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Effect of Health Education on Awareness of Stroke Warning Signs among Adults in Nigeria

Abstract

Stroke is a major public health concern that can result in long-term disability, reduced quality of life, and death, particularly when appropriate medical care is delayed. Early recognition of stroke warning signs and prompt access to emergency healthcare are essential for reducing the risk of severe complications. However, many adults may have limited knowledge of common stroke warning signs and may misinterpret early symptoms or delay seeking professional medical attention. Health education provides an opportunity to improve public knowledge about stroke symptoms, risk factors, prevention, emergency response, and the importance of seeking immediate medical care. Against this background, this study investigates the effect of health education on awareness of stroke warning signs among adults in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Health Literacy Framework. The Health Belief Model explains how adults' perceptions of susceptibility to stroke, perceived severity, perceived benefits of recognizing warning signs, perceived barriers, and cues to action may influence their awareness and intended response to stroke symptoms. Social Cognitive Theory emphasizes observational learning, self-efficacy, social influence, and reinforcement in the development of appropriate health-related behaviours. The Health Literacy Framework emphasizes individuals' ability to access, understand, appraise, and apply health information to make appropriate health decisions. Collectively, these theoretical perspectives provide a suitable framework for explaining how health education may influence awareness of stroke warning signs 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 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 education will be assessed using indicators such as exposure to structured stroke education, frequency and duration of educational sessions, information on stroke risk factors, recognition of common warning signs, emergency response, importance of immediate medical attention, prevention strategies, and availability of educational materials. Awareness of stroke warning signs will be assessed using indicators such as recognition of sudden facial weakness or drooping, weakness or numbness of an arm or leg, speech or language difficulties, sudden visual disturbances, sudden severe headache, dizziness or loss of balance, confusion, and the need for immediate emergency medical attention. Participants may also be assessed on their ability to identify stroke symptoms from standardized clinical scenarios or illustrations. Data will be collected using structured questionnaires, validated stroke knowledge or awareness instruments, health education attendance records, and relevant community health programme documents. Descriptive statistics will be used to summarize participants' demographic characteristics, exposure to health education, and levels of stroke awareness. 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 education on awareness of stroke warning signs. Where a quasi-experimental design is adopted, awareness scores before and after the health education intervention may be compared to determine changes associated with the programme. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that health education has a significant positive effect on awareness of stroke warning signs among adults in Nigeria. Adults exposed to structured and understandable stroke health education are expected to demonstrate greater ability to recognize common warning signs and understand the importance of seeking immediate medical attention than adults without similar exposure. Health education may correct misconceptions about stroke, improve recognition of symptoms, increase awareness of modifiable risk factors, and strengthen knowledge of appropriate emergency responses. Practical demonstrations, visual materials, community campaigns, and repeated health messages may further improve retention and recognition of warning signs. However, low health literacy, cultural beliefs, misinformation, limited exposure to healthcare information, language barriers, and inadequate access to health education programmes may continue to affect awareness levels. The study therefore expects accessible, culturally appropriate, evidence-based, and repeated health education to contribute significantly to improved awareness of stroke warning signs among adults in Nigeria. The study is expected to contribute to the literature on stroke health education, stroke warning-sign awareness, stroke prevention, health literacy, emergency healthcare-seeking, non-communicable disease prevention, community health education, 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, hospitals, primary healthcare centres, healthcare professionals, community health workers, stroke organizations, public health educators, development partners, and policymakers regarding strategies for improving public awareness of stroke. The study will also provide evidence-based recommendations for integrating stroke education into routine primary healthcare and community health programmes, developing culturally appropriate educational materials, improving public recognition of stroke warning signs, promoting rapid emergency response, and strengthening community-based stroke prevention and awareness programmes across Nigeria.

Keywords: Health education, stroke warning signs, stroke awareness, adults, stroke prevention, health literacy, emergency healthcare-seeking, non-communicable diseases, community health education, Nigeria, public health.