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Impact of Community Blood Pressure Screening on Hypertension Detection among Market Traders in Nigeria

Abstract

Hypertension is a major public health concern and an important risk factor for cardiovascular disease, stroke, kidney disease, and premature mortality. The condition may remain undiagnosed for prolonged periods because many individuals do not experience noticeable symptoms until complications develop. Market traders may face barriers to routine healthcare utilization because of demanding work schedules, financial constraints, limited time, low awareness, and difficulties accessing healthcare facilities during working hours. Community blood pressure screening provides an opportunity to bring basic cardiovascular risk assessment closer to populations in their workplaces and communities and may facilitate the identification of adults with previously undetected elevated blood pressure. Against this background, this study investigates the impact of community blood pressure screening on hypertension detection among market traders in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Health Systems Framework. The Health Belief Model explains how market traders' perceptions of susceptibility to hypertension, perceived severity of hypertension-related complications, perceived benefits of screening, perceived barriers, and cues to action may influence participation in blood pressure screening. The Social Ecological Model emphasizes the influence of individual, interpersonal, community, workplace, healthcare, and environmental factors on access to preventive health services. The Health Systems Framework highlights the importance of service delivery, healthcare personnel, health information, medical equipment, financing, accessibility, referral systems, and continuity of care in the effective delivery of community screening programmes. Collectively, these theoretical perspectives provide a suitable framework for explaining how community blood pressure screening may influence hypertension detection among market traders in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise adult market traders aged 18 years and above operating in selected markets across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, markets, sections of markets, and eligible traders. Community blood pressure screening will be assessed using indicators such as availability and frequency of screening activities, screening coverage, accessibility of screening locations, availability of trained healthcare personnel, appropriate blood pressure measurement procedures, equipment availability, participant education, repeat measurements where indicated, risk assessment, referral arrangements, and follow-up mechanisms. Hypertension detection will be assessed using indicators such as elevated blood pressure readings identified during screening, traders requiring repeat assessment, newly suspected cases, referrals for clinical evaluation, confirmation of hypertension following appropriate clinical assessment, and linkage to hypertension care. Data will be collected using structured questionnaires, standardized blood pressure screening forms, screening registers, referral records, healthcare records where available, and relevant community health programme documents. Descriptive statistics will be used to summarize participants' characteristics, screening participation, and blood pressure findings. 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 impact of community blood pressure screening on hypertension detection. Where a quasi-experimental design is adopted, hypertension detection rates before and after implementation of community screening activities may 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 community blood pressure screening has a significant positive impact on hypertension detection among market traders in Nigeria. Traders who participate in community-based screening are expected to have a higher likelihood of previously undetected elevated blood pressure being identified than traders without access to screening services. Conducting screening within market environments may reduce geographical and time-related barriers to preventive healthcare and provide convenient opportunities for traders to assess their blood pressure without leaving their places of work for extended periods. Screening may also increase awareness of hypertension and encourage traders with abnormal findings to seek further clinical assessment and appropriate management. However, inadequate screening equipment, shortage of trained healthcare personnel, limited funding, poor follow-up systems, low awareness, fear of diagnosis, and difficulties accessing confirmatory healthcare services may reduce the effectiveness of community screening programmes. The study therefore expects accessible, properly conducted, adequately staffed, and well-integrated community blood pressure screening programmes to contribute significantly to improved hypertension detection among market traders in Nigeria. The study is expected to contribute to the literature on community blood pressure screening, hypertension detection, cardiovascular disease prevention, market traders, community health services, screening programmes, healthcare utilization, 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, hospitals, healthcare professionals, market associations, community health workers, development partners, and policymakers regarding strategies for improving hypertension detection. The study will also provide evidence-based recommendations for expanding community blood pressure screening in markets, improving access to trained healthcare personnel and functional screening equipment, strengthening referral and follow-up systems, integrating hypertension screening into community outreach programmes, increasing awareness among market traders, and improving linkage to appropriate hypertension treatment and long-term care across Nigeria.

Keywords: Community blood pressure screening, hypertension detection, market traders, hypertension, cardiovascular disease prevention, blood pressure screening, community health services, early detection, healthcare utilization, Nigeria, public health.