Effectiveness of Below-the-Line (BTL) Health Campaigns in Reducing Non-Communicable Diseases (NCDs) Among Industrial Workers: A Quasi-Experimental Study

Effectiveness of Below-the-Line (BTL) Health Campaigns in Reducing Non-Communicable Diseases (NCDs) Among Industrial Workers: A Quasi-Experimental Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effectiveness of Below-the-Line (BTL) Health Campaigns in Reducing Non-Communicable Diseases (NCDs) Among Industrial Workers: A Quasi-Experimental Study Nasrul Zaman, Fahrun Nur Rosyid Fahrun, Umi Salmah Umi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7012132/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The prevalence of non-communicable diseases (NCDs) among industrial workers in Indonesia continues to rise due to occupational hazards, unhealthy lifestyles, and limited access to preventive healthcare services. Below-the-line (BTL) health campaigns, which utilise direct communication media such as posters and brochures, have been employed to promote healthy behaviours; however, their effectiveness in industrial settings remains underexplored. Objective: This study aimed to evaluate the effectiveness of BTL health campaigns in reducing NCD risks among industrial workers, focusing on campaign characteristics, message accessibility, and media content. Method: A cross-sectional design was employed, surveying 1,200 industrial workers exposed to BTL campaigns at IHSP. Data were gathered through structured questionnaires and interviews, and path analysis using SmartPLS 3.0 was conducted to examine the relationships between campaign characteristics, accessibility, media content, and effectiveness. Results indicated that campaign characteristics significantly enhanced message accessibility (coefficient = 0.709, p < 0.001) and media content (coefficient = 0.741, p < 0.001), directly influencing campaign effectiveness (coefficient = 0.298, p = 0.005). Additionally, accessibility (coefficient = 0.287; p = 0.003) and relevant media content (coefficient = 0.216; p = 0.009) contributed to campaign success. All model paths showed strong statistical significance. In conclusion , BTL health campaigns effectively improve NCD-related health behaviours among industrial workers, particularly when tailored to audience characteristics and supported by accessible, relevant content. An evidence-based BTL strategy is crucial for optimising NCD prevention in industrial settings. BTL campaign Quality of life Campaign effectiveness NCDs Health behaviour Introduction The prevalence of non-communicable diseases (NCDs) in Indonesia, based on the 2023 Indonesian Health Survey (SKI), shows a significant increase, especially in hypertension and diabetes mellitus [1], [2]. The prevalence of hypertension, based on blood pressure measurements, increased from 25.8% to 34.1%, and the prevalence of diabetes, based on blood sugar checks, increased from 6.9% to 8.5% [2]. The prevalence of non-communicable diseases (NCDs) is increasing among industrial workers due to a combination of various factors in the working environment, lifestyle, and individual characteristics that interact with each other [3], [4], [5], [6]. First, exposure to hazardous chemicals, dust, air pollution, and noise in industrial environments can trigger chronic health disorders such as respiratory, cardiovascular, and metabolic disorders [7], [8], [9], [10], [11]. Second, work patterns that demand long working hours, night shifts, and high work stress contribute to circadian rhythm disruption and an increased risk of hypertension, diabetes, and psychological disorders [12], [13], [14]. Third, the lifestyle of industrial workers is often unhealthy; for example, consumption of non-nutritious food, lack of physical activity, smoking, and alcohol consumption, which are major risk factors for NCDs (Jamatia et al., 2009; Kar et al., 2015; Sonia et al., 2016). In addition, limited access to preventive health services and health education in the work environment exacerbates these conditions, resulting in less-than-optimal early detection and risk management [17], [18], [19], [20]. Socio-economic factors and low education can also hinder the understanding and implementation of healthy living behaviours among industrial workers [21], [22]. The BTL campaign on NCDs has long been the primary strategy in reducing the prevalence of NCDs to improve public health behaviour in Indonesia [23], [24], including for industrial workers who have not explicitly been considered in the early detection of NCDs in IHSP industrial areas [24]. BTL’s campaign program on NCDs involving the participation of industrial workers has been conducted in various countries and has shown promising results in raising awareness and promoting healthy behaviours among workers [5], [25]. The NCDs campaign utilises BTL media, employing direct communication methods such as posters, brochures, pamphlets, and other printed materials that can be distributed in easily accessible locations for industrial workers [26], [27]. The effectiveness of the BTL of NCDs campaign can be measured through direct feedback, surveys, and material distribution reach [28], [29]. The impact of the NCDs component of the BTL campaign on changes in health behaviour can also be seen through increased industrial workers’ knowledge and understanding of NCDs [29], [30], which workers demonstrate through increased participation in early detection of NCDs at the nearest IHSP. In the Indonesian context, the NCDs addressed by the BTL campaign have been tackled in several industrial estates through healthy lifestyle promotion activities and the promotion of early detection, aiming to raise awareness of non-communicable diseases. The campaign is a well-designed health campaign and is expected to effectively increase the participation of industrial workers in the more effective use of