Meta-Analysis: Application of Health Belief Model in Encouraging Preventive Behavior of Self-Care for Hypertensive Patients


  • Gusti Fathoni Firmansyah Faculty of Dentistry, Universitas Gadjah Mada
  • Husna Arwa Salsabil Universitas Muhammadiyah Surakarta


Background: Hypertension is one of the most critical public health problems and has affected more than 1.2 billion people worldwide. Risk factors for hypertension can be divided into two, namely factors that cannot be controlled (such as gender, genetics and age) and those that can be controlled such as obesity, excess BMI, smoking, and excessive salt and fat consumption. Hypertension prevalence in age groups productive tends to increase from year to year, especially in the elderly group which reaches 63.22%. This study aimed to investigate behavior change and prevention of hypertension is the Health Belief Model (HBM).

Subjects and Method: This article was compiled with a systematic review and meta-analysis study. This study uses the PICO Model as follows Population: Hypertension patients. Intervention: high self-efficacy and perceived susceptibility. Comparison: low self-efficacy and perceived suscepti­bility. Outcome: behavior change. The meta-analysis study was conducted by searching for articles from databases in electronic form including Google Scholar, PubMed, and Scopus. The keywords used are "hypertension" AND "health belief model (OR self efficacy OR perceived susceptibility)" AND "change behavior". The inclusion criteria for this study were full articles using a cross-sectional study, with the publication year 2012-2022. Analysis of articles in this study using RevMan 5.3 . software.

Results: A total of 10 articles reviewed in the meta-analysis showed that perceived susceptibility influenced behavioral changes in hypertensive patients (aOR= 2.16; 95% CI= 1.59 to 2.53; p<0.001) and self-efficacy also influenced behavioral changes in hypertensive patients (aOR= 1.37; 95% CI= 1.06 to 1.76; p= 0.020).

Conclusion: perceptions of vulnerability and self-efficacy affect behavior changes in hypertensive patients.

Keywords: hypertension, health belief model, self efficacy, perceived susceptibility.


Gusti Fathoni Firmansyah. Faculity of Dentistry, Universitas Gadjah Mada. Jl. Bulaksumur, Caturtunggal, Depok, Sleman, Yogyakarta 55281. Email: Mobile: +62 812-3710-7609.

Journal of Health Promotion and Behavior (2022), 07(02): 108-118


Crowley MJ, Grubber JM, Olsen MK, Bosworth HB (2013). Factors associated with non-adherence to three hypertension self-management behaviors: preliminary data for a new instrument. J Gen Intern Med. 28(1): 99-106. DOI: 10.1007/s11606-012-21-95-1.

Di Palo KE, Barone NJ (2020). Hypertension and Heart Failure: Prevention, Targets, and Treatment. Heart Fail Clin. 16(1): 99-106. DOI: 10.1016/j.hfc.2019.09.001.

Fithri R, Athiyah U, Zairina E (2021). The development and validation of the health belief model questionnaire for measuring factors affecting adherence in the elderly with hypertension. J Basic Clin Physiol Pharmacol. 32(4): 415-419. DOI: 10.1515/jbc-pp-2020-0459.

Hu HH, Li G, Arao T (2015). The association of family social support, depression, anxiety and self-efficacy with specific hypertension self-care behaviours in Chinese local community. Journal of Human Hypertension, 29(3), 198–203. DOI: 10.1038/jhh.2014.58

Hu L, Huang X, You C, Li J, Hong K, Li P, et al. (2017). Prevalence and Risk Factors of Prehypertension and Hypertension in Southern China. PLoS One. 12(1): e0170238. DOI: 10.1371/journal.pone.0170238.

Kamran A, Biria M, Malepour A, Heydari H (2013). Determinants of Patient ’ s Adherence to Hypertension Medications: Application of Health Belief Model Among Rural Patients. Annals of Medical and Health Sciences Rese-arch, 4(6), 2–7.

Ketata N, Ben Ayed H, Ben Hmida M, Abdelhedi Z, Ben Jemaa M, Trigui M, Maamri H, et al. (2021). Prevalence and predictors of hypertension self-care practice in primary health-care facilities in Southern Tunisia. JMV-Journal de Medecine Vasculaire, 46 (2): 72–79. DOI: 10.101-6/j.jdmv.20-21.01.005.

