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Effect of Community-Based Blood Pressure Kiosks on Blood Pressure Screening Uptake among Adults in Nigeria

Abstract

Hypertension is a major public health concern among adults in Nigeria and is an important risk factor for cardiovascular disease, stroke, kidney disease, and premature mortality. Because hypertension may develop without obvious symptoms, regular blood pressure screening is essential for identifying individuals with elevated blood pressure and facilitating appropriate clinical evaluation. However, utilization of blood pressure screening services may be limited by low awareness, financial constraints, long waiting times, geographical barriers, limited access to healthcare facilities, and inadequate opportunities for routine screening. Community-based blood pressure kiosks may provide a convenient and accessible approach to increasing opportunities for adults to check their blood pressure within community settings. Against this background, this study investigates the effect of community-based blood pressure kiosks on blood pressure screening uptake among adults in Nigeria. The study will be anchored on the Health Belief Model, Andersen's Behavioral Model of Health Services Use, and the Social Ecological Model. The Health Belief Model explains how adults' perceptions of their susceptibility to hypertension, perceived severity, perceived benefits of blood pressure screening, perceived barriers, and cues to action may influence screening uptake. Andersen's Behavioral Model explains healthcare utilization through predisposing characteristics, enabling resources, and perceived or evaluated health needs. The Social Ecological Model emphasizes the influence of individual, interpersonal, community, environmental, and healthcare-system factors on preventive healthcare utilization. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based blood pressure kiosks may influence blood pressure screening uptake 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, and eligible participants. Community-based blood pressure kiosks will be assessed using indicators such as availability of kiosks, geographical accessibility, operating hours, frequency of use, availability and functionality of blood pressure devices, presence of trained personnel where applicable, user guidance, privacy, screening cost or affordability, recording systems, health education, referral arrangements, and follow-up mechanisms. Blood pressure screening uptake will be assessed using indicators such as the proportion of eligible adults who use the kiosks, frequency of blood pressure checks, repeat screening, completion of recommended screening, acceptance of blood pressure assessment, identification of elevated readings, and referral to appropriate healthcare facilities when indicated. Data will be collected using structured questionnaires, kiosk utilization registers, blood pressure screening records, referral registers, observation checklists, and relevant community health programme documents, subject to appropriate ethical and confidentiality safeguards. Descriptive statistics will be used to summarize participants' characteristics, kiosk accessibility, and patterns of blood pressure screening uptake. 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-based blood pressure kiosks on screening uptake. Where a quasi-experimental design is adopted, screening uptake before and after introduction of the kiosks may be compared with that 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-based blood pressure kiosks have a significant positive effect on blood pressure screening uptake among adults in Nigeria. Adults with convenient access to community-based kiosks are expected to demonstrate greater utilization of blood pressure screening services than adults without access to such facilities. The availability of easily accessible screening points in markets, community centres, workplaces, transport areas, pharmacies, and other appropriate locations may reduce geographical, financial, and time-related barriers to routine blood pressure assessment. Regular screening may also increase awareness of individual blood pressure status and encourage adults with elevated readings to seek appropriate professional evaluation. However, equipment malfunction, inaccurate measurement techniques, inadequate maintenance, lack of trained personnel, privacy concerns, low awareness, poor referral systems, and limited linkage between kiosk screening and formal healthcare services may reduce programme effectiveness. The study therefore expects accessible, reliable, affordable, and properly supervised community-based blood pressure kiosks to contribute significantly to improved blood pressure screening uptake among adults in Nigeria. The study is expected to contribute to the literature on community-based blood pressure screening, hypertension prevention, screening uptake, digital and automated health technologies, community health services, preventive healthcare, and non-communicable disease prevention 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, primary healthcare facilities, local government health authorities, community health workers, healthcare organizations, technology providers, development partners, and policymakers regarding strategies for expanding access to hypertension screening. The study will also provide evidence-based recommendations for strategically locating blood pressure kiosks, ensuring regular equipment calibration and maintenance, strengthening referral and follow-up systems, integrating kiosk screening with primary healthcare services, improving public awareness, and developing sustainable community-based hypertension prevention programmes across Nigeria.

Keywords: Community-based blood pressure kiosks, blood pressure screening uptake, hypertension screening, adults, blood pressure monitoring, community health, preventive healthcare, hypertension prevention, non-communicable diseases, Nigeria, public health.