IHSP. This prompted the need for research on the effectiveness of NCD campaigns conducted with the concept of BTL, aimed at workers in industrial estates, to determine how effective the BTL campaign was in influencing changes in the health behaviour of industrial workers. Research method Research design : The method employed is a cross-sectional study to analyse the phenomenon and relationship between exogenous and endogenous variables, specifically the effectiveness of NCD campaigns through BTL. The study was conducted using questionnaires and interviews with residents in the industrial areas of IHSP. Population and samples : The research population consists of industrial workers who receive IHSP services. The sample consisted of 1,200 industrial workers in industrial areas at IHSP who had been exposed to NCD campaigns. Instruments : A questionnaire to measure the effectiveness of the NCDs campaign through BTL, which consists of accessibility, target characteristics, media content, and BTL effectiveness that the government or other stakeholders have carried out. Procedures : Data were collected through questionnaires and interviews. Data analysis was performed using SmartPLS version 3.0, and the results were interpreted. Conclusions and suggestions for further research were included. Results and Discussion SmartPLS is used to assess the strength of relationships between variables, assess statistical significance, analyse the contribution of each variable, and validate conceptual models. These things are as explained in Table 1 below: Table 1 Path Coefficients on the Inner Model Original Sample (O) Sample Mean (M) Standard Deviation (STDEV) T Statistics (|O/STDEV|) P Values Accessibility ->Effectiveness 0,287 0,288 0,096 2,994 0,003 Characteristic ->Accessibility 0,709 0,712 0,048 14,742 0,000 Characteristic ->Content Media 0,741 0,744 0,036 20,737 0,000 Characteristic ->Effectiveness 0,298 0,305 0,105 2,845 0,005 Content Media ->Effectiveness 0,216 0,215 0,083 2,616 0,009 Based on Table 1 above, the calculation of exogenous and endogenous variables reveals that the effect of Accessibility on Effectiveness has a coefficient of 0.287, a t-statistical value of 2.994, and a p-value of 0.003. This value indicates that Accessibility has a positive and significant effect on the Effectiveness of the BTL campaign for NCDs, as p < 0.05 and the t-value is greater than 1.96, indicating a statistically significant influence at a 5% significance level. The increased accessibility of BTL campaign messages for NCDs among industrial workers is expected to be followed by a moderate increase in campaign effectiveness. These findings align with health communication theory, asserting that ease of access to information or campaign resources is crucial in influencing the success of behaviour change or increasing health awareness [ 31 ], [ 32 ], [ 33 ]. Therefore, improving the accessibility aspect for industrial workers by providing easy-to-reach and user-friendly information channels should be a priority in designing BTL campaigns for NCDs to maximise their impact on workers’ health. The influence of Characteristics on Accessibility has a coefficient of 0.709 with a t-statistic value of 14.742 and a p-value of 0.000. These results indicate a significant positive influence, reinforcing the role of the characteristic BTL of the NCDs campaign in determining the level of accessibility of the BTL message in industrial workers. A coefficient approaching 0.7 indicates a very close relationship between the BTL characteristics of NCDs in industrial workers and the level of accessibility of their campaign messages. Theoretically, these results reinforce the concept that the audience’s demographic, psychographic, and socio-cultural characteristics, in this case, industrial workers, play a crucial role in determining the ease of access to BTL NCDs campaign information [ 31 ], [ 32 ], [ 33 ]. Adjusting the content and delivery methods to match the characteristics of the target audience can increase the accessibility of the message, thereby enhancing the chances of success for health interventions. These findings are consistent with the health communication literature that emphasises the importance of segmentation and tailoring of messages to maximise the reach and acceptance of BTL of NCD campaigns [ 34 ], [ 35 ]. Therefore, an in-depth understanding of the characteristics of industrial workers should be the basis for designing BTL campaign strategies that effectively suppress NCDs. The influence of Characteristics on Content Media resulted in a coefficient of 0.741 with a t-statistic of 20.737 and a p-value of 0.000, indicating a highly significant positive influence. The characteristics of content media imply that the campaign characteristics of BTL for NCDs strongly determine the form and content of the campaign media used for industrial workers. The characteristics of the BTL of the NCDs campaign substantially influenced the selection and development of the content and form of media used in the BTL of the NCDS campaign. The t-statistical value was well beyond the critical limit of 1.96, and the near-zero p-value reinforced the statistical reliability of these findings, suggesting that the influence was not the result of chance. These findings align with the communication theory that adapting media content to the target audience’s characteristics—such as demographics, culture, preferences, and needs—is a key factor in increasing the attractiveness and effectiveness of BTL of NCDs campaign media [ 34 ], [ 35 ]. Therefore, a deep understanding of the characteristics of BTL NCDs campaigns is fundamental in designing BTL NCDs campaign media for industrial workers that are not only relevant but also able to motivate the desired behaviour change. The practical implications of these results are the importance of a segmentation