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Impact of Sickle Cell Trait Education on Sickle Cell Screening Practices among University Students in Nigeria

Abstract

Sickle cell trait is an important genetic health issue in Nigeria because individuals who carry the sickle cell trait may be unaware of their carrier status and may not understand its implications for reproductive and family health. University students represent an important population for sickle cell education and screening because many are young adults who may be making decisions about relationships, marriage, and future childbearing. Limited knowledge of sickle cell inheritance, carrier status, screening procedures, and the importance of knowing one's genotype may contribute to low utilization of sickle cell screening services. Sickle cell trait education provides an opportunity to improve students' understanding of inheritance, genotype status, screening procedures, and the importance of informed reproductive health decisions. Against this background, this study investigates the impact of sickle cell trait education on sickle cell screening practices among university students in Nigeria. The study will be anchored on the Health Belief Model, Theory of Planned Behavior, and Social Cognitive Theory. The Health Belief Model explains how students' perceptions of susceptibility to sickle cell conditions, perceived severity, perceived benefits of screening, perceived barriers, self-efficacy, and cues to action may influence screening practices. The Theory of Planned Behavior emphasizes attitudes toward sickle cell screening, subjective norms, perceived behavioural control, and behavioural intentions as determinants of screening behaviour. Social Cognitive Theory emphasizes observational learning, self-efficacy, peer influence, social support, reinforcement, and environmental factors in shaping health behaviours. Collectively, these theoretical perspectives provide a suitable framework for explaining how sickle cell trait education may influence sickle cell screening practices 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. Sickle cell trait education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, information on sickle cell inheritance, genotype and carrier status, sickle cell screening procedures, interpretation of screening results, benefits of knowing one's genotype, misconceptions about sickle cell trait, reproductive implications, availability of screening services, confidentiality, and appropriate sources of genetic-health information. Sickle cell screening practices will be assessed using indicators such as previous genotype screening, willingness to undergo screening, uptake of screening services following education, confirmation of genotype status where appropriate, knowledge of personal genotype, use of recognized healthcare facilities or laboratories, retention of screening results, intention to repeat testing where clinically indicated, and willingness to encourage eligible peers to obtain appropriate screening. Data will be collected using structured questionnaires, standardized sickle cell knowledge and screening-practice assessment tools, scenario-based questions, screening records where available and ethically accessible, 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 screening experiences, sources of sickle cell information, education exposure, knowledge, attitudes, and screening practices. 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 impact of sickle cell trait education on sickle cell screening practices. Where a quasi-experimental design is adopted, screening-practice scores or screening uptake 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 sickle cell trait education has a significant positive impact on sickle cell screening practices among university students in Nigeria. Students exposed to structured, accurate, culturally sensitive, and sustained sickle cell trait education are expected to demonstrate greater knowledge of sickle cell inheritance and a higher likelihood of participating in appropriate screening than students without comparable exposure. Education may improve students' understanding of carrier status, the importance of knowing one's genotype, and the role of screening in informed reproductive and family-health decisions. Practical information about where and how to access reliable screening services may reduce perceived barriers and encourage students to obtain screening. Education may also correct misconceptions and reduce stigma associated with sickle cell conditions. However, financial barriers, limited access to reliable screening services, fear of test results, misinformation, stigma, cultural beliefs, and concerns about relationship or marriage implications may reduce the effectiveness of education alone. The study therefore expects accessible, accurate, non-stigmatizing, and sustained sickle cell trait education, supported by affordable and confidential screening services, to contribute significantly to improved sickle cell screening practices among university students in Nigeria. The study is expected to contribute to the literature on sickle cell trait, sickle cell screening, genetic-health education, genotype awareness, university student health, reproductive health, genetic counselling, health literacy, disease prevention, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, universities, university health centres, medical laboratories, genetic counselling services, healthcare professionals, student organizations, sickle cell advocacy organizations, public health practitioners, development partners, and policymakers regarding strategies for strengthening sickle cell screening among young adults. The study will also provide evidence-based recommendations for integrating sickle cell trait education into university health programmes, improving access to affordable and confidential screening services, strengthening genetic-health literacy, addressing misconceptions and stigma, promoting informed knowledge of genotype status, and developing sustainable university-based interventions that encourage appropriate sickle cell screening practices among students across Nigeria.

Keywords: Sickle cell trait education, sickle cell screening practices, university students, sickle cell trait, genotype screening, genetic-health education, genotype awareness, genetic counselling, reproductive health, health education, Nigeria, public health.