Health Beliefs Regarding Uptake of Hypertension Screening in an Urban Setting: A Population Segmentation Strategy

Introduction: The prevalence of hypertension is rapidly rising in low and middle income countries. Detection of hypertension largely depends on screening of healthy individuals. Therefore, screening behaviour is very important in early diagnosis and treatment. Objectives: This study aimed at surveying the health beliefs with respect to hypertension screening, of a typical urban community in Chennai, south India and segmenting the population into clusters based on their health beliefs in order to effectively target behaviour change interventions. Methods: A cross sectional survey was conducted among 140 adult men and women selected by a multistage random sampling method in Chennai. A questionnaire to collect information on hypertension screening behaviours, health belief model domains such as perceived susceptibility, severity, benefits, barriers and cues to action was administered. Results: Factor analysis of the questions revealed the same five health belief domains with good factor loadings on each question. Based on their responses the participants were clustered into 6 groups by k means cluster analysis namely, (1) extrinsically motivated with perception of severity and (2) without, (3) intrinsically motivated with risk acceptance and (4) risk denial, (5) unfavourable health belief with negative attitudes focussing mainly on barriers and (6) overall apathy towards screening. Older age, male gender, married status and nuclear type of family were important factors positively influencing health beliefs regarding hypertension screening. Conclusions: The health belief model can be effectively used to segment the population into groups that are different by virtue of their motivation types and attitudes towards screening for hypertension.