and personalisation approach in workers’ health communication strategies to suppress optimal NCDs. The direct influence of Characteristics on Effectiveness has a coefficient of 0.298 with a t-statistic value of 2.845 and a p-value of 0.005. This influence demonstrates that characteristics have a significant impact on campaign effectiveness, as well as indirect influences through Accessibility and Content Media. This positive coefficient indicates that the campaign characteristics of BTL of NCDs directly increase the campaign’s effectiveness in industrial workers, although the magnitude of the effect is relatively moderate compared to the indirect pathway through Accessibility and Content Media [ 36 ]. A t-statistic value that exceeds the critical limit of 1.96 and a p-value below 0.05 corroborate the statistical significance of this relationship, so the influence of the characteristic cannot be a coincidence. These findings are consistent with communication behavioural theory that emphasises the importance of personal characteristic factors such as motivation, knowledge, and attitudes in influencing audience responses to health messages [ 37 ], [ 38 ]. In addition, these results confirm that while media and accessibility are important, individual characteristics still play a direct role in determining the success of BTL campaigns for NCDs. Therefore, campaign strategies must directly consider the audience’s unique characteristics to maximise the effectiveness of health interventions through message adjustments and delivery methods. The influence of Content Media on Effectiveness was significant, with a coefficient of 0.216, a t-statistic of 2.616, and a p-value of 0.009, indicating a positive and significant effect. This influence means that the quality and relevance of the BTL of the NCDs campaign media directly increase the effectiveness of delivering NCD health messages to industrial workers. This positive coefficient implies that the improvement in the quality and relevance of the BTL content of the NCDs campaign media directly contributes to the increase in the effectiveness of delivering health messages for NCDs. These findings are consistent with the health communication theory, which states that media designed with the audience’s context in mind and delivered attractively will maximise the acceptance of the message and encourage the expected behaviour change [ 34 ]. Therefore, improving media content—visually, messaging, and culturally relevant—is a key strategy in developing effective NCD health campaigns, especially for industrial workers with specific characteristics [ 26 ], [ 39 ]. Overall, all the influences between variables in this model showed positive and statistically significant influences, which confirms the validity of the model in explaining the factors that affect the effectiveness of health campaigns in the industrial worker environment. The results of the path analysis showed that all the influences between variables in this model had a positive and statistically significant influence, which comprehensively confirms the validity of the model in explaining the determinants of the effectiveness of the BTL of NCDs campaign in the industrial worker environment. Consistent significance across all paths, characterised by t-statistic values exceeding the critical threshold and p-values below 0.05, indicates that variables such as Characteristics, Accessibility, and Media Content simultaneously and continuously contribute to increased campaign effectiveness. These findings align with the framework of health communication theory [ 40 ], [ 41 ] and behaviour change models that emphasise the importance of complex interactions between audience characteristics, ease of access, and media quality in determining the success of health interventions [ 42 ], [ 43 ]. As such, this model offers a strong empirical understanding and provides a valid conceptual foundation for developing more effective and targeted campaign strategies in an industry context, where Characteristic, Accessibility, and Content Media reinforce each other in driving healthy behaviour change. Conclusion The conclusions of this study indicate that the effectiveness of Below-the-Line (BTL) campaigns in reducing non-communicable diseases (NCDs) among industrial workers is strongly influenced by three primary factors: campaign characteristics, message accessibility, and campaign media content. The characteristics of BTL campaigns play a central role, both directly and indirectly, in increasing the effectiveness of campaigns by increasing the accessibility of messages and the relevance of the media content used. The results of the path analysis revealed that campaign characteristics had a positive and significant influence on message accessibility (coefficient = 0.709), media content (coefficient = 0.741), and direct campaign effectiveness (coefficient = 0.298). Furthermore, message accessibility also significantly contributes positively to campaign effectiveness (coefficient = 0.287), and relevant and high-quality media content directly increases the effectiveness of health message delivery (coefficient = 0.216). All these relationships between variables demonstrate strong statistical significance, reinforcing the model’s validity in explaining the determinants of BTL campaign success in suppressing NCDs among industrial workers. These findings confirm the importance of tailoring the campaign to the demographic, psychographic, and socio-cultural characteristics of industrial workers, as well as providing accessible information channels and using relevant and engaging media [44], [45], [46]. Therefore, BTL’s campaign strategy must be comprehensively designed with all three aspects in mind to maximise the impact of health interventions on industrial workers. When this study was conducted, it was also known that