Effectiveness of Chronic Disease Management Program in Improving “CERDIK” Healthy Behavior in Patients with Hypertension in Gunungkidul, Yogyakarta

Tri Puji Pangesti, Didik Gunawan Tamtomo, Bhisma Murti


Background: Hypertension is the single largest con­tributor to the global burden of disease (GBD). The Chronic Disease Management Prog­ram (Prolanis) is a health service system and a pro­active approach implemented in an integrated manner. This study aimed to determine the ef­fec­tive­ness of Prolanis on the "CERDIK" healthy be­ha­vior for hypertensive patients.

Subjects and Method: This cross-sectional stu­dy was conducted in hypertensive patients in 25 working areas of health centers in Gunung­ki­dul, Special Region of Yogyakarta, from January to February 2020. A sample of 200 hypertensive pa­tients was selected by simple random sampl­ing. The dependent variable was the "CERDIK" healt­hy behavior for hypertensive patients. The in­dependent variables were chronic disease ma­na­gement program (Prolanis), education level, peer support, family support, and sex. Other data we­re collected by using a questionnaire. Data we­re analyzed by path analysis using the Stata 13 application.

Results: “CERDIK" healthy behavior for hyper­ten­­sive patients increased with active prolanis acti­vity (b= 5.00; 95% CI= 2.80 to 7.20; p <0.001), higher education (b= 1.52; 95% CI= 0.48 to 2.54; p= 0.004), strong family support (b= 1.­38; 95% CI= 0.20 to 2.57; p= 0.023), strong pe­er support (b= 0.61; 95% CI= -0.67 to 2.51; p= 0.­352), and female (b= 2.8; 95% CI= -5.01 to -0.64; p= 0.011). Education, family support, and peer sup­port were associated with “CERDIK” healthy behavior through Prolanis.

Conclusion: “CERDIK" healthy behavior for hyper­ten­­sive patients increases with active pro­lanis acti­vity, higher education, strong family support, strong pe­er support, and female. Edu­cation, family support, and peer sup­port were associated with “CERDIK” healthy behavior through Prolanis.

Keywords: Prolanis, “CERDIK” healthy beha­vi­our, hypertension, path analysis

Correspondence: Tri Puji Pangesti. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: tri­pu­ji­pangesti8@gmail.com. Mobile: 0823­126­57­­779.

Journal of Health Promotion and Behavior (2020), 05(03): 187-196


Full Text:



Adisa R, Olajide OO, Fakeye TO. (2017). Social Support, Treatment Adherence and Outcome among Hypertensive and Type 2 Diabetes Patients in Ambulatory Care Settings in southwestern Nigeria. Ghana Med J, 51(2), 64–77.

Haidari A, Moeini E, Khosravi A. (2017). The Impact of Peer Support Program on Adherence to the Treatment Regimen in Patients with Hypertension: A Randomized Clinical Trial Study. Iran J Nurs Midwifery Res. https://doi.org/10.4103/ijnmr.IJNMR

Bahari G, Krall J, Mallinson RK, Weinstein AA. (2019). Mediating role of self ‐ efficacy in the relationship between family social support and hypertension self ‐ care behaviours: A cross‐sectional study of Saudi men with hypertension. Int J Nurs Pract. https://doi.org/10.1111/ijn.12785

Bjørnevik K, Riise T. Cortese M, Holmøy T, Kampman MT, Magalhaes S, Pugliatti M. (2016). Level of education and mul-tiple sclerosis risk after adjustment for known risk factors: The EnvIMS study. (Figure 1). MULT SCLER J. 104–111. https://doi.org/10.1177/135245851557-9444

Daneshmandi H, Choobineh A, Ghaem H, Karimi M. (2017). Lifestyle Adverse Ef-fects of Prolonged Sitting Behavior on the General Health of Office Workers. Am J Lifestyle Med, 7(2), 69–75.

Dinkes DIY (2017). Profil kesehatan provinsi daerah istimewa yogyakarta tahun 2017. Dinas Kesehatan DIY. Retrieved from http://www.depkes.go.id/resources/download/profil/PROFIL_KES_PROVINSI_2017/14_DIY_2017.pdf

Donnell MJO, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, Zhang X. (2016). Global and regional eff ects of potentially modifi able risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. The Lancet, 1–15. https://doi.org/10.1016/S0140-6736(16)30506-2

Ferreira A, Szwarcwald CL, Damacena GN. (2013). Prevalence of obesity and associated factors in the Brazilian population: a study of data from the 2013 Na-tional Health Survey. Rev. bras. Epidemiol. https://doi.org/10.1590/1980-54-9720190024

Goryoda S, Nishi N, Hozawa A, Yoshita K, Arai Y, Kondo K, Ohkubo T (2018). In a Representative Japanese Population: NIPPON DATA 2010. J Epidemiol. https://doi.org/10.2188/jea.JE2017-0254.

Idris F (2014). Panduan praktis PROLANIS (Program pengelolaan penyakit kronis). BPJS Kesehatan, 3–6.

Kim YJ, Lee JS, Park J, Choi DS, Kim DM, Lee K, Lee J (2017). Trends in socio-economic inequalities in five major risk factors for cardiovascular disease in the Korean population: a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, 2001–2014. BMJ Open. https://doi.org/10.1136/bmjopen201-6-014070

Kandpal V, Sachdeva MP, Saraswathy KN (2020). An assessment study of CVD related risk factors in a tribal popu-lation of India. BMC Public Health, (2016), 1–8. https://doi.org/10.1186/s12889-016-3106-x

Karatzi K, Moschonis G, Botelli S, Androut-sos O, George P, Lionis C, Manios Y. (2018). Physical activity and sedentary behavior thresholds for identifying childhood hypertension and its phenoltypes: The Healthy Growth Study. J Am Soc Hypertens. https://doi.org/10.10-16/j.jash.2018.07.001

Lee S. (2018). Power of Peer Support to Change Health Behavior to Reduce Risks for Heart Disease and Stroke for African American Men in a Faith-Based Community. J Racial Ethn Health Disparities. https://doi.org/10.1007/s40615-018-0460-7

Marshall IJ, Wolfe CDA, Mckevitt C. (2018). ‘People like you?’: how people with hypertension make sense of future cardiovascular risk - a qualitative study. BMJ Open. https://doi.org/10.1136/bmjopen2018-023726.

Murti B (2018). Prinsip dan Metode Riset Epidemiologi Edisi ke Empat. Jawa Tengah. Bintang Fajar Offset

Nelson K, Gray KE, Williams JL, Lutton MC, Silverman J, Jain K, Vanderwarker C. (2019). Veteran peer Coaches Optimizing and Advancing Cardiac Health (VetCOACH ); design and rationale for a randomized controlled trial of peer support among Veterans with poorly controlled hypertension and other CVD risks. Contemp Clin Trials. https://doi.org/10.1016/j.cct.2018.08.011

Peraturan Presiden No. 72 Tahun 2012 ten-tang Sistem Kesehatan Nasional

Riskesdes (2018). Laporan Nasional Riskesdas 2018. In Jakarta: Badan Penelitian dan Pengembangan Kesehatan Departemen Kesehatan Republik Indonesia.

Ribeiro ALP, Duncan BB, Brant LCC, Lotufo PA, Mill JG, Barreto SM (2016). Global burden of cardiovascular disease cardiovascular health in Brazil Trends and Perspectives. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.114.008727.

Su J, Cui L, Du WC, Miao WG, Zhou JY, Zhou YL, Qin Y (2019). Prevalence, awareness, treatment and control of hypertension in adult residents in Jiangsu province. Europe PMC. https://doi.org/10.3760/cma.j.issn.0254-6450.2019.09.023.

Uchmanowicz J, Froelicher ES (2018). Factors influencing adherence to treatment in older adults with hypertension. Clin Interv Aging. https://doi.org/10.2147/CIA.S182881.

World Health Organization (2015). Global brief hypertension. Accessed October 2019. Retrieved from: http://www.-who.int/nmh/publication/fact_sheet_cardiovascular_en.pdf?ua=17.

Yao Q Liu C Zhang Y, Xu L. (2019). Health-related quality of life of people with self-reported hypertension: A national cross-sectional survey in China. Int J Environ Res Public Health, 16(10): 1–24. https://doi.org/10.3390/ijerph16-101721.

Yang TJ, Cooper LA, Boulware LE, Thornton RLJ (2019). Leveraging delivery of blood pressure control interventions among low-income African American Adults: Opportunities to increase social support and produce family - level behavior change. Ethn Dis. https://doi.org/10.18865/ed.29.4.549

Yang Z, Zhao Q, Jiang P, Zheng S, Xu B. (2017). Prevalence and control of hy-pertension among a Community of Elderly Population in Changning District of shanghai: a cross- sectional study. BMC Geriatric. https://doi.org/10.118-6/s12877-017-0686-y.

Yen ST, Tan AKG, Mutapha FI (2017). Awareness of diabetes, hypertension, and hypercholesterolemia in Malaysia. J Diabetes. https://doi.org/10.1111/175-3-0407.12502.


  • There are currently no refbacks.