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

Andi Mayasari Usman,1,2 Cecep Eli Kosasih,3 Iqbal Pramukti,3 Yulia Sofiatin,4 Rian Adi Pamungkas5 1Department of Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 2Department of Nursing, Faculty of Health Sciences, Universitas Nasional, Jakarta, South Jakarta, Indonesia; 3Department of Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, Indonesia; 4Department of Epidemiology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 5Department of Nursing, Faculty of Health Sciences, Universitas Esa Unggul, Jakarta, West Jakarta, IndonesiaCorrespondence: Cecep Eli Kosasih, Email [email protected]: 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.Keywords: hypertension self-care, salt preference, behavior-tailored intervention, mindfulness-based health coaching, theory of planned behavior