not all industrial estates in Indonesia had an IHSP available. However, because the NCDs campaign through BTL is very effective in influencing the awareness and understanding of workers to be willing to carry out early detection of NCDs, it is time for the government or the management of industrial estates/companies to be obliged to provide IHSP facilities around industrial estates/companies that are easily accessible to these industrial workers. Providing IHSP in this industrial estate is crucial to reducing the prevalence of NCDs and enhancing worker productivity and company efficiency. Declarations In this study, all participants have given written consent after being informed of the objectives, procedures, and potential risks associated with their participation. By signing the consent form, participants declare they understand and agree to participate in the study. This research does not receive specific grants from funding institutions in the public, commercial, or non-profit sectors. While preparing this work, the author used [scopus.ai/grammarly] to [search for better literature/English grammar]. After using such tools and services, the author returns to review and edit the content as necessary and is fully responsible for the content of the published article. Author Contribution Author’s ContributionsBy submitting this article, the authors state the following contributions:Nasrul Zaman: Research planning, methodology, data collection, analysis Fahrun Nur Rosyid: Statistical analysis, interpretation of results Umi Salmah: Data interpretation, literature review, manuscript writingEach author listed in this manuscript has made a significant contribution to the research and is responsible for the accuracy and integrity of the content Data Availability Data is provided within the manuscript or supplementary information files. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7012132","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":481603950,"identity":"3f807f43-41a7-4d27-8a9c-53fc7e19d368","order_by":0,"name":"Nasrul Zaman","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5klEQVRIiWNgGAWjYNCCAjDJ+ICBIQHMOsBDUIsBmGQ2IFkLmwRMCwM+Lebsx5995jGok9dtP3usmudPGgN/+wHGA2/waLHsyTGezWPAZrjtTF7abd62HAaJMwkMB+fgc9KBHGZmHgMexm0Hcsxu8zZUMDDcYGA4jM9hBuefPwZqkbDfdv6NWTHPnwoGeYJabiQYA7UYJG67kWPGzMOWAxQhqOWNMeMcg4TkbUCG5Ny2NB7DM4kN+P1yPv0xw5uKOttt53MMP7z5kywnd/zw4Q/4QgwDAJ3E2ECKhlEwCkbBKBgFWAAA5HpK9Emu4ggAAAAASUVORK5CYII=","orcid":"","institution":"Syiah Kuala University","correspondingAuthor":true,"prefix":"","firstName":"Nasrul","middleName":"","lastName":"Zaman","suffix":""},{"id":481603951,"identity":"6d2dc2b1-cc9d-4b0c-bbb2-8ca4742f949a","order_by":1,"name":"Fahrun Nur Rosyid Fahrun","email":"","orcid":"","institution":"Muhammadiyah University of Surakarta","correspondingAuthor":false,"prefix":"","firstName":"Fahrun","middleName":"Nur Rosyid","lastName":"Fahrun","suffix":""},{"id":481603952,"identity":"17293543-7f25-4890-9c24-629e21e0e791","order_by":2,"name":"Umi Salmah Umi","email":"","orcid":"","institution":"University of North Sumatra","correspondingAuthor":false,"prefix":"","firstName":"Umi","middleName":"Salmah","lastName":"Umi","suffix":""}],"badges":[],"createdAt":"2025-06-30 15:23:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7012132/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7012132/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90964784,"identity":"62e78250-ce71-49e5-a828-8cbfde48f7ff","added_by":"auto","created_at":"2025-09-10 06:09:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":468137,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7012132/v1/ff56f5eb-4c00-45b1-b5c9-82294d3ee8ba.pdf"},{"id":86517805,"identity":"0eabb85f-423d-49db-a033-a76a65b1dd16","added_by":"auto","created_at":"2025-07-11 14:25:32","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":86909,"visible":true,"origin":"","legend":"","description":"","filename":"StatisticalTestResultsData.docx","url":"https://assets-eu.researchsquare.com/files/rs-7012132/v1/80ba11106977ec053fe1ea82.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effectiveness of Below-the-Line (BTL) Health Campaigns in Reducing Non-Communicable Diseases (NCDs) Among Industrial Workers: A Quasi-Experimental Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe prevalence of non-communicable diseases (NCDs) in Indonesia, based on the 2023 Indonesian Health Survey (SKI), shows a significant increase, especially in hypertension and diabetes mellitus [1], [2]. The prevalence of hypertension, based on blood pressure measurements, increased from 25.8% to 34.1%, and the prevalence of diabetes, based on blood sugar checks, increased from 6.9% to 8.5% [2]. The prevalence of non-communicable diseases (NCDs) is increasing among industrial workers due to a combination of various factors in the working environment, lifestyle, and individual characteristics that interact with each other [3], [4], [5], [6]. First, exposure to hazardous chemicals, dust, air pollution, and noise in industrial environments can trigger chronic health disorders such as respiratory, cardiovascular, and metabolic disorders [7], [8], [9], [10], [11]. Second, work patterns that demand long working hours, night shifts, and high work stress contribute to circadian rhythm disruption and an increased risk of hypertension, diabetes, and psychological disorders [12], [13], [14]. Third, the lifestyle of industrial workers is often unhealthy; for example, consumption of non-nutritious food, lack of physical activity, smoking, and alcohol consumption, which are major risk factors for NCDs (Jamatia et al., 2009; Kar et al., 2015; Sonia et al., 2016). In addition, limited access to preventive health services and health education in the work environment exacerbates these conditions, resulting in less-than-optimal early detection and risk management [17], [18], [19], [20]. Socio-economic factors and low education can also hinder the understanding and implementation of healthy living behaviours among industrial workers [21], [22].