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Effect of Health Education on Knowledge of Blood Pressure Self-Monitoring among University Students in Nigeria

Abstract

Blood pressure monitoring is an important component of cardiovascular health promotion and early identification of abnormal blood pressure among young adults. Although hypertension is commonly associated with older populations, elevated blood pressure may also occur among university students because of factors such as unhealthy dietary practices, physical inactivity, obesity, stress, tobacco use, alcohol consumption, and other lifestyle behaviours. Limited knowledge of blood pressure measurement, appropriate use of monitoring devices, preparation before measurement, interpretation of readings, and appropriate responses to abnormal results may reduce students' ability to participate effectively in blood pressure self-monitoring. Health education provides an opportunity to improve students' understanding of blood pressure self-monitoring and promote informed preventive health practices. Against this background, this study investigates the effect of health education on knowledge of blood pressure self-monitoring among university students in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Self-Efficacy Theory. The Health Belief Model explains how students' perceptions of susceptibility to hypertension, perceived severity, perceived benefits of blood pressure monitoring, perceived barriers, and cues to action may influence their knowledge and willingness to engage in self-monitoring. Social Cognitive Theory emphasizes observational learning, behavioural modelling, reinforcement, environmental influences, and social support in shaping health-related knowledge and behaviours. Self-Efficacy Theory emphasizes individuals' confidence in their ability to correctly perform health-related tasks, including preparing for blood pressure measurement, operating monitoring devices, recording readings, and seeking appropriate assistance when necessary. Collectively, these theoretical perspectives provide a suitable framework for explaining how health education may influence knowledge of blood pressure self-monitoring among university students in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise undergraduate and postgraduate students aged 18 years and above enrolled in selected public and private universities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, universities, faculties or departments, levels of study, and eligible students. Health education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, information on blood pressure and hypertension, recommended conditions for measurement, appropriate body positioning, rest before measurement, correct cuff placement, appropriate use of automated blood pressure monitors, frequency of monitoring, recording of readings, interpretation of results, factors that may temporarily influence blood pressure, recognition of abnormal readings, and appropriate healthcare-seeking following concerning results. Knowledge of blood pressure self-monitoring will be assessed using indicators such as students' understanding of the purpose of self-monitoring, preparation before measurement, correct positioning, appropriate cuff placement, device operation, measurement procedures, repeated measurements where appropriate, recording and interpretation of readings, recognition of unusually high or low readings, understanding of measurement errors, and knowledge of when professional medical assessment should be sought. Data will be collected using structured questionnaires, standardized blood pressure self-monitoring knowledge assessment tools, scenario-based questions, practical demonstrations, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize students' demographic and academic characteristics, previous exposure to blood pressure information, sources of health information, awareness of hypertension, experience with blood pressure measurement, and knowledge levels. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of health education on knowledge of blood pressure self-monitoring. Where a quasi-experimental design is adopted, knowledge scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that health education has a significant positive effect on knowledge of blood pressure self-monitoring among university students in Nigeria. Students exposed to structured, practical, and sustained health education are expected to demonstrate greater knowledge of correct blood pressure self-monitoring procedures than students without comparable exposure. Education may improve students' understanding of appropriate preparation, body positioning, cuff placement, device operation, measurement frequency, recording of readings, and interpretation of results. Practical demonstrations may increase students' confidence in using automated blood pressure monitors correctly and recognizing circumstances that may produce inaccurate readings. Education may also improve awareness of the importance of seeking professional medical assessment when persistently abnormal readings are identified rather than relying solely on self-monitoring. However, limited access to validated blood pressure monitors, misconceptions about hypertension, low perceived susceptibility among young adults, inadequate health information, cost of monitoring devices, and limited access to healthcare professionals may reduce the effectiveness of education alone. The study therefore expects accessible, practical, evidence-based, and sustained health education, supported by appropriate monitoring equipment and reliable healthcare guidance, to contribute significantly to improved knowledge of blood pressure self-monitoring among university students in Nigeria. The study is expected to contribute to the literature on blood pressure self-monitoring, hypertension prevention, cardiovascular health education, university student health, health promotion, preventive healthcare, non-communicable disease prevention, self-care practices, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Primary Health Care Development Agency, universities, university health centres, healthcare professionals, public health practitioners, student health organizations, development partners, and policymakers regarding strategies for strengthening cardiovascular health awareness among young adults. The study will also provide evidence-based recommendations for integrating blood pressure self-monitoring education into university health programmes, improving access to validated monitoring devices, strengthening practical health education, increasing awareness of hypertension risk among young adults, promoting appropriate interpretation of blood pressure readings, and encouraging timely healthcare-seeking among university students across Nigeria.

Keywords: Health education, blood pressure self-monitoring, knowledge, university students, hypertension prevention, blood pressure monitoring, cardiovascular health, self-care, health promotion, Nigeria, public health.a