A Family-Based Approach to Prehypertension Prevention: Development of the WINDA Model from a Qualitative Study

Abstract

Prehypertension is a transitional blood-pressure state associated with an increased risk of hypertension and cardiovascular disease. Lifestyle modification is the principal preventive strategy, but its implementation is strongly shaped by family support, household routines, and sociocultural context. This study explored family perceptions, roles, barriers, and educational needs related to lifestyle modification among individuals with prehypertension and used the findings to develop a family-based conceptual model. An exploratory qualitative design with a phenomenological orientation was used in three primary healthcare centers in Makassar, Indonesia. Eighteen participants representing individuals with prehypertension, family members, community health volunteers, and healthcare workers were recruited purposively. Data were generated through focus group discussions, in-depth interviews, and field observations, then analyzed using Braun and Clarke’s six-phase thematic analysis. Four analytical themes were identified: fragmented family knowledge and culturally influenced understandings of prehypertension; the need for interactive, practical, and contextualized health education; the family’s role as the primary driver of lifestyle modification; and multidimensional barriers to sustainable behavior change. These themes informed the WINDA model: Wellness-Oriented, Interactive, Needs-Based, Family-Driven, and Action-Oriented. The model positions family awareness, tailored education, active support, and practical daily action as an integrated pathway toward sustainable prevention. Family-centered interventions should therefore move beyond information delivery and incorporate culturally responsive education, behavioral rehearsal, family role clarification, and continuous reinforcement.