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe BTL campaign on \u003cem\u003eNCDs\u0026nbsp;\u003c/em\u003ehas long been the primary strategy in reducing the prevalence of \u003cem\u003eNCDs\u0026nbsp;\u003c/em\u003eto improve public health behaviour in Indonesia [23], [24], including for industrial workers who have not explicitly been considered in the early detection of NCDs in IHSP industrial areas [24]. BTL\u0026rsquo;s campaign program on NCDs involving the participation of industrial workers has been conducted in various countries and has shown promising results in raising awareness and promoting healthy behaviours among workers [5], [25].\u003c/p\u003e\n\u003cp\u003eThe NCDs campaign utilises BTL media, employing direct communication methods such as posters, brochures, pamphlets, and other printed materials that can be distributed in easily accessible locations for\u0026nbsp;industrial workers [26], [27]. The effectiveness of the BTL of NCDs campaign can be measured through direct feedback, surveys, and material distribution reach [28], [29]. The impact of the NCDs component of the BTL campaign on changes in health behaviour can also be seen through increased industrial workers\u0026rsquo; knowledge and understanding of NCDs [29], [30], which workers demonstrate\u0026nbsp;through increased participation in early detection of NCDs at the nearest IHSP.\u003c/p\u003e\n\u003cp\u003eIn the Indonesian context, the NCDs addressed by the BTL campaign have been tackled in several industrial estates through healthy lifestyle promotion activities and the promotion of early detection, aiming to raise awareness of non-communicable diseases. The campaign is a well-designed health campaign and is expected to effectively increase the participation of industrial workers in the more effective use of IHSP. This prompted the need for research on the effectiveness of NCD campaigns conducted with the concept of BTL, aimed at workers in industrial estates, to determine how effective the BTL campaign was in influencing changes in the health behaviour of industrial workers.\u003c/p\u003e"},{"header":"Research method","content":"\u003cp\u003e\u003cstrong\u003eResearch design\u003c/strong\u003e: The method employed is a cross-sectional study to analyse the phenomenon and relationship between exogenous and endogenous variables, specifically the effectiveness of NCD campaigns through BTL. The study was conducted using questionnaires and interviews with residents in the industrial areas of IHSP.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePopulation and samples\u003c/strong\u003e: The research population consists of industrial workers who receive IHSP services. The sample consisted of 1,200 industrial workers in industrial areas at IHSP who had been exposed to NCD campaigns.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstruments\u003c/strong\u003e: A questionnaire to measure the effectiveness of the NCDs campaign through BTL, which consists of accessibility, target characteristics, media content, and BTL effectiveness that the government or other stakeholders have carried out.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProcedures\u003c/strong\u003e: Data were collected through questionnaires and interviews. Data analysis was performed using SmartPLS version 3.0, and the results were interpreted. Conclusions and suggestions for further research were included.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Results and Discussion","content":"\u003cp\u003eSmartPLS is used to assess the strength of relationships between variables, assess statistical significance, analyse the contribution of each variable, and validate conceptual models. These things are as explained in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e below:\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003ePath Coefficients\u003c/em\u003e on the Inner Model\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOriginal Sample (O)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSample Mean (M)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eStandard Deviation (STDEV)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eT Statistics (|O/STDEV|)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eP Values\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAccessibility -\u0026gt;Effectiveness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0,287\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0,288\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0,096\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2,994\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0,003\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristic -\u0026gt;Accessibility\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0,709\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0,712\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0,048\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14,742\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0,000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristic -\u0026gt;Content Media\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0,741\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0,744\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0,036\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e20,737\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0,000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristic -\u0026gt;Effectiveness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0,298\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0,305\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0,105\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2,845\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0,005\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eContent