Multilevel Analysis on Factors Associated with Hypertension Prevention Behavior

Abstract

Background: Chronic diseases are becoming a growing challenge for modern medical care in developed countries. Most of them are associated with cardiovascular disease. Appropriate prevention of hypertension can improve blood pressure control and reduce cardiovascular disease risk. This study aimed to examine factors associated with hy­pertension prevention behavior. Subjects and Method: This was a cross sectional study carried out at 25 integrated health posts (posbindu) in Bantul, Yogyakarta, from February to March 2019. A sample of 200 study subjects was selected by simple random sampling. The dependent variable was hypertension prevention behavior. The independent variables at level 1 were gen­der, age, self efficacy, know­ledge, family support, and health personnel support. The in­de­pendent variable at level 2 was posbindu. The data were collected by questionnaire and analyzed by a multiple linear regression run on Stata 13. Results: Hypertension prevention behavior increased with self efficacy (b= 0.06; 95% CI= 0.00 to 0.13; p= 0.024), knowledge (b= 0.23; 95% CI= 0.06 to 0.40; p= 0.007), family support (b= 0.71; 95% CI= 0.40 to 1.01; p<0.001), and health personnel support (b= 0.24; 95% CI= 0.06 to 0.42; p= 0.008). Gender (b= 0.39; 95% CI= -1.01 to 1.79; p= 0.585) and age (b= -0.01; 95% CI= -0.05 to 0.01; p= 0.313) were associated with hy­per­ten­sion preventive behavior, but it was statistically non significant. Posbindu had strong contextual effect on hypertension preventive behavior with ICC= 14.93%. Conclusion: Hypertension prevention behavior increases with self efficacy, knowl­edge, family support, and health personnel support. Gender and age are associated with hypertension preventive behavior, but it is statistically non significant. Posbindu has strong contextual effect on hypertension preventive behavior. Keywords: hypertension, preventive behavior, self efficacy, posbindu level