Monitoring Hypertension Group Regularly and Intensively with Officers and Cadres (Fit Heart Group) as an Effort to Increase the Knowledge of Elderly Cadres about Controlled Hypertension

: Controlled hypertension is a health problem that is closely related to mortality. The prevalence of this disease increases significantly every year throughout the world. Failure in self-awareness results in decreased self-control and decreased self-efficacy, resulting in patients not having regular control and not regularly taking hypertension medication. This study aims to increase the knowledge of female cadres about controlled hypertension. Using pre-test and post-test results of elderly cadres in blood pressure measurement training for hypertensive patients with the T-Test. Inclusion criteria of elderly cadres who have a blood pressure measurement training certificate at the UPTD Tegalampel Public Health Center. The 20 elderly cadres who took part in blood pressure measurement training with using T-Test to see the effect of training for elderly cadres toward blood pressure measurement level of knowledge. Based on the results of the T-Test, there was no significant improvement after health education regarding the prevention and treatment of hypertension (p=0.115). Given to the level of knowledge of elderly cadres regarding blood pressure measurement training. This is caused by increased self-awareness, self-control, and self-efficacy. Efforts to increase the level of knowledge of elderly cadres about controlled hypertension can increase self-awareness by forming a healthy heart group (the hypertension group is supervised regularly and intensively by officers and cadres) by forming a WA group, training elderly cadres with blood pressure measurement training and therapy counseling traditional (guava leaves, garlic, cat's whiskers leaves, ginger, bay leaves, noni, soursop leaves, soak feet in warm water)to increase awareness of controlled hypertension patients in improving healthy lifestyles, namely regular health checks, taking medication regularly.


INTRODUCTION
Uncontrolled hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) of at least 90 mmHg, is the most significant risk factor that can cause morbidity and mortality worldwide.The high incidence of hypertension with controlled blood pressure is caused by decreased self-awareness (Kreibich et al., 2020), decreased self-control (self-control) (Arini Ayu et al., 2023), and decreased self-efficacy (self-efficacy) (Tan et al., 2021).As a result, patients with hypertension who do not regularly take antihypertensive drugs experience high blood pressure, which can cause complications and death (Bakhsh et al., 2017).
Based on previous research in Saudi Arabia, self-awareness about hypertension was (72.6%) (Bakhsh et al., 2017).Based on data on controlled hypertension patients at the Tegalampel Community Health Center in 2023, the achievements of the Individual Health Effort (UKP) show that there are 6689 hypertension patients with high but controlled blood pressure.The number of patients with stable blood pressure was 752 people (11.24%) according to the program 17%, while the target of achieving 63% has not been achieved (Tegalampel Community Health Center, Bondowoso District Health Service, 2023), and this achievement has not met the target.This is because the behavior of the residents of the Tegalampel sub-district towards awareness of healthy living is still low.
Self-awareness is a person's ability to recognize, understand, and evaluate oneself objectively.
It includes understanding an individual's thoughts, feelings, motivations, strengths, weaknesses, and behaviors.Self-awareness also involves awareness of how individuals influence others around them and how the environment influences them (Bakhsh et al., 2017).
Self-control is a person's ability to control their impulses, emotions, and behavior to achieve larger, long-term goals.It involves the ability to refrain from undesirable or harmful actions, even in the face of temptation or challenging situations.Self-control also involves the ability to regulate negative feelings, manage stress, and make good decisions in difficult situations (Arini Ayu et al., 2023).
Self-efficacy is an individual's belief in his or her ability to succeed in achieving certain goals or in overcoming certain challenges.It is a belief based on an individual's assessment of his or her ability to manage a particular situation and produce a desired outcome (Tan et al., 2021).
Based on behavioral theory by Lawrence Green, Factors that influence the formation of behavior include1) predisposing factors (age, gender, occupation, economic status, employment, marital status), 2) factor enabling factors (Distance to health facilities, health insurance, medicines, transportation 3) Reinforcing factors (Family support, support from health workers, support from community leaders (Green, 2021).
Hypertension cadres are individuals who are trained and empowered to provide education, monitoring, and support services to the community in efforts to prevent, early detect, and manage hypertension.They are usually part of a public health program that aims to increase awareness and understanding of hypertension, teach healthy lifestyles, help monitor blood pressure, and provide psychosocial support to hypertension sufferers and their families (Sadewa, 2023).
Individual Health Efforts (UKP) are a series of actions aimed at improving individual health on a personal basis.The UKP program aims to provide holistic and integrated health services to each individual based on their needs and health conditions (Amaliah, 2017).