Media -\u0026gt;Effectiveness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0,216\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0,215\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0,083\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2,616\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0,009\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eBased on Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e above, the calculation of exogenous and endogenous variables reveals that the effect of Accessibility on Effectiveness has a coefficient of 0.287, a t-statistical value of 2.994, and a p-value of 0.003. This value indicates that Accessibility has a positive and significant effect on the Effectiveness of the BTL campaign for NCDs, as p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 and the t-value is greater than 1.96, indicating a statistically significant influence at a 5% significance level. The increased accessibility of BTL campaign messages for NCDs among industrial workers is expected to be followed by a moderate increase in campaign effectiveness. These findings align with health communication theory, asserting that ease of access to information or campaign resources is crucial in influencing the success of behaviour change or increasing health awareness [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e], [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Therefore, improving the accessibility aspect for industrial workers by providing easy-to-reach and user-friendly information channels should be a priority in designing BTL campaigns for NCDs to maximise their impact on workers\u0026rsquo; health.\u003c/p\u003e\u003cp\u003eThe influence of Characteristics on Accessibility has a coefficient of 0.709 with a t-statistic value of 14.742 and a p-value of 0.000. These results indicate a significant positive influence, reinforcing the role of the characteristic BTL of the NCDs campaign in determining the level of accessibility of the BTL message in industrial workers. A coefficient approaching 0.7 indicates a very close relationship between the BTL characteristics of NCDs in industrial workers and the level of accessibility of their campaign messages. Theoretically, these results reinforce the concept that the audience\u0026rsquo;s demographic, psychographic, and socio-cultural characteristics, in this case, industrial workers, play a crucial role in determining the ease of access to BTL NCDs campaign information [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e], [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Adjusting the content and delivery methods to match the characteristics of the target audience can increase the accessibility of the message, thereby enhancing the chances of success for health interventions. These findings are consistent with the health communication literature that emphasises the importance of segmentation and tailoring of messages to maximise the reach and acceptance of BTL of NCD campaigns [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e], [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Therefore, an in-depth understanding of the characteristics of industrial workers should be the basis for designing BTL campaign strategies that effectively suppress NCDs.\u003c/p\u003e\u003cp\u003eThe influence of Characteristics on Content Media resulted in a coefficient of 0.741 with a t-statistic of 20.737 and a p-value of 0.000, indicating a highly significant positive influence. The characteristics of content media imply that the campaign characteristics of BTL for NCDs strongly determine the form and content of the campaign media used for industrial workers. The characteristics of the BTL of the NCDs campaign substantially influenced the selection and development of the content and form of media used in the BTL of the NCDS campaign. The t-statistical value was well beyond the critical limit of 1.96, and the near-zero p-value reinforced the statistical reliability of these findings, suggesting that the influence was not the result of chance. These findings align with the communication theory that adapting media content to the target audience\u0026rsquo;s characteristics\u0026mdash;such as demographics, culture, preferences, and needs\u0026mdash;is a key factor in increasing the attractiveness and effectiveness of BTL of NCDs campaign media [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e], [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Therefore, a deep understanding of the characteristics of BTL NCDs campaigns is fundamental in designing BTL NCDs campaign media for industrial workers that are not only relevant but also able to motivate the desired behaviour change. The practical implications of these results are the importance of a segmentation and personalisation approach in workers\u0026rsquo; health communication strategies to suppress optimal NCDs.\u003c/p\u003e\u003cp\u003eThe direct influence of Characteristics on Effectiveness has a coefficient of 0.298 with a t-statistic value of 2.845 and a p-value of 0.005. This influence demonstrates that characteristics have a significant impact on campaign effectiveness, as well as indirect influences through Accessibility and Content Media. This positive coefficient indicates that the campaign characteristics of BTL of NCDs directly increase the campaign\u0026rsquo;s effectiveness in industrial workers, although the magnitude of the effect is relatively moderate compared to the indirect pathway through Accessibility and Content Media [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. A t-statistic value that exceeds the critical limit of 1.96 and a p-value below 0.05 corroborate the statistical significance of this relationship, so the influence of the characteristic cannot be a coincidence. These findings are consistent with communication behavioural theory that emphasises the importance of personal characteristic factors such as motivation, knowledge, and attitudes in influencing audience responses to health messages [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. In addition, these results confirm that while media and accessibility are important, individual characteristics still play a direct role in determining the success of BTL campaigns for NCDs. Therefore, campaign strategies must directly consider the audience\u0026rsquo;s unique characteristics to maximise the effectiveness of health interventions through message adjustments and delivery methods.