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Effect of Hepatitis B Education on Hepatitis B Prevention Practices among University Students in Nigeria

Abstract

Hepatitis B virus (HBV) infection remains an important public health concern in Nigeria and may cause acute and chronic liver disease, including cirrhosis and hepatocellular carcinoma. University students may face exposure to hepatitis B through unprotected sexual activity, contact with infected blood or body fluids, unsafe injections or procedures, sharing of personal items that may be contaminated with blood, and other preventable routes of transmission. Limited knowledge of hepatitis B transmission, symptoms, vaccination, testing, prevention measures, and available healthcare services may contribute to risky practices and delayed healthcare-seeking. Hepatitis B education provides an opportunity to improve students' understanding of the disease and promote behaviours that reduce the risk of infection and transmission. Against this background, this study investigates the effect of hepatitis B education on hepatitis B prevention practices among university students in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Health Literacy Theory. The Health Belief Model explains how students' perceptions of susceptibility to hepatitis B infection, perceived severity, perceived benefits of preventive measures, perceived barriers, self-efficacy, and cues to action may influence their prevention practices. Social Cognitive Theory emphasizes observational learning, behavioural modelling, self-efficacy, reinforcement, peer influence, and environmental factors in shaping students' adoption of hepatitis B prevention behaviours. Health Literacy Theory emphasizes students' ability to obtain, understand, evaluate, and apply accurate information concerning hepatitis B transmission, vaccination, testing, prevention, and healthcare services. Collectively, these theoretical perspectives provide a suitable framework for explaining how hepatitis B education may influence hepatitis B prevention practices among university students in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise undergraduate and postgraduate students aged 18 years and above enrolled in selected public and private universities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, universities, faculties or departments, levels of study, and eligible students. Hepatitis B education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, information on HBV transmission, symptoms, complications, vaccination, testing, safe sexual practices, blood and body-fluid exposure, safe injection practices, avoidance of sharing razors and other potