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Effect of Blood Pressure Self-Monitoring Education on Blood Pressure Monitoring Practices among Women in Nigeria

Abstract

Hypertension is a major public health concern and an important risk factor for cardiovascular disease, stroke, kidney disease, and premature mortality. Women in Nigeria may experience difficulties with regular blood pressure monitoring because of limited awareness, inadequate access to healthcare facilities, financial constraints, busy schedules, low confidence in using blood pressure devices, and misconceptions about hypertension. Regular self-monitoring of blood pressure can support early identification of elevated blood pressure and provide useful information for healthcare decision-making, particularly among women who have hypertension or are at increased risk. However, effective self-monitoring requires appropriate knowledge of blood pressure measurement procedures, correct use of validated devices, appropriate measurement timing, accurate recording of readings, and understanding of when professional medical assessment is necessary. Blood pressure self-monitoring education may improve women's knowledge and confidence and encourage consistent monitoring practices. Against this background, this study investigates the effect of blood pressure self-monitoring education on blood pressure monitoring practices among women in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Self-Efficacy Theory. The Health Belief Model explains how women's perceptions of their susceptibility to hypertension and its complications, perceived severity, perceived benefits of self-monitoring, perceived barriers, and cues to action may influence monitoring practices. Social Cognitive Theory emphasizes observational learning, behavioural reinforcement, social support, environmental influences, and self-regulation in the adoption and maintenance of health behaviours. Self-Efficacy Theory emphasizes women's confidence in correctly using blood pressure-monitoring devices, interpreting readings appropriately, and maintaining regular monitoring behaviours. Collectively, these theoretical perspectives provide a suitable framework for explaining how self-monitoring education may influence blood pressure monitoring practices among women in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise women residing in selected urban and rural communities and attending primary healthcare centres, hospitals, women's health clinics, workplaces, community health programmes, and other relevant settings across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, and eligible women. Blood pressure self-monitoring education will be assessed using indicators such as exposure to structured education sessions, knowledge of blood pressure, training in correct device use, appropriate cuff placement, correct body positioning, recommended measurement frequency, timing of measurements, recording of readings, interpretation of results, device maintenance, and guidance on when to seek professional healthcare. Blood pressure monitoring practices will be assessed using indicators such as frequency of monitoring, correct measurement technique, consistency of monitoring, accurate recording of readings, appropriate use of validated devices, adherence to recommended monitoring schedules, and appropriate response to abnormal readings. Data will be collected using structured questionnaires, observation checklists, blood pressure monitoring logs, device-use assessments, and healthcare records where appropriate. Descriptive statistics will be used to summarize participants' characteristics, exposure to education, and patterns of blood pressure monitoring. 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 blood pressure self-monitoring education on monitoring practices. Where a quasi-experimental design is adopted, monitoring-practice scores before and after the educational intervention will be compared 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 blood pressure self-monitoring education has a significant positive effect on blood pressure monitoring practices among women in Nigeria. Women exposed to structured and practical self-monitoring education are expected to demonstrate improved knowledge of correct blood pressure measurement, greater confidence in using monitoring devices, more consistent monitoring, better recording of readings, and improved adherence to recommended monitoring schedules. Education may also help women recognize the importance of repeated measurements and encourage appropriate communication of abnormal readings to healthcare professionals rather than relying solely on symptoms. However, the cost and availability of validated blood pressure devices, inadequate digital or health literacy, limited access to professional guidance, incorrect device use, forgetfulness, and misconceptions about hypertension may limit the effectiveness of self-monitoring education. The study therefore expects accessible, practical, culturally appropriate, and continuously reinforced blood pressure self-monitoring education to contribute significantly to improved blood pressure monitoring practices among women in Nigeria. The study is expected to contribute to the literature on blood pressure self-monitoring education, blood pressure monitoring practices, hypertension prevention and management, women's cardiovascular health, self-care, health education, non-communicable 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, hospitals, primary healthcare centres, healthcare providers, community health workers, women's health organizations, development partners, and policymakers regarding strategies for improving blood pressure monitoring among women. The study will also provide evidence-based recommendations for integrating blood pressure self-monitoring education into hypertension and women's health programmes, improving access to validated blood pressure devices, training healthcare workers to teach correct measurement techniques, strengthening monitoring and follow-up systems, improving health literacy, and promoting appropriate self-care and timely healthcare-seeking among women across Nigeria.

Keywords: Blood pressure self-monitoring education, blood pressure monitoring practices, hypertension, women, self-care, cardiovascular health, hypertension management, health education, blood pressure monitoring, non-communicable disease prevention, Nigeria, public health.