Hypertension prevention behavior and its predictors among rural adults in Bangladesh: A community survey using the theory of planned behavior

Abstract

Bangladesh faces a rising burden of non-communicable diseases (NCDs), with rural communities being particularly vulnerable due to limited healthcare access. Despite hypertension (HTN) being preventable, the disease is often overlooked in rural areas. This study aimed to assess health practices related to HTN prevention and its determinants among rural Bangladeshi adults using the theory of planned behaviour (TPB) and the World Health Organization's 4X4 NCD prevention model. A community-based survey was conducted with 355 rural participants selected via multi-stage sampling in the latter half of 2023. Data were collected through face-to-face interviews using a validated, pretested questionnaire. The average age of the respondents was 41.5 years, with 66.8% of them being male participants. The findings revealed inadequate knowledge, negative attitudes, and poor self-control regarding HTN prevention. Socioeconomic factors, including gender, income, education, and region, significantly influenced HTN prevention behaviors (p<0.05), while knowledge, attitude, and self-control were strongly linked to HTN prevention practices (p<0.05). The study’s causal model based on the TPB demonstrated a good fit, showing that attitude (β=0.34, p<0.001), motivation (β=0.16, p<0.05), and self-control significantly influenced intention (β=0.34, p<0.001), which strongly predicted hypertension prevention practices (β=0.54, p<0.001). Rural populations displayed reluctance to adopt healthy practices for HTN prevention. Enhancing community awareness and promoting behavioral change, therefore, should be prioritized in policy development to improve HTN prevention practices in rural Bangladesh.