Sociodemographic and Cultural Determinants of Hypertension-Controlling Beliefs Among Older Adults: A Cross-Sectional Study Based on the Health Belief Model
DOI:
https://doi.org/10.55018/janh.v8i1.581Keywords:
Hypertension, Older adults, Health belief model, Cultural beliefs, Self-managementAbstract
Background: Hypertension control among older adults in Indonesia is hindered by low adherence and strong cultural beliefs. However, there is insufficient evidence on how sociodemographic and cultural determinants interact with health belief constructs to influence hypertension-control beliefs in older populations. This study examines sociodemographic and cultural determinants of hypertension-controlling beliefs using the Health Belief Model (HBM).
Methods: A cross-sectional study was conducted among 232 older adults (≥60 years) in coastal Madura, Indonesia. Data were collected via structured interviews using the HBM Questionnaire (HBMQ) and cultural belief items. Descriptive, bivariate, and multivariate analyses were performed.
Results: Higher education, retirement, and perceiving hypertension as a lifestyle consequence were significantly associated with stronger beliefs (p < 0.05). Although 76.3% trusted doctors, 40.9% still visited traditional healers. Belief in lifestyle etiology was the strongest predictor (β = 0.20, p = 0.002).
Conclusion: Cultural and educational factors significantly shape hypertension beliefs. Interventions should integrate biomedical education with cultural sensitivity to improve self-management in older populations.
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Alfaqeeh, Mohammed, S. Alfian, and R. Abdulah. 2023. “Factors Associated with Hypertension Among Adults: A Cross-Sectional Analysis of the Indonesian Family Life Survey.” Vascular Health and Risk Management 19:827–36. doi:10.2147/VHRM.S438180.
Alinejad, Navid, Fateme Khosromanesh, Mostafa Bijani, Ali Taghinezhad, Zahra Khiyali, and A. Dehghan. 2025. “Spiritual Well-Being, Resilience, and Health-Promoting Lifestyle among Older Adult Hypertensive Patients: A Cross-Sectional Study.” BMC Geriatrics 25. doi:10.1186/s12877-025-05877-x.
Babazadeh, T., S. Ranjbaran, S. Pourrazavi, Arman Latifi, and Khalil Maleki Chollou. 2024. “Impact of Health Literacy and Illness Perception on Medication Adherence among Older Adults with Hypertension in Iran: A Cross-Sectional Study.” Frontiers in Public Health 12. doi:10.3389/fpubh.2024.1347180.
Cahya, Azalia, Gita Fitri, Dhea Anggraeni Putri, Falaah Azurra Desyasti, Lenggogeni Trity Humaira, Muhammad Abdan Syakuuron, Nining Ni’mah Yohana, and Regina Fajari Briana. 2023. “PSSE: PARENTINGParenting Style Sex Education On Understanding Sexual Violence What Parents Do Towards Children In Tiktok.” Health Frontiers: A Multidisciplinary Journal for Health Professionals 1(2):149–57.
Defianna, Selly Ruth, A. Santosa, A. Probandari, and F. Dewi. 2021. “Gender Differences in Prevalence and Risk Factors for Hypertension among Adult Populations: A Cross-Sectional Study in Indonesia.” International Journal of Environmental Research and Public Health 18. doi:10.3390/ijerph18126259.
Dewi, R., A. Sholikhah, and Purbodjati. 2022. “Sociodemographic Correlates of Hypertension Among Older Adults: A Community Based-Cross Sectional Study.” Proceedings of the International Joint Conference on Arts and Humanities 2021 (IJCAH 2021). doi:10.2991/assehr.k.211223.078.
Dwi, Indi, Shofi Yanti, Fatma Lutfiyatus Sayyida, Anggun Novia, and Indah Fitri. 2025. “Ethnopsychiatry Nursing : A Transformative Model for Patient-Centered Care in Diverse Societies.” International Journal of Ethnopsychiatric Nursing 1(1):12–22.
