Application of the health belief model in developing a community-based health literacy kit for diabetes prevention
DOI:
https://doi.org/10.22437/proca.v1i2.50512Keywords:
health Belief Model; health literacy; diabetes prevention; community education; cultural adaptationAbstract
Background: Type 2 Diabetes Mellitus (T2DM) remains a major global and national health challenge, particularly in Indonesia where the prevalence has reached 10.6%. Low health literacy among high-risk populations limits preventive efforts and self-management. Objective: This study aimed to apply the Health Belief Model (HBM) in developing a culturally contextualized health literacy kit for diabetes prevention and to evaluate its theoretical relevance, content validity, and practical feasibility. Methods: A mixed-method design was employed involving 10 health educators and 60 high-risk community members recruited purposively. The development process consisted of five stages: needs assessment, prototype design, expert validation, limited trial, and revision. Data were collected through questionnaires, expert validation sheets, focus group discussions, and pre–post knowledge tests. The kit was assessed using the Content Validity Index (CVI), and quantitative data were analyzed using paired t-tests. Results: The health literacy kit achieved a CVI score of 0.87, indicating strong content validity. Participants’ knowledge increased by 17.4% (p < 0.001), diabetes risk awareness by 22%, and healthy behavior intention by 19% after the intervention. Qualitative feedback supported the clarity, cultural relevance, and usability of the materials. Conclusion: The integration of all six HBM constructs effectively enhanced cognitive and motivational engagement in diabetes prevention. The developed kit proved feasible for community-based health education and can serve as a model for culturally sensitive interventions in other chronic disease prevention programs.
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[1] PERKI 2023. Pedomam Tatalaksana Penyakit Gagal Jantung [Internet]. Perhimpunan Dokter Spesialis Kardiovaskular Indonesia. Jaka; 2023. 89 p. Available from: http://www.nber.org/papers/w16019
[2] Chen QF, Chen L, Katsouras CS, Liu C, Shi J, Liang D, et al. Global burden of heart failure and its underlying causes in 204 countries and territories, 1990-2021. Eur Hear journal Qual care Clin outcomes. 2025 Jun;11(4):493–509.
[3] Delima D, Mihardja L, Siswoyo H. Prevalensi dan Faktor Determinan Penyakit Jantung di Indonesia. Indones Bull Heal Res. 2009;37(3).
[4] Mumpuni H, Adhi Kusumastuti D, Purnasidha Bagaswoto H, Yuli Setianto B. Acta Cardiologia Indonesiana Epidemiology, Aetiology and Risk Profile of Heart Failure in a Tertiary Referral Hospital: a Report from the Sardjito Heart Failure Registry. ACI (Acta Cardiol Indones. 2020;7(1):7–12.
[5] Kemenkes RI. Laporan Riskesdas Provinsi Jambi 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan (LPB); 2019.
[6] Eguchi S, Morita Y, Mitani H, Kanegasaki A, Iwasaki K, Yoshikawa T, et al. Burden of Repeated Hospitalizations on Patients with Heart Failure: An Analysis of Administrative and Claims Data in Japan. Drugs - real world outcomes. 2022 Sep;9(3):377–89.
[7] Dewi IGAAGS, Putri LALN, Silalahi LD, Dewi IGAWP, Hapsari MD, Dewa JAP, et al. Systematic literature review on sterile injectable dates of use, stability and implications for use. Svāsthya Trends Gen Med Public Health. 2025 Jan. 12;2(1):e66. https://doi.org/10.70347/svsthya.v2i1.66
[8] Fedacko J, Tuppo EE, Singh RB, Elkilany GN, Hristova K. Chapter 2 - Epidemiology and mortality due to heart failure. In: Singh RB, Fedacko J, Hristova K, Elkilany GN, editors. Pathophysiology, Risk Factors, and Management of Chronic Heart Failure [Internet]. Academic Press; 2024. p. 23–40. Available from: https://www.sciencedirect.com/science/article/pii/B9780128229729000171
[9] AHA/ACC/HFSA. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. J Card Fail. 2022 May;28(5):e1–167.
[10] Wang X, Lei M, Wang J, Sun X, Li C, Li Y, et al. The Effectiveness of In-hospital Initiation Guideline-directed Medical Therapy on the Prognosis of Patients with Heart Failure after Acute Anterior Myocardial Infarction. 2024.
