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Effect of Community Health Storytelling Sessions on Knowledge of Healthy Behaviours among Rural Residents in Nigeria

Abstract

Knowledge of healthy behaviours is essential for preventing disease, promoting healthy lifestyles, and improving overall health outcomes among rural populations. Rural residents in Nigeria may have limited access to formal health education and may be influenced by cultural beliefs, traditional practices, misinformation, low health literacy, and limited interaction with healthcare professionals. Community health storytelling sessions provide a culturally relevant and interactive approach to health education by using relatable stories, local experiences, characters, and practical examples to communicate health messages. Storytelling can be used to address healthy eating, physical activity, personal hygiene, sanitation, disease prevention, responsible healthcare-seeking, medication adherence, mental wellbeing, and other health-promoting behaviours. Against this background, this study investigates the effect of community health storytelling sessions on knowledge of healthy behaviours among rural residents in Nigeria. The study will be anchored on Social Cognitive Theory, the Health Belief Model, and the Health Literacy Framework. Social Cognitive Theory explains how individuals may acquire knowledge and behaviours through observation, modelling, social interaction, and perceived self-efficacy. The Health Belief Model explains how perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action may influence residents' understanding and adoption of healthy behaviours. The Health Literacy Framework emphasizes residents' ability to access, understand, evaluate, and apply health information to make appropriate health decisions. Collectively, these theoretical perspectives provide a suitable framework for explaining how community health storytelling may influence knowledge of healthy behaviours among rural residents in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise adults aged 18 years and above residing in selected rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, rural communities, households, and eligible participants. Community health storytelling sessions will be assessed using indicators such as frequency of sessions, duration, attendance, storytelling format, relevance of stories to community health concerns, use of local languages, cultural appropriateness, involvement of trained health educators or community health workers, audience participation, opportunities for questions and discussion, use of visual or audio materials, and follow-up activities. Knowledge of healthy behaviours will be assessed using indicators such as knowledge of healthy nutrition, physical activity, personal hygiene, sanitation, adequate sleep, tobacco avoidance, responsible alcohol use, stress management, preventive healthcare utilization, appropriate medication practices, disease prevention, and timely healthcare-seeking. Data will be collected using structured questionnaires, interviewer-administered health-knowledge assessment tools, storytelling attendance registers, facilitator records, educational materials, and relevant community health programme documents. Descriptive statistics will be used to summarize participants' characteristics, exposure to storytelling sessions, and healthy-behaviour knowledge scores. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of community health storytelling sessions on knowledge of healthy behaviours. Where a quasi-experimental design is adopted, knowledge scores before and after participation in storytelling sessions may be compared with those of a comparison community 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 community health storytelling sessions have a significant positive effect on knowledge of healthy behaviours among rural residents in Nigeria. Residents exposed to regular and culturally appropriate storytelling sessions are expected to demonstrate greater knowledge of healthy lifestyle practices than residents without comparable exposure. Stories may make health information easier to understand and remember by presenting abstract health concepts through familiar situations, characters, experiences, and practical examples. The use of local languages and culturally recognizable settings may further improve comprehension and encourage participation. Interactive storytelling may also provide opportunities for residents to discuss personal experiences, ask questions, challenge misconceptions, and learn from the experiences of others. However, limited availability of trained storytellers or health educators, cultural misconceptions, inaccurate health messages, low attendance, language diversity, limited educational resources, and inconsistent organization of storytelling sessions may reduce effectiveness. The study therefore expects regular, accurate, culturally appropriate, and participatory community health storytelling sessions to contribute significantly to improved knowledge of healthy behaviours among rural residents in Nigeria. The study is expected to contribute to the literature on storytelling-based health education, community health communication, health literacy, healthy behaviours, health promotion, rural health education, community participation, 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, state ministries of health, local government health authorities, primary healthcare centres, community health workers, health educators, traditional and community leaders, development partners, and policymakers regarding culturally appropriate approaches to health education. The study will also provide evidence-based recommendations for incorporating storytelling into community health programmes, training health educators and community facilitators in effective health storytelling, using local languages and culturally relevant narratives, ensuring accuracy of health messages, encouraging community participation, and integrating storytelling with other health education and primary healthcare interventions across rural Nigeria.

Keywords: Community health storytelling, healthy behaviours, health knowledge, rural residents, health education, health literacy, health promotion, community participation, disease prevention, healthy lifestyle, Nigeria, public health.