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Effect of Community Health Walks on Participation in Preventive Health Activities among Adults in Rural Nigeria

Abstract

Participation in preventive health activities is essential for reducing the burden of preventable diseases, promoting healthy lifestyles, supporting early detection of health conditions, and improving overall population health. Adults living in rural communities in Nigeria may have limited participation in preventive health activities because of inadequate health awareness, limited access to healthcare facilities, financial constraints, geographical barriers, cultural beliefs, and competing household or occupational responsibilities. Community health walks provide an opportunity to combine physical activity, health education, community mobilization, and promotion of preventive healthcare services within the community. Through organized walks, health workers and community leaders can engage residents, disseminate health information, promote healthy lifestyles, and encourage participation in screening, immunization, health education, sanitation, and other preventive activities. Against this background, this study investigates the effect of community health walks on participation in preventive health activities among adults in rural Nigeria. The study will be anchored on the Social Ecological Model, Social Cognitive Theory, and Health Belief Model. The Social Ecological Model emphasizes the influence of individual, interpersonal, community, organizational, and environmental factors on participation in preventive health activities. Social Cognitive Theory explains how observational learning, social interaction, modelling, reinforcement, and self-efficacy may influence participation in health-promoting activities. The Health Belief Model explains how perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action may influence individuals' decisions to engage in preventive health activities. Collectively, these theoretical perspectives provide a suitable framework for explaining how community health walks may influence participation in preventive health activities among adults in rural 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 walks will be assessed using indicators such as frequency of walks, duration, distance covered, attendance, community mobilization, participation of healthcare workers, health education activities conducted during the walks, distribution of health information materials, use of local languages, promotion of preventive services, and referral information provided. Participation in preventive health activities will be assessed using indicators such as attendance at health screening programmes, blood pressure and blood glucose checks, immunization activities where applicable, health education sessions, family planning services, infectious disease prevention activities, sanitation programmes, healthy lifestyle activities, cancer screening where appropriate, and participation in other community-based preventive health programmes. Data will be collected using structured questionnaires, preventive-health participation assessment tools, community health walk attendance registers, health education records, screening registers, referral records, and relevant community health programme documents. Descriptive statistics will be used to summarize participants' characteristics, exposure to community health walks, and patterns of preventive health participation. 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 walks on participation in preventive health activities. Where a quasi-experimental design is adopted, participation levels before and after implementation of community health walks 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 walks have a significant positive effect on participation in preventive health activities among adults in rural Nigeria. Adults who participate in organized community health walks are expected to demonstrate greater participation in preventive health activities than adults without comparable exposure. The combination of physical activity, health education, social interaction, and community mobilization may increase awareness of preventive healthcare and motivate residents to participate in available services. Community health walks may also create opportunities for health workers to identify individuals who require further screening, counselling, or referral. The involvement of community leaders, local organizations, and respected community members may further strengthen participation and community ownership. However, poor weather conditions, inadequate mobilization, safety concerns, limited healthcare personnel, lack of screening equipment, physical limitations among participants, cultural barriers, and inconsistent organization of health walks may reduce their effectiveness. The study therefore expects regular, inclusive, well-organized, and community-supported health walks to contribute significantly to improved participation in preventive health activities among rural adults in Nigeria. The study is expected to contribute to the literature on community health walks, preventive health participation, physical activity promotion, community mobilization, health education, health promotion, rural healthcare, 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, state ministries of health, local government health authorities, primary healthcare centres, community health workers, community leaders, development partners, and policymakers regarding strategies for increasing community participation in preventive healthcare. The study will also provide evidence-based recommendations for incorporating health walks into community health programmes, strengthening community mobilization, integrating health education and screening activities into health walks, ensuring participant safety, involving local leaders and organizations, and establishing referral and follow-up systems for residents identified with health risks across rural Nigeria.

Keywords: Community health walks, preventive health activities, community participation, rural adults, health promotion, physical activity, health education, disease prevention, community mobilization, preventive healthcare, Nigeria, public health.