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Effect of Hypertension Screening Education on Blood Pressure Screening Uptake among Adults in Nigeria

Abstract

Hypertension is a major public health problem and an important risk factor for cardiovascular diseases, stroke, kidney disease, and premature death in Nigeria. Because hypertension may occur without obvious symptoms, regular blood pressure screening is essential for early detection, diagnosis, and appropriate management. Hypertension screening education provides adults with information about hypertension, its risk factors, possible complications, the importance of regular blood pressure measurement, appropriate screening intervals, and the need to seek professional healthcare when elevated blood pressure is detected. Blood pressure screening uptake refers to the utilization of blood pressure measurement and screening services by adults, particularly those who may be at increased risk of hypertension. In Nigeria, inadequate awareness, misconceptions about hypertension, low perceived risk among asymptomatic individuals, limited knowledge of screening services, financial constraints, and inadequate access to healthcare facilities may contribute to low screening uptake. Effective hypertension screening education may improve knowledge, perceived susceptibility, awareness of the consequences of undiagnosed hypertension, and willingness to participate in regular blood pressure screening. Against this background, this study investigates the effect of hypertension screening education on blood pressure screening uptake among adults in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding adults' decisions to participate in blood pressure screening. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, behavioural capabilities, social influences, and environmental conditions in shaping preventive health behaviours. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from hypertension screening education may influence blood pressure screening practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how hypertension screening education may influence blood pressure screening uptake among adults in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from adults in selected communities, workplaces, primary healthcare facilities, and other appropriate community settings in Nigeria using a structured interviewer-administered questionnaire and standardized blood pressure measurement procedures. A multistage sampling technique will be employed to select states, local government areas, communities, facilities, and eligible participants. Where feasible, selected communities or participant groups will be assigned to intervention and comparison groups. Participants in the intervention group will receive structured hypertension screening education covering the meaning and risk factors of hypertension, common misconceptions, potential complications, the importance of regular blood pressure screening, appropriate screening procedures, interpretation of screening results, lifestyle-related risk reduction, and the importance of seeking professional healthcare following elevated readings. Blood pressure screening uptake will be assessed using indicators such as previous history of blood pressure measurement, frequency of screening, recent participation in blood pressure screening, willingness to undergo screening, and completion of recommended follow-up screening where applicable. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, hypertension knowledge, exposure to screening education, and blood pressure screening uptake. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple logistic regression analysis, will be used to determine the effect of hypertension screening education on blood pressure screening uptake. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that hypertension screening education has a significant positive effect on blood pressure screening uptake among adults in Nigeria. Adults exposed to structured hypertension screening education are expected to demonstrate improved knowledge of hypertension, greater awareness of their risk, increased perception of the importance of early detection, and greater utilization of blood pressure screening services. Education may also encourage adults who have previously considered themselves healthy because they have no symptoms to participate more regularly in blood pressure screening. However, education alone may not guarantee sustained screening uptake because adults may continue to face barriers such as limited access to healthcare facilities, financial constraints, transportation difficulties, low availability of screening services, competing daily responsibilities, and inadequate follow-up systems. Consequently, hypertension screening education is expected to be most effective when supported by accessible, affordable, routine, and community-based blood pressure screening services and appropriate referral systems. The study is expected to contribute to the literature on hypertension prevention, non-communicable disease control, health education, screening, early detection, health promotion, and public health in Nigeria by providing empirical evidence on the effect of hypertension screening education on blood pressure screening uptake among adults. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), state ministries of health, primary healthcare facilities, hospitals, community health workers, public health practitioners, non-communicable disease programmes, development partners, and policymakers regarding strategies for improving early detection of hypertension. The study will also provide evidence-based recommendations for strengthening community-based hypertension education, integrating blood pressure screening into routine healthcare and outreach services, increasing access to affordable screening, improving referral and follow-up systems, and promoting regular blood pressure screening among adults across Nigeria.

Keywords: Hypertension screening education, blood pressure screening uptake, hypertension, adults, early detection, blood pressure measurement, non-communicable diseases, health education, screening practices, health promotion, public health, Nigeria.