\u003c/p\u003e\u003cp\u003eThe influence of Content Media on Effectiveness was significant, with a coefficient of 0.216, a t-statistic of 2.616, and a p-value of 0.009, indicating a positive and significant effect. This influence means that the quality and relevance of the BTL of the NCDs campaign media directly increase the effectiveness of delivering NCD health messages to industrial workers. This positive coefficient implies that the improvement in the quality and relevance of the BTL content of the NCDs campaign media directly contributes to the increase in the effectiveness of delivering health messages for NCDs. These findings are consistent with the health communication theory, which states that media designed with the audience\u0026rsquo;s context in mind and delivered attractively will maximise the acceptance of the message and encourage the expected behaviour change [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Therefore, improving media content\u0026mdash;visually, messaging, and culturally relevant\u0026mdash;is a key strategy in developing effective NCD health campaigns, especially for industrial workers with specific characteristics [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOverall, all the influences between variables in this model showed positive and statistically significant influences, which confirms the validity of the model in explaining the factors that affect the effectiveness of health campaigns in the industrial worker environment. The results of the path analysis showed that all the influences between variables in this model had a positive and statistically significant influence, which comprehensively confirms the validity of the model in explaining the determinants of the effectiveness of the BTL of NCDs campaign in the industrial worker environment. Consistent significance across all paths, characterised by t-statistic values exceeding the critical threshold and p-values below 0.05, indicates that variables such as Characteristics, Accessibility, and Media Content simultaneously and continuously contribute to increased campaign effectiveness. These findings align with the framework of health communication theory [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e], [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e] and behaviour change models that emphasise the importance of complex interactions between audience characteristics, ease of access, and media quality in determining the success of health interventions [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e], [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. As such, this model offers a strong empirical understanding and provides a valid conceptual foundation for developing more effective and targeted campaign strategies in an industry context, where Characteristic, Accessibility, and Content Media reinforce each other in driving healthy behaviour change.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe conclusions of this study indicate that the effectiveness of Below-the-Line (BTL) campaigns in reducing non-communicable diseases (NCDs) among industrial workers is strongly influenced by three primary factors: campaign characteristics, message accessibility, and campaign media content. The characteristics of BTL campaigns play a central role, both directly and indirectly, in increasing the effectiveness of campaigns by increasing the accessibility of messages and the relevance of the media content used. The results of the path analysis revealed that campaign characteristics had a positive and significant influence on message accessibility (coefficient = 0.709), media content (coefficient = 0.741), and direct campaign effectiveness (coefficient = 0.298). Furthermore, message accessibility also significantly contributes positively to campaign effectiveness (coefficient = 0.287), and relevant and high-quality media content directly increases the effectiveness of health message delivery (coefficient = 0.216). All these relationships between variables demonstrate strong statistical significance, reinforcing the model\u0026rsquo;s validity in explaining the determinants of BTL campaign success in suppressing NCDs among industrial workers. These findings confirm the importance of tailoring the campaign to the demographic, psychographic, and socio-cultural characteristics of industrial workers, as well as providing accessible information channels and using relevant and engaging media [44], [45], [46]. Therefore, BTL\u0026rsquo;s campaign strategy must be comprehensively designed with all three aspects in mind to maximise the impact of health interventions on industrial workers.\u003c/p\u003e\n\u003cp\u003eWhen this study was conducted, it was also known that not all industrial estates in Indonesia had an IHSP available. However, because the NCDs campaign through BTL is very effective in influencing the awareness and understanding of workers to be willing to carry out early detection of NCDs, it is time for the government or the management of industrial estates/companies to be obliged to provide IHSP facilities around industrial estates/companies that are easily accessible to these industrial workers. Providing IHSP in this industrial estate is crucial to reducing the prevalence of NCDs and enhancing worker productivity and company efficiency.