Khorsandi M, Fekrizadeh Z, Roozbahani N (2017). Investigation of the effect of education based on the health belief model on the adoption of hypertension controlling behaviors in the elderly. Clinical Interventions in Aging, 12: 233–240. DOI: 10.2147/CIA-S117142.

Laporan Nasional Riskesdas (2018). Hipertensi. Retrieved from:

Ma C (2018). An investigation of factors influencing self-care behaviors in young and middle aged adults with hypertension based on a health belief model. Heart lung: J. Crit. Care, 47(2), 136–141. DOI: 10.1016/j.hrtlng.2017.12.001

Mariyasoosai R, Chompikul J, Keiwkarnka B, Wongsawass S (2016). Hypertension preventive behavior among pre-hypertensive adults in Phuttha-monthon district, Nakhon Pathom province , Thailand. 13(3), 51–65.

Mostafavi F, Najimi A, Sharifirad G, Golshiri P (2016). Beliefs About Medicines in Patients with Hypertension: The Instrument Validity and Reliability in Iran. Mater Sociomed. 2016 Aug; 28(4): 298-302. DOI: 10.5455/msm.2016.28.298-302.

Najimi A, Mostafavi F, Sharifirad G, Gols¬hiri P (2017). Development and study of self‑efficacy scale in medication adherence among Iranian patients with hypertension. Journal of Educa-tion and Health Promotion. J Edu Health Promot 2017;6:83. DOI:


Obirikorang Y, Obirikorang C, Acheampong E, Odame AE, Gyamfi D, Philip SS, Opoku BM, et al. (2018). Predictors of noncompliance to antihypertensive therapy among hypertensive patients Ghana: Application of Health Belief Model. Int J Hypertension.

DOI: 10.-1155/2018/4701097.

Onorouiza SI, Musa A, Umar BD, Kunle YS (2015). Using Health Beliefs Model as an Intervention to Non Compliance with Hypertension Information among Hypertensive Patient. Journal Of Humanities And Social Science. 20: 11-16. DOI: 10.9790/0837-20951116.

Rossier BC, Bochud M, Devuyst O (2017). The Hypertension Pandemic: An Evolutionary Perspective. J Physiology. 32: 112-125. DOI: 10.1152/physiol.00026.2016.

Setiyaningsih R, Tamtomo D, Suryani N (2016). Health Belief Model: Determinants of Hypertension Prevention Behavior in Adults at Community Health Center, Sukoharjo, Central Java. J Health Promot Behav. 1(3): 161-171. DOI: 10.26911/the-jhpb.20-

Shen Y, Chang C, Zhang J, Jiang Y, Ni B, Wang Y (2017). Prevalence and risk factors associated with hypertension and prehypertension in a working population at high altitude in China: a cross-sectional study. Environ Health Prev Med. 22: 19-26. DOI: 10.1186/s1-2199-017-0634-7.

Warren-Findlow J, Seymour RB, Shenk D (2015). Intergenerational transmission of chronic illness self-care: Results from the caring for hypertension in African American families study. Gerontologist, 51(1): 64–75. DOI: 10.1093/geront/gnq077.

Yousefi P, Farmanbar R, Omidi SS, Farhadi HR (2015). A Study on the Predictive Power of the Health Belief Model Constructs in Self-Care Behaviors of Patients with Hypertension. Health Education Health Promotion, 3(3), 5–13.

Yue Z, Li C, Weilin Q, Bin W (2015). Application of the health belief model to improve the understanding of anti-hypertensive medication adherence among Chinese patients. Patient Education and Counseling, 98(5): 669–673. DOI: 10.1016/j.pec.2015.02.007.




How to Cite

Firmansyah, G. F., & Salsabil, H. A. (2022). Meta-Analysis: Application of Health Belief Model in Encouraging Preventive Behavior of Self-Care for Hypertensive Patients. Journal of Health Promotion and Behavior, 7(2), 108–118. Retrieved from