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This thesis presents proposal design and data exercise of reliability on the questionnaire. The questionnaire will be used as a tool to assess the effectiveness of the program, and has developed based on literature reviews and recommendations of health promotion staff and health education experts. Reliability test was conducted as data exercise by using internal consistency method. In addition, the reliability coefficient was tested. The results of the reliability coefficient on the perception of severity and vulnerability of hypertension complications, self-efficacy, and response efficacy of preventive behavior were 0.61, 0.67, 0.88, and 0.88 respectively. The overall reliability of those variables was 0.89, which was more than 0.7 and is acceptable for the purposes of this study.