Path Analysis: Application of Health Belief Model on the Determinants of Clean and Healthy Behavior among Elderly with Hypertension

Abstract

Background: Lifestyle or behavioral factors critically determine high blood pressure in individuals. Elderly with hypertension in Indonesia aged 55-64 years by 45.9%, 65-74 years by 57.6%, and > 75 years by 63.8%. This study aimed to examine factors affecting healthy behavior in elderly with hypertension using health belief model. Subjects and Method: This was a cross sectional study conducted in Ngawi, East Java, from June to July 2019. A sample of 200 elderly was selected by multistage random sampling. The dependent variable was clean and healthy behavior. The independent variables were perceived susceptibility, perceived severity, perceived benefit, cues to action, self-efficacy, knowledge, attitude, and access to health service. The data were collected by questionnaire and analyzed by path analysis. Results: Clean and healthy behavior was positively and directly affected by self-efficacy (b= 1.51; 95% CI= 0.29 to 2.74; p= 0.015), attitude (b= 2.37; 95% CI = 1.17 to 3.56; p<0.001) , cues for action (b = 2.48; 95% CI= 1.11 to 3.86; p <0.001), perceived susceptibility (b= 2.07; 95% CI= 0.89 to 3.26; p= 0.001), perceived severity (b= 1.76; 95% CI= 0.54 to 2.99; p= 0.005), perceived benefit (b= 1.47; 95% CI= 0.36 to 2.57; p = 0.009), and access to health services (b= 2.26; 95% CI= 1.00 to 3.53; p<0.001). Clean and healthy behavior was indirectly affected by knowledge. Conclusion: The clean and healthy lifestyle behavior of the elderly is directly affected by perceived vulnerability, perceivedseverity, perceivedbenefits, cues to act, self-efficacy, attitudes and access to health services. Clean and healthy behavior is affected by knowledge.