovascular Risk and Prevention evaluated a hybrid Teach-Back program in southeastern Iran. The study enrolled 150 adults with chronic conditions, randomly assigning 75 to the intervention group and 75 to routine care.

Over one year, participants in the intervention group received a one-month structured education program delivered through videos, interactive exercises, peer support through domestic apps, and ongoing follow-up. This hybrid model aimed to strengthen nutritional self-care and improve cardiovascular outcomes.

Results showed nutritional self-care scores in the intervention group increased from 11.9 at baseline to 24.1 at 3 months and remained stable at 23.7 at 12 months, while the control group showed no significant change. Diet quality also improved, with the proportion of participants classified as having an unhealthy diet declining from 98.7% to 49.3% and 13.3% achieving healthy diet status.

Clinical outcomes improved significantly at 12 months:: mean systolic blood pressure decreased from 142.2 mmHg to 132.2 mmHg, diastolic pressure from 104.7 mmHg to 92.2 mmHg,, fasting glucose from 212.7 mg/dL to 151.5 mg/dL, and BMI from 27.9 kg/m² to 25.3 kg/m² (all p < 0.001).by nearly 3 points. No comparable changes were observed intThe control group. 

The trial was limited by its small sample size and single-site design. Even so, the findings suggest that a hybrid Teach-Back and digital education program can support sustained behavior change and improve chronic disease management in resource-limited settings.