IMPLEMENTATION METHOD
This research is a review of public awareness regarding hypertension by assessing the results of pre-test and post-test training for elderly cadres regarding measuring hypertension blood pressure.With a sample size of 20 people, who are representatives from 8 villages in the Tegalampel sub-district, Bondowoso Regency.The activities carried out include 1) the Establishment of a WhatsApp group 2) Cadre training (pre-test, hypertension material, how to diet for hypertension, types of hypertensions, the impact of hypertension, traditional and pharmacological therapy, questions and answers, post-test, the practice of measuring blood pressure, door prize for 2 outstanding participants) using the T-Test.

Table 1 .
Summary of Previous Research healthy living by regularly checking at posyandu and community health centers as well as a lack of awareness about drinking.medicationregularly, which is due to various factors including: 1) Predisposing factors (age, gender, economy, job) 2) Enabling factors (distance to health facilities, transportation, health insurance factors) 3) Strengthening factors (friend support, family support, support from health workers, support from community leaders).So, to achieve the target of 63%, it is necessary to make regular reporting and inspection efforts every 1 month by forming a fit heart group (the hypertension group is monitored regularly and intensively with officers and cadres), including: 1) forming a WhatsApp group consisting of Head of Tegalampel Community Health Center, Coordinator UKM, UKM Coordinator, Person in Charge of PTM, Village Health Officer, Elderly Cadre in Handling Hypertension who has received a Decree from the Village Head.2)Training for elderly cadres on blood pressure checks includes pre-test, the material on controlled hypertension, causes of hypertension, impact of hypertension, healthy lifestyle, post-test, practice on how to measure blood pressure correctly, distribution of door prizes to 2 training cadres who excel.
RESULT AND DISCUSSIONThe results of the annual report of the Individual Health Effort (UKP) program for controlled hypertension patients in 2023 at the UPTD Tegalampel Community Health Center, Bondowoso Regency, were 17% and had not met the target due to a lack of public awareness of the importance of

Table 2 .
Analysis of Pre-test and Post-test Scores T-Test to see the effect of training for elderly cadres regarding blood pressure measurement on their level of knowledge.The criteria for change is when the value is sig≤0.05,whereas if sig>0.05 then no difference in value is observed after the intervention.Based on test results pre-test and posttest values produced a significant 2-tailed equal variance assumed value of 0.115 and an equal variance not assumed value of 0.117, indicating that there was no significant improvement after health education regarding the prevention and treatment of hypertension.given to the level of knowledge of elderly cadres regarding blood pressure measurement training.
WhatsApp group consisting of Head of Tegalampel Community Health Center, UKM Coordinator, UKM Coordinator, Person in Charge of PTM, Village Health Officer, Elderly cadres in handling hypertension who have received a decree from the Village Head.2) Training for elderly cadres regarding blood pressure checks includes pre-test, controlled hypertension material, causes of hypertension, counseling on traditional therapy (guava leaves, garlic, cat's whisker leaves, ginger, bay leaves, noni, soursop leaves, soak feet in warm water).impact of hypertension, healthy lifestyle, post-test, practice on how to measure blood pressure correctly, distribution of door prizes to 2 training cadres who excel to increase awareness of controlled hypertension patients in improving healthy lifestyle, namely regular health checks, taking medication regularly.