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Effect of Diabetes Awareness on Diabetes Screening Uptake among Adults in Nigeria

Abstract

Diabetes mellitus is a major public health concern and an important contributor to morbidity, premature mortality, and healthcare expenditure worldwide. The condition is associated with serious complications affecting the cardiovascular system, kidneys, eyes, nerves, and other organs, particularly when it remains undiagnosed or poorly controlled. Early identification of diabetes through appropriate screening can provide an opportunity for timely diagnosis, lifestyle modification, clinical management, and prevention of complications. Diabetes awareness refers to an individual's knowledge and understanding of diabetes risk factors, signs and symptoms, complications, prevention, treatment, and the importance of regular screening. Diabetes screening uptake refers to the extent to which eligible individuals participate in blood glucose testing or other recommended procedures for identifying possible diabetes or elevated blood glucose levels. In Nigeria, a substantial proportion of adults may remain unaware of their diabetes status, while factors such as inadequate health information, low perceived risk, financial constraints, limited access to healthcare facilities, fear of diagnosis, and misconceptions about diabetes may discourage participation in screening. Improving diabetes awareness may increase individuals' understanding of their susceptibility to the disease and the benefits of early detection and may consequently encourage utilization of screening services. Against this background, this study investigates the effect of diabetes awareness on diabetes screening uptake among adults in Nigeria. The study is anchored on the Health Belief Model (HBM), Andersen's Behavioral Model of Health Services Use, and the Knowledge-Attitude-Practice (KAP) framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding how diabetes awareness may influence screening behaviour. Andersen's Behavioral Model explains healthcare utilization through predisposing, enabling, and need-related factors and provides a framework for examining how awareness, access, affordability, and perceived need influence screening uptake. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge of diabetes may influence attitudes toward screening and subsequent participation in preventive health services. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how diabetes awareness may influence diabetes screening uptake among adults in Nigeria. The study adopts a quantitative cross-sectional research design. Primary data will be collected from adults aged 18 years and above in selected communities and healthcare facilities in Nigeria using a structured interviewer-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible participants. Diabetes awareness will be measured using knowledge of diabetes risk factors, common signs and symptoms, complications, prevention, treatment, risk groups, and the importance of early detection and regular screening. Diabetes screening uptake will be assessed based on participants' history of blood glucose testing, frequency of screening, location of screening, previous screening results, and willingness to undergo recommended screening. Where feasible and ethically appropriate, blood glucose measurements may be obtained using standardized procedures and appropriate referral provided for participants with abnormal results. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, levels of diabetes awareness, and screening patterns. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple logistic regression analysis, will be employed to determine the effect of diabetes awareness on diabetes screening uptake. Appropriate diagnostic tests will also be conducted to assess multicollinearity, model specification, goodness of fit, and the robustness of the findings. The study anticipates that diabetes awareness will have a significant positive effect on diabetes screening uptake among adults in Nigeria. Adults with higher levels of awareness are expected to demonstrate greater understanding of diabetes risk factors, symptoms, complications, and the importance of early detection and consequently show a higher likelihood of participating in diabetes screening. Increased awareness may also correct misconceptions, improve perceived susceptibility, and encourage individuals who consider themselves apparently healthy to undergo routine blood glucose testing. However, awareness alone may not guarantee screening uptake because adults may continue to experience barriers such as cost of screening, limited availability of screening services, distance to healthcare facilities, long waiting times, fear of receiving a diabetes diagnosis, and low perceived personal risk. Consequently, diabetes awareness programmes are expected to be more effective when combined with accessible, affordable, convenient, and appropriately linked screening services. This study is expected to contribute to the literature on diabetes prevention, health education, screening behaviour, non-communicable disease prevention, and public health in Nigeria by providing empirical evidence on the relationship between diabetes awareness and screening uptake among adults. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), state ministries of health, primary healthcare facilities, hospitals, community health workers, public health practitioners, diabetes associations, development partners, and policymakers regarding strategies for improving early detection of diabetes. The study will also provide evidence-based recommendations for strengthening diabetes health education, increasing community awareness, integrating diabetes screening into primary healthcare services, improving access to affordable screening, encouraging routine blood glucose testing among at-risk adults, and strengthening referral and follow-up systems for individuals with abnormal screening results.

Keywords: Diabetes awareness, diabetes screening, screening uptake, diabetes mellitus, adults, blood glucose screening, health education, early detection, non-communicable diseases, public health, Nigeria.