Effect of CERDIK-Based Health Promotion on Healthy Lifestyle Behavior among Patients with Coronary Heart Disease: A Quasi-Experimental Study
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Abstract
Background: Coronary heart disease (CHD) remains a major cause of morbidity and mortality, and sustained lifestyle modification is essential for secondary prevention. The Indonesian Ministry of Health promotes CERDIK, a six-component healthy-lifestyle strategy comprising regular health checks, avoidance of cigarette smoke, regular physical activity, a healthy balanced diet, adequate rest, and stress management. Evidence regarding structured CERDIK education among patients with established CHD in hospital outpatient settings remains limited. Objective: This study evaluated the effect of CERDIK-based health promotion on knowledge, attitudes, and healthy lifestyle practices among patients with CHD. Methods: A quasi-experimental two-group pretest-posttest study was conducted in the cardiac outpatient clinic of Murni Teguh Hospital, Medan. Forty patients were recruited by purposive sampling and allocated to an intervention group (n=20) and a control group (n=20). The intervention group received structured CERDIK-based health education for four weeks, whereas the control group received routine education. Outcomes were measured before and after the intervention using questionnaires assessing knowledge, attitudes, and practices. Change scores were compared between groups using the Mann-Whitney U test. Results: After the intervention, 85% of participants in the intervention group had good knowledge, 85% had positive attitudes, and 45% had good practices; the corresponding proportions in the control group were 0%, 0%, and 10%, respectively. Mean change scores were substantially greater in the intervention group than in the control group for knowledge (25.75 vs 2.95), attitudes (27.30 vs 1.85), and practices (23.35 vs 1.85). Between-group differences were statistically significant for all outcomes (all p<0.001). Conclusion: Structured CERDIK-based health promotion significantly improved short-term knowledge, attitudes, and healthy lifestyle practices among patients with CHD. The intervention may be incorporated into outpatient secondary-prevention education, although larger randomized studies with longer follow-up are needed to assess sustained behavioral effects.
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References
World Health Organization. Cardiovascular diseases (CVDs) 2023. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (accessed September 4, 2026).
Rosengren A, Hawken S, Ounpuu S, Sliwa K, Zubaid M, Almahmeed WA, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11,119 cases and 13,648 controls from 52 countries (the INTERHEART study): case-control study. Lancet 2004;364:953–62. https://doi.org/10.1016/S0140-6736(04)17019-0.
Virani SS, Newby LK, Arnold SV, Bittner V, Brewer LC, Demeter SH, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease. Circulation 2023;148:e9–e119. https://doi.org/10.1161/CIR.0000000000001168.
Vrints C, Andreotti F, Koskinas KC, Rossello X, Adamo M, Ainslie J, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J 2024;45:3415–537. https://doi.org/10.1093/eurheartj/ehae177.
Qanitha A, Qalby N, Amir M, Uiterwaal CSPM, Henriques JPS, de Mol BAJM, et al. Clinical cardiology in South East Asia: Indonesian lessons from the present towards improvement. Glob Heart 2022;17:66. https://doi.org/10.5334/gh.1133.
Kementerian Kesehatan Republik Indonesia. CERDIK, rahasia masa muda sehat dan masa tua nikmat! 2019. https://ayosehat.kemkes.go.id/cerdik-rahasia-masa-muda-sehat-dan-masa-tua-nikmat (accessed September 4, 2026).
World Health Organization. WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization; 2020.
Rosenstock IM. Historical origins of the Health Belief Model. Health Educ Monogr 1974;2:328–35.
Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process 1991;50:179–211.
Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice-Hall; 1986.
Green LW, Kreuter MW. Health program planning: an educational and ecological approach. 4th ed. New York: McGraw-Hill; 2005.
Papachristou Nadal I, Angkurawaranon C, Singh A, Choksomngam Y, Sadana V, Kock L, et al. Effectiveness of behaviour change techniques in lifestyle interventions for non-communicable diseases: an umbrella review. BMC Public Health 2024;24:3082. https://doi.org/10.1186/s12889-024-20612-8.
Apriza A, Shafie ZM, Langputeh P, Nurman M. Exploring the impact of lifestyle habits and environmental factors on the risk of hypertension in rural populations. J Promosi Kesehat Indones 2025;21:17–25. https://doi.org/10.14710/jpki.21.1.17-25.
Ratnawati R, Putri MA. Key factors influencing help-seeking behavior toward hypertension treatment among the productive-age population. J Promosi Kesehat Indones 2026;21:67–76. https://doi.org/10.14710/jpki.21.1.67-76.
Azhari A, Setiawan R. Efektivitas film pendek CERDIK terhadap pengetahuan pengendalian hipertensi pada lansia peserta Posbindu. J Kesehat Siliwangi 2021;2:231–8. https://doi.org/10.34011/jks.v2i1.672.
Hariawan H, Pefbrianti D. CERDIK meningkatkan pengendalian penyakit tidak menular di Indonesia: systematic review. 2-TRIK Tunas-Tunas Ris Kesehat 2020;10:16–20. https://doi.org/10.33846/2trik10104.
Rahmawati ST, Rohman F, Rosyada DP, Ramadhanty RA, Hati SP, Anggraeni SD, et al. Cegah penyakit jantung koroner dengan CERDIK dan PATUH. Community Empowerment Journal 2024;2:217–22. https://doi.org/10.61251/cej.v2i4.88.
Rahma AN, Lita L, Purba CVG. Determinan perilaku CERDIK sebagai upaya pencegahan dini penyakit tidak menular pada mahasiswa Universitas Hang Tuah Pekanbaru. J Kesehat Komunitas 2025;11:224–31. https://doi.org/10.25311/keskom.Vol11.Iss2.2172.
Hakim AL, Sari A. Determinants of CERDIK behavior in hypertension prevention among women of childbearing age. J Ilmu Kesehat Masy 2023;12:320–9.
Li Y, Pan A, Wang DD, Liu X, Dhana K, Franco OH, et al. Impact of healthy lifestyle factors on life expectancies in the US population. Circulation 2018;138:345–55. https://doi.org/10.1161/CIRCULATIONAHA.117.032047.
Notoatmodjo S. Promosi kesehatan dan perilaku kesehatan. Jakarta: Rineka Cipta; 2018.