Ernawati, Naya, Eka Wulandari, Erlina Suci Astuti, and Fitriana Kurniasari Solikhah. 2023. “Analysis Of Predisposing Factors Related To Mothers With Toddler’s Visit To Integrated Community Health Service.” Health Frontiers: A Multidisciplinary Journal for Health Professionals 1(2):85–100.
Fitri, Anggun Novia Indah, Indi Dwi Shofi Yanti, and Fatma Lutfiyatus Sayyida. 2025. “Ethnopsychiatry Nursing as a Transformative Paradigm: Enhancing Equity and Patient-Centered Care in Mental Health.” International Journal of Ethnopsychiatric Nursing 1(1):36–49.
Giena, Vike Pebri, Sunanta Thongpat, and Pornruedee Nitirat. 2018. “Predictors of Health-Promoting Behaviour among Older Adults with Hypertension in Indonesia.” International Journal of Nursing Sciences 5(2):201–5.
Iqbal, Muhammad Zahid, Naeem Mubarak, Sara Shahid, Minahil Akram, Shaikh Muhammad Usama Latif, Ayesha Nawaz, Afshan Abdul Shakoor, Maria Asghar, Ambreen Ijaz, Muskan Irfan, Gohar Jaan, Amna Nadeem, Fateh Sher, Neha Fatima, and Tooba Farooq. 2024. “Impact of Sociodemographic Determinants on Control in Hypertension Patients: A Community Pharmacy-Based Cross-Sectional Study.” Medical Science. doi:10.54905/disssi.v28i145.e11ms3301.
Irwan, A., Kathleen Potempa, N. Abikusno, and Syahrul Syahrul. 2024. “Health Coaching Intervention to Improve Self-Care Management of Hypertension Among Older People in Indonesia: A Randomized Controlled Study Protocol.” Journal of Multidisciplinary Healthcare 17:2799–2808. doi:10.2147/JMDH.S461166.
Jung, Soojeong, and K. Moon. 2023. “Factors Affecting Self‐care among Community‐dwelling Hypertensive Older Adults: A Cross‐sectional Study.” Nursing Open 10:3892–3905. doi:10.1002/nop2.1647.
Khasanah, Uswatun, Budi Anna Kelliat, Yati Afiyanti, B. Besral, and D. Sari. 2024. “The Problems and Needs of Self-Management Among Indonesian Older Adults With Hypertension: A Qualitative Study.” SAGE Open Nursing 10. doi:10.1177/23779608241282915.
Lee, Jinkook, J. Wilkens, E. Meijer, T. Sekher, David Bloom, and Peifeng Hu. 2022. “Hypertension Awareness, Treatment, and Control and Their Association with Healthcare Access in the Middle-Aged and Older Indian Population: A Nationwide Cohort Study.” PLoS Medicine 19. doi:10.1371/journal.pmed.1003855.
Liew, S., J. Lee, C. Tan, Choon Huat Gerald Koh, R. Van Dam, and F. Müller-Riemenschneider. 2019. “Sociodemographic Factors in Relation to Hypertension Prevalence, Awareness, Treatment and Control in a Multi-Ethnic Asian Population: A Cross-Sectional Study.” BMJ Open 9. doi:10.1136/bmjopen-2018-025869.
Mahwati, Yeni, Dieta Nurrika, and K. Latief. 2022. “The Determinants of Undiagnosed Hypertension Among Indonesian Adults: A Cross-Sectional Study Based on the 2014-2015 Indonesia Family Life Survey.” Journal of Preventive Medicine and Public Health 55:60–67. doi:10.3961/jpmph.21.500.
Mashuri, Y., N. Ng, and A. Santosa. 2021. “DETERMINANTS FOR THE DEVELOPMENT OF HYPERTENSION AMONG INDONESIAN ADULTS: A PROSPECTIVE COHORT STUDY.” Journal of Hypertension 39. doi:10.1097/01.HJH.0000747216.63359.9E.
