Role of the Health Belief Model in the Management of Hypertension: A Systematic Review

TL;DR

This paper reviews how the Health Belief Model influences hypertension management, focusing on blood pressure control, medication adherence, and self-management in low- and middle-income countries.

Contribution

The study systematically evaluates the Health Belief Model's role in hypertension management in low- and middle-income countries using a rigorous review methodology.

Findings

HBM-based interventions are linked to reduced blood pressure and improved medication adherence.

Perceived susceptibility and self-efficacy are positively associated with better self-management.

Perceived barriers negatively impact medication adherence.

Abstract

Theory-driven behavioral models such as the health belief model (HBM) offer predictive and influential insights into hypertension management. This study aims to explore the role of the health belief model in hypertension management, with a focus on blood pressure control, medication adherence, and self-management.

This review included English full-text quantitative studies on HBM and hypertension management in low- and middle-income countries (LMICs), excluding qualitative, mixed methods, protocols, and nonoriginal data. The review was registered in PROSPERO (PROSPERO 2023 CRD42023467247) and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was carried out across six electronic databases, PubMed, APA PsycINFO, CINAHL, Scopus, Embase, and the Cochrane Library, between September 26 and October 2, 2023, to identify relevant published studies. The risk of bias was assessed via the RoB-2 (The Risk of Bias 2) and JBI (Joanna Briggs Institute) Critical Appraisal Tools. Data were extracted into an Excel data sheet (Microsoft Corporation, Redmond, Washington) for result synthesis and tabulation.

An initial total of 1,064 articles were identified for review. Following the removal of duplicates and a full-text assessment, 24 articles with a sample size of 6,106 met the inclusion criteria. The application of interventions based on the HBM constructs was associated with reduced blood pressure, improved medication adherence, and self-management. Most studies have shown that perceived susceptibility, severity, and self-efficacy are positively associated with BP reduction, whereas perceived barriers have a negative impact on adherence. Perceived susceptibility and self-efficacy are also frequently linked to better self-management.

The HBM has the potential to predict health behaviors among individuals with hypertension. Interventions based on the HBM offer potential for effective hypertension control.

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