# Factors Influencing Hypertension Prevention Behaviors in Rural Areas: A Cross-Sectional Study in Indonesia

## TL;DR

This study explores why people in rural Indonesia don't adopt hypertension prevention behaviors and finds that attitudes and perceived control are key factors.

## Contribution

The study applies the Theory of Planned Behavior to identify internal and external factors influencing hypertension prevention in rural Indonesia.

## Key findings

- Internal factors like experience significantly influence attitudes and perceived behavioral control.
- Media exposure only affects subjective norms, not other behavioral factors.
- Both attitudes and perceived behavioral control, through intention, significantly influence hypertension prevention behaviors.

## Abstract

The prevalence of hypertension in rural communities remains high despite various preventive measures. Contributing factors to suboptimal hypertension prevention include a lack of positive attitudes, weak social norms, and the adoption of unhealthy behaviors. This study aimed to analyze the factors influencing hypertension prevention behaviors in rural communities of Indonesia.

A cross-sectional study was conducted among 380 hypertension patients selected through proportional random sampling from three primary health centers with the highest rates of unmet hypertension management in Bondowoso Regency, Indonesia. A self-administered questionnaire was used to collect sociodemographic data. Additional questionnaires were utilized to assess attitudes, subjective norms, perceived behavioral control, intentions, and hypertension prevention behaviors, as developed from the Theory of Planned Behavior (TPB). Blood pressure was measured using a calibrated Omron HBP-1100 sphygmomanometer. Data analysis was performed using Structural Equation Modeling (SEM) with Partial Least Squares (PLS).

The blood pressure classification showed that 60.3% of respondents had stage I systolic hypertension, 72.9% had stage I diastolic hypertension, and 59.2% had abnormal Mean Arterial Pressure (MAP). Internal factors (experience) significantly influenced attitudes, subjective norms, and perceived behavioral control, while external factors (media exposure) only significantly influenced subjective norms. Both attitudes, through intention, and perceived behavioral control, both directly and through intention, significantly influenced hypertension prevention behaviors (p-value < 0.05).

TPB can effectively explain the factors influencing hypertension prevention behaviors in rural areas. Interventions that can strengthen perceived behavioral control through education and social support are essential for improving the effectiveness of hypertension prevention programs in rural communities.