Mohanty, S., S. Pedgaonkar, A. Upadhyay, F. Kämpfen, Prashant Shekhar, R. Mishra, Jürgen Maurer, and O. O’Donnell. 2021. “Awareness, Treatment, and Control of Hypertension in Adults Aged 45 Years and over and Their Spouses in India: A Nationally Representative Cross-Sectional Study.” PLoS Medicine 18. doi:10.1371/journal.pmed.1003740.
Nagamine, Yuiko, Y. Shobugawa, Yuri Sasaki, D. Takagi, T. Fujiwara, Yu Par Khin, I. Nozaki, Y. Shirakura, Lwin Kay Thi, Zin Poe Ei, Zarchibo Thae, and H. Win. 2023. “Associations between Socioeconomic Status and Adherence to Hypertension Treatment among Older Adults in Urban and Rural Areas in Myanmar: A Cross-Sectional Study Using Baseline Data from the JAGES in Myanmar Prospective Cohort Study.” BMJ Open 13. doi:10.1136/bmjopen-2022-065370.
Nematzad, Pouya, P. Pourghane, F. Besharati, and Bahare Gholami-Chaboki. 2023. “Effects of Health Belief Model in Promoting Self-Care Behaviors among Hypertensive Older Adults.” Journal of Education and Health Promotion 12. doi:10.4103/jehp.jehp_689_22.
Ni, W., Xueli Yuan, Jia Zhang, Ping Li, Hong Zhang, Yan Zhang, and Jian Xu. 2021. “Factors Associated with Treatment and Control of Hypertension among Elderly Adults in Shenzhen, China: A Large-Scale Cross-Sectional Study.” BMJ Open 11. doi:10.1136/bmjopen-2020-044892.
Peltzer, K., and S. Pengpid. 2018. “The Prevalence and Social Determinants of Hypertension among Adults in Indonesia: A Cross-Sectional Population-Based National Survey.” International Journal of Hypertension 2018. doi:10.1155/2018/5610725.
Puriastuti, Alifia Candra, Esti Dwi Yulianita, and Poppy Farantia Saputri. 2023. “The Affect Of Covid-19 Pandemic Anxiety on Breast Milk Ejection of Postpartum Mother in PMB Hj. Faridatul Ampera.” Health Frontiers: A Multidisciplinary Journal for Health Professionals 381(9885):2246. doi:10.1016/S0140-6736(13)61471-3.
Rojanasumapong, Auswin, W. Jiraporncharoen, Nopakoon Nantsupawat, M. Gilder, C. Angkurawaranon, and K. Pinyopornpanish. 2021. “Internet Use, Electronic Health Literacy, and Hypertension Control among the Elderly at an Urban Primary Care Center in Thailand: A Cross-Sectional Study.” International Journal of Environmental Research and Public Health 18. doi:10.3390/ijerph18189574.
Sayyida, Fatma Lutfiyatus, Indi Dwi, Shofi Yanti, Anggun Novia, and Indah Fitri. 2025. “Enhancing Cultural Competence in Ethnopsychiatry: A Systematic Review of Evidence-Based Strategies for Nursing Practice.” International Journal of Ethnopsychiatric Nursing 1(1):50–60.
Sayyida, Fatma Lutfiyatus, Anggun Novia, Indah Fitri, Indi Dwi, and Shofi Yanti. 2025. “Cultural Humility in Ethnopsychiatry Nursing: A Transformative Framework for Culturally Responsive and Equity-Oriented Mental Health Care.” International Journal of Ethnopsychiatric Nursing 1(1):1–11.
Yanti, Indi Dwi Shofi, Anggun Novia Indah Fitri, and Fatma Lutfiyatus Sayyida. 2025. “Cultural Safety Over Competence : A Paradigm Shift In.” International Journal of Ethnopsychiatric Nursing 1(1):23–34.
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