Increased disaster risk in Indonesia requires strengthening public health preparedness, especially in vulnerable areas such as Padang Panjang. This study aims to analyze the effectiveness of community-based health education on health disaster preparedness behavior in Padang Panjang in 2025 and to examine the mediating role of knowledge, attitude, and self-efficacy. The study used a non-equivalent control group quasi-experimental design with a pre-test and post-test approach. A total of 120 adult respondents were divided into an intervention group (n=60) and a control group (n=60). The intervention was carried out for one month through participatory counseling, group discussions, and preparedness simulations. Data were collected using a structured questionnaire and analyzed using paired t-tests, independent t-tests, and multiple linear regression. The results show a significant increase in knowledge, attitude, self-efficacy, and preparedness behavior in the intervention group (p<0.001), with the largest increase in preparedness behavior (Δ=17.5). There were no significant changes in the control group (p>0.05). Regression analysis showed that knowledge (β=0.32), attitude (β=0.28), and self-efficacy (β=0.41) had a significant effect on preparedness behavior (R²=0.64), with self-efficacy as the dominant predictor. These findings confirm that community-based health education is effective in improving health preparedness by strengthening psychosocial determinants, particularly self-efficacy. The integration of participatory approaches into disaster risk reduction policies is recommended to strengthen sustainable community health resilience in disaster-prone areas.