Effectiveness of BHATIN (Behavior-Tailored Intervention) for Self-Care Management and Clinical Biomarkers Among Patients with Hypertension: A Quasi Experimental Study

行为干预(BHATIN)对高血压患者自我管理及临床生物标志物有效性的准实验研究

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Abstract

BACKGROUND: Sustained self-care is essential for effective hypertension management, particularly dietary salt reduction. In many community-based settings, including primary care areas in Indonesia, hypertension control remains suboptimal due to inadequate self-care practices and persistent high salt consumption, contributing to unfavorable biomarkers such as elevated blood pressure, BMI, and metabolic indicators. OBJECTIVE: This study aimed to evaluate the effectiveness of the Behavior-Tailored Intervention (BHATIN) model on knowledge, Theory of Planned Behavior (TPB) constructs, self-efficacy, hypertension self-care behaviors, salt preference, and clinical outcomes (blood pressure, BMI, and metabolic biomarkers) among adults with hypertension. METHODS: A quasi-experimental pretest-posttest design with a non-equivalent control group was conducted among 90 adults with hypertension (intervention = 45; control = 45). The intervention group received the BHATIN program integrating TPB-based behavioral strategies, mindfulness-informed coaching, skill-based training, and social support, while the control group received standard care. Data were collected using knowledge, TPB-based questionnaires and clinical measurements (salt preference, blood pressure, BMI, and metabolic biomarkers) and analyzed using paired and independent t-tests (p < 0.05). RESULTS: The intervention group showed significant improvements in attitude, subjective norm, perceived behavioral control, intention, self-efficacy, and self-care behaviors (all p < 0.001). Significant reductions were also observed in systolic and diastolic blood pressure, total cholesterol, random blood glucose, and salt preference (p < 0.05), where the control group showed minimal change. CONCLUSION: The BHATIN model improves psychosocial determinants, self-care behaviors, salt preference, and selected clinical biomarkers among adults with hypertension, providing a feasible nurse-led strategy for community-based hypertension management.

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