The The Effects of a Health Education Intervention on Knowledge, Attitudes, and Self-Prevention Practices Related to Hypertension Among Workers at the Kampung Lalang Traditional Market

Abstract

Background: Hypertension is one of the leading non-communicable diseases and a major contributor to cardiovascular morbidity and mortality worldwide. The World Health Organization estimates that approximately 1.28 billion adults aged 30–79 years are living with hypertension, with nearly half remaining undiagnosed. Uncontrolled hypertension substantially increases the risk of stroke, coronary heart disease, heart failure, and chronic kidney disease. In addition to its health consequences, hypertension also reduces work productivity and increases healthcare expenditures. Traditional market workers represent a vulnerable occupational group because they are frequently exposed to unhealthy lifestyles, including excessive salt intake, inadequate physical activity, prolonged working hours, smoking, and work-related stress. These risk factors are often accompanied by limited access to health information and preventive healthcare services, resulting in poor awareness and inadequate hypertension prevention practices. Health education has been recognized as an effective non-pharmacological intervention to improve health literacy, promote healthy behaviors, and encourage self-management of hypertension. Educational interventions based on the Health Belief Model (HBM) are particularly effective because they enhance individuals' perceptions of susceptibility, severity, benefits, barriers, and self-efficacy toward preventive behaviors. However, evidence regarding the effectiveness of HBM-based health education among traditional market workers remains limited. Therefore, this study aimed to evaluate the effect of a health education intervention on hypertension-related knowledge, attitudes, and self-prevention practices among workers at Kampung Lalang Traditional Market, Medan, Indonesia.

Objective: The objective of this study was to evaluate the effect of a Health Belief Model (HBM)-based health education intervention on hypertension-related knowledge, attitudes, and self-prevention practices among workers at Kampung Lalang Traditional Market, Medan, Indonesia.

Methods: A quasi-experimental study with a nonequivalent control group pretest–posttest design was conducted between February and March 2026 at Kampung Lalang Traditional Market, Medan, Indonesia. The study involved 46 market workers selected using purposive sampling and equally assigned to an intervention group (n = 23) and a control group (n = 23).

Results: The health education intervention significantly improved participants' knowledge, attitudes, and self-prevention practices related to hypertension. Post-intervention analysis demonstrated significantly higher knowledge scores in the intervention group than in the control group (p < 0.001). Attitude scores also showed a significant improvement following the intervention (p = 0.036). Furthermore, participants who received the comprehensive health education program demonstrated significantly better hypertension self-prevention practices compared with those receiving leaflets alone (p = 0.001). These findings indicate that HBM-based health education effectively promotes cognitive, affective, and behavioral changes among traditional market workers.

Conclusion: Health education based on the Health Belief Model significantly improved hypertension-related knowledge, attitudes, and self-prevention practices among traditional market workers. Comprehensive educational interventions combining lectures, printed educational materials, and continuous reinforcement through social media were more effective than the provision of leaflets alone. Implementing similar health education programs in traditional market settings may contribute to hypertension prevention and support the reduction of non-communicable disease risk among informal workers.