[11] Lei M, Wang J, Wang X, Sue X, Li C, Yang Y, et al. The effect of guideline-directed medicine on patients with new-onset heart failure following acute myocardial infarction. Front Cardiovasc Med. 2025;12:1639213.
[12] Subagyo A, Andrianto A, Wiyasihati S, Ratri A. Chronic Heart Failure Management: A Literature Review of Guideline-Directed Medical Therapy. Int J Sci Adv. 2024 Jan 1;5.
[13] Scholten M, Midlöv P, Halling A. Disparities in prevalence of heart failure between the genders in relation to age, multimorbidity and socioeconomic status in southern Sweden: a cross-sectional study. Scand J Prim Health Care. 2023 Jun;41(2):160–9.
[14] van Deursen VM, Urso R, Laroche C, Damman K, Dahlström U, Tavazzi L, et al. Co-morbidities in patients with heart failure: an analysis of the European Heart Failure Pilot Survey. Eur J Heart Fail. 2014 Jan;16(1):103–11.
[15] Mastromarino V, Casenghi M, Testa M, Gabriele E, Coluccia R, Rubattu S, et al. Polypharmacy in heart failure patients. Curr Heart Fail Rep. 2014 Jun;11(2):212–9.
[16] Alsultan MM, Alamer R, Alammar F, Alzlaiq W, Alahmari AK, Almalki ZS, et al. Prevalence of polypharmacy in heart failure patients: A retrospective cross-sectional study in a tertiary hospital in Saudi Arabia. Saudi Pharm J SPJ Off Publ Saudi Pharm Soc. 2023 Dec;31(12):101875.
[17] Haider R. Congestive Coronary Heart Failure. Cardiol Res Reports. 2023 Nov 30;5:1–12.
[18] Rosano GM, Vitale C, Seferovic P. Heart Failure in Patients with Diabetes Mellitus. Card Fail Rev. 2017 Apr;3(1):52–5.
[19] Ishaq F, Nguyen DT, Graviss EA, Ebunlomo E, Bhimaraj A, Fida N. Impact of optimal medical therapy in heart failure certification for hospitalists on guideline-directed medical therapy utilization. World J Cardiol. 2025 Jun;17(6):107102.
[20] Roghani SH, Khan DS, Shafiq A, Akbar A, Mustafa W, Shah SQA, et al. Efficacy of Different Beta Blockers in Reducing Mortality in Heart-Failure Patients. Cureus. 2024 Nov;16(11):e74171.
[21] Mitsuda H, Shiga Y, Suematsu Y, Kato Y, Arimura T, Kuwano T, et al. Effect of Angiotensin Receptor-Neprilysin Inhibitor in Patients With Heart Failure: A Real-World Study. Cardiol Res. 2025 Aug;16(4):321–30.
[22] Jhund PS, Talebi A, Henderson AD, Claggett BL, Vaduganathan M, Desai AS, et al. Mineralocorticoid receptor antagonists in heart failure: an individual patient level meta-analysis. Lancet (London, England). 2024 Sep;404(10458):1119–31.
[23] Faulkenberg K, Williams J, Isaacs D, West L. Practical Considerations and Opportunities for SGLT2 Inhibitor Prescription in Heart Failure. Curr Treat Options Cardiovasc Med. 2020 Sep 22;22:36.
[24] Fujihashi T, Nochioka K, Yasuda S, Sakata Y, Hayashi H, Shiroto T, et al. Underuse of heart failure medications and poor long-term prognosis in chronic heart failure patients with polypharmacy - A report from the CHART-2 study. Int J Cardiol Hear Vasc. 2024 Feb;50:101345.
[25] Ozasa N, Kato T, Morimoto T, Yaku H, Yamamoto E, Inuzuka Y, et al. Polypharmacy and Clinical Outcomes in Hospitalized Patients With Acute Decompensated Heart Failure. J Cardiovasc Nurs. 2023;38(1):33–43.
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Copyright (c) 2025 Armaidi Darmawan, Ahmad Syauqy, Budi Justisia, Patrick Wiliam Gading, Wahyu Indah Dewi Aurora, Erny Kusdiyah, Repelita Witri
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