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Effect of Health Scam Awareness Education on Recognition of Fraudulent Health Services among Adults in Nigeria

Abstract

Fraudulent health services and health-related scams are emerging consumer and public health concerns because individuals may be exposed to deceptive medical claims, unlicensed health providers, fake treatment programmes, fraudulent online consultations, misleading health products, and other schemes that may result in financial loss, delayed appropriate treatment, harmful health practices, and loss of trust in legitimate healthcare services. Adults in Nigeria may be particularly vulnerable to health scams because of limited health literacy, inadequate knowledge of legitimate healthcare services, financial pressures, reliance on social media and informal sources of health information, and difficulty distinguishing genuine healthcare providers from fraudulent services. Health scam awareness education provides an opportunity to improve adults' knowledge of common health scams and strengthen their ability to recognize potentially fraudulent health services. Against this background, this study investigates the effect of health scam awareness education on recognition of fraudulent health services among adults in Nigeria. The study will be anchored on the Health Belief Model, Protection Motivation Theory, and Health Literacy Theory. The Health Belief Model explains how adults' perceptions of susceptibility to health scams, perceived severity of potential financial and health consequences, perceived benefits of verifying healthcare services, perceived barriers, and cues to action may influence scam-recognition practices. Protection Motivation Theory explains how perceived threats associated with fraudulent healthcare services, response efficacy, response costs, and self-efficacy may influence individuals' motivation to protect themselves from health scams. Health Literacy Theory emphasizes the ability of adults to obtain, understand, evaluate, and appropriately use health information when making healthcare decisions. Collectively, these theoretical perspectives provide a suitable framework for explaining how health scam awareness education may influence recognition of fraudulent health services among adults 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 urban, semi-urban, and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, and eligible adults. Health scam awareness education will be assessed using indicators such as exposure to health scam education sessions, frequency and duration of education, knowledge of common health scams, awareness of fake medical practitioners, knowledge of fraudulent online health services, awareness of deceptive health-product advertisements, knowledge of common scam techniques, awareness of unrealistic treatment claims, understanding of healthcare provider verification, knowledge of legitimate health facility identification, awareness of fraudulent payment requests, knowledge of suspicious health-service communication, and understanding of appropriate reporting channels. Recognition of fraudulent health services will be assessed using indicators such as ability to identify unlicensed providers, recognition of unrealistic health claims, identification of suspicious treatment promises, recognition of fraudulent online consultation platforms, identification of misleading advertisements, ability to distinguish legitimate from suspicious healthcare services, verification of healthcare-provider credentials, verification of health-facility information, recognition of suspicious payment requests, and appropriate decisions when presented with potentially fraudulent health services. Data will be collected using structured questionnaires, health scam knowledge assessment tools, scenario-based recognition tests, health-service verification instruments, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize participants' demographic and socioeconomic characteristics, healthcare-seeking patterns, sources of health information, exposure to health scam education, and ability to recognize fraudulent services. 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 health scam awareness education on recognition of fraudulent health services. Where a quasi-experimental design is adopted, recognition 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 scam awareness education has a significant positive effect on recognition of fraudulent health services among adults in Nigeria. Adults exposed to structured and practical health scam education are expected to demonstrate greater ability to identify suspicious healthcare providers, unrealistic treatment claims, fraudulent online services, misleading advertisements, and suspicious payment requests than adults without comparable exposure. Education may improve participants' ability to verify healthcare-provider credentials, check the legitimacy of health facilities, critically evaluate health claims, recognize pressure or urgency tactics, and seek information from reliable healthcare authorities before making healthcare decisions. Scenario-based exercises using realistic examples of fraudulent health services may further strengthen participants' recognition skills and confidence. However, low health literacy, limited access to reliable verification information, financial desperation, trust in informal providers, social media exposure, sophisticated scam techniques, and limited awareness of reporting mechanisms may reduce the effectiveness of education alone. The study therefore expects continuous, practical, accessible, and culturally appropriate health scam awareness education, supported by stronger healthcare regulation and accessible verification systems, to contribute significantly to improved recognition of fraudulent health services among adults in Nigeria. The study is expected to contribute to the literature on health scams, healthcare fraud prevention, health literacy, consumer protection, health-service verification, digital health safety, healthcare-seeking behaviour, health education, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Agency for Food and Drug Administration and Control, Medical and Dental Council of Nigeria, Nursing and Midwifery Council of Nigeria, Pharmacists Council of Nigeria, relevant regulatory authorities, healthcare institutions, consumer-protection organizations, public health practitioners, community health workers, development partners, and policymakers regarding strategies for protecting adults from fraudulent health services. The study will also provide evidence-based recommendations for strengthening public education on health scams, improving awareness of healthcare-provider verification, promoting critical evaluation of health claims, strengthening reporting mechanisms, improving regulation of online health services and health-related advertising, and developing sustainable consumer health-protection programmes across Nigeria.

Keywords: Health scam awareness education, fraudulent health services, health scam recognition, adults, healthcare fraud, health literacy, consumer protection, health-service verification, health education, Nigeria, public health.