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Impact of Stroke Education on Stroke Recognition Knowledge among Adults in Nigeria

Abstract

Stroke is a major public health concern in Nigeria and can result in substantial mortality, disability, and long-term healthcare needs. Early recognition of stroke symptoms and prompt access to emergency medical care are essential because delays in treatment may increase the risk of permanent neurological damage and death. However, limited public knowledge of stroke warning signs, risk factors, appropriate emergency responses, and the importance of seeking immediate medical attention may contribute to delays in healthcare-seeking among adults. Stroke education provides an opportunity to improve public understanding of stroke symptoms, risk factors, emergency response, and appropriate healthcare-seeking behaviour through community programmes, healthcare facilities, workplaces, media campaigns, and other health-promotion platforms. Improved stroke recognition knowledge may enable adults to identify possible stroke symptoms more quickly and respond appropriately when symptoms occur. Against this background, this study investigates the impact of stroke education on stroke recognition knowledge among adults in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice Framework. The Health Belief Model explains how adults' perceptions of stroke susceptibility and severity, perceived benefits of early recognition, perceived barriers, and cues to action may influence their willingness to learn about and respond to stroke symptoms. Social Cognitive Theory emphasizes observational learning, self-efficacy, social reinforcement, and environmental influences in the acquisition and application of health knowledge. The Knowledge-Attitude-Practice Framework provides a basis for examining how health education may improve knowledge and potentially influence subsequent attitudes and health-related practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how stroke education may influence stroke recognition knowledge 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 communities in Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, households, workplaces, and eligible adult participants. Stroke education exposure will be assessed using indicators such as participation in stroke awareness programmes, exposure to community health education, attendance at health-promotion sessions, receipt of stroke educational materials, exposure to media-based stroke campaigns, frequency of educational contacts, duration of education, content covered, use of culturally appropriate educational materials, and participation in interactive educational activities. Stroke recognition knowledge will be assessed using indicators such as identification of common stroke warning signs, recognition of sudden facial weakness, arm or leg weakness, speech difficulties, sudden vision problems, sudden severe headache, loss of balance or coordination, understanding of stroke risk factors, knowledge of appropriate emergency actions, awareness of the need for immediate medical attention, and recognition of inappropriate responses to suspected stroke. Data will be collected using structured questionnaires administered before and after stroke education where a quasi-experimental design is adopted, or through community-based surveys in an analytical cross-sectional design. Additional information may be obtained from health-promotion programme records and educational materials. Descriptive statistics will be used to summarize participants' demographic characteristics, exposure to stroke education, and levels of stroke recognition knowledge. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of stroke education on stroke recognition knowledge. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that stroke education has a significant positive impact on stroke recognition knowledge among adults in Nigeria. Adults exposed to structured and appropriate stroke education are expected to demonstrate greater ability to identify common stroke warning signs, recognize the urgency of stroke symptoms, identify major risk factors, and describe appropriate emergency responses compared with adults who have not received similar education. Interactive education, repeated exposure, culturally appropriate materials, and practical recognition of stroke symptoms may strengthen knowledge retention and confidence in responding to suspected stroke. Improved knowledge may also increase awareness of the importance of seeking immediate professional healthcare rather than relying on inappropriate home remedies or delaying treatment. However, limited access to health information, low literacy, language barriers, misinformation, cultural beliefs, inadequate community health-promotion resources, and inconsistent exposure to educational programmes may reduce the effectiveness of stroke education. The study therefore expects regular, accessible, culturally appropriate, and well-designed stroke education programmes to contribute significantly to improved stroke recognition knowledge among adults in Nigeria. The study is expected to contribute to the literature on stroke education, stroke recognition, health education, stroke prevention, emergency healthcare-seeking, non-communicable disease awareness, community health promotion, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention, state ministries of health, primary healthcare facilities, hospitals, community health workers, health educators, non-governmental organizations, media organizations, development partners, and policymakers regarding strategies for improving public awareness of stroke. The study will also provide evidence-based recommendations for expanding community-based stroke education, strengthening health-promotion campaigns, improving public understanding of stroke warning signs, developing culturally and linguistically appropriate educational materials, training community health workers and health educators, using mass media and digital platforms for stroke awareness, and promoting rapid recognition and emergency response to suspected stroke across Nigeria.

Keywords: Stroke education, stroke recognition knowledge, stroke awareness, stroke warning signs, health education, stroke prevention, emergency healthcare-seeking, adults, community health promotion, Nigeria, public health.