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u0026nbsp;\u003cspan\u003eIn this study, all participants have given written consent after being informed of the objectives, procedures, and potential risks associated with their participation. By signing the consent form, participants declare they understand and agree to participate in the study.\u003c/span\u003e\u003c/p\u003e\u003cp\u003eThis research does not receive specific grants from funding institutions in the public, commercial, or non-profit sectors.\u003c/p\u003e\n\u003cp\u003eWhile preparing this work, the author used [scopus.ai/grammarly] to [search for better literature/English grammar]. After using such tools and services, the author returns to review and edit the content as necessary and is fully responsible for the content of the published article.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAuthor\u0026rsquo;s ContributionsBy submitting this article, the authors state the following contributions:Nasrul Zaman: Research planning, methodology, data collection, analysis Fahrun Nur Rosyid: Statistical analysis, interpretation of results Umi Salmah: Data interpretation, literature review, manuscript writingEach author listed in this manuscript has made a significant contribution to the research and is responsible for the accuracy and integrity of the content\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData is provided within the manuscript or supplementary information files. Please refer to our data availability statements page for assistance.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKemenkes RI, \u0026ldquo;SKI Report 2023,\u0026rdquo; 2024. [Online]. Available: https://drive.google.com/file/d/1rjNDG_f8xG6-Y9wmhJUnXhJ-vUFevVJC/view\u003c/li\u003e\n\u003cli\u003eE. P. Pamungkasari \u003cem\u003eet al.\u003c/em\u003e, \u0026ldquo;Identifying relevant diabetes and hypertension control management guidelines in primary healthcare and community settings in Indonesia: A Delphi survey,\u0026rdquo; \u003cem\u003ePLoS One\u003c/em\u003e, vol. 19, no. 11, p. e0310295, 2024, doi: 10.1371/journal.pone.0310295.\u003c/li\u003e\n\u003cli\u003eB. Jamatia, K. Anand, S. K. Kapoor, and R. M. Pandey, \u0026ldquo;Behavioral risk factors for non-communicable disease among factory employees in Faridabad; Haryana,\u0026rdquo; \u003cem\u003eJ. Nepal Med. Assoc.\u003c/em\u003e, vol. 48, no. 175, pp. 203\u0026ndash;208, 2009, [Online]. 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Healthc.\u003c/em\u003e, vol. 10, no. 3, pp. 180\u0026ndash;187, 2017, doi: 10.1080/17538068.2017.1343173.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"BTL campaign, Quality of life, Campaign effectiveness, NCDs, Health behaviour","lastPublishedDoi":"10.21203/rs.3.rs-7012132/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7012132/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe prevalence of non-communicable diseases (NCDs) among industrial workers in Indonesia continues to rise due to occupational hazards, unhealthy lifestyles, and limited access to preventive healthcare services. Below-the-line (BTL) health campaigns, which utilise direct communication media such as posters and brochures, have been employed to promote healthy behaviours; however, their effectiveness in industrial settings remains underexplored.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e This study aimed to evaluate the effectiveness of BTL health campaigns in reducing NCD risks among industrial workers, focusing on campaign characteristics, message accessibility, and media content.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod:\u003c/strong\u003e A cross-sectional design was employed, surveying 1,200 industrial workers exposed to BTL campaigns at IHSP. Data were gathered through structured questionnaires and interviews, and path analysis using SmartPLS 3.0 was conducted to examine the relationships between campaign characteristics, accessibility, media content, and effectiveness.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e indicated that campaign characteristics significantly enhanced message accessibility (coefficient = 0.709, p \u0026lt; 0.001) and media content (coefficient = 0.741, p \u0026lt; 0.001), directly influencing campaign effectiveness (coefficient = 0.298, p = 0.005). Additionally, accessibility (coefficient = 0.287; p = 0.003) and relevant media content (coefficient = 0.216; p = 0.009) contributed to campaign success. All model paths showed strong statistical significance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIn conclusion\u003c/strong\u003e, BTL health campaigns effectively improve NCD-related health behaviours among industrial workers, particularly when tailored to audience characteristics and supported by accessible, relevant content. An evidence-based BTL strategy is crucial for optimising NCD prevention in industrial settings.\u003c/p\u003e","manuscriptTitle":"Effectiveness of Below-the-Line (BTL) Health Campaigns in Reducing Non-Communicable Diseases (NCDs) Among Industrial Workers: A Quasi-Experimental Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-11 14:25:27","doi":"10.21203/rs.3.rs-7012132/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6fc9d510-f2a5-46cd-828f-98d509400a13","owner":[],"postedDate":"July 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-10T06:08:44+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-11 14:25:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7012132","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7012132","identity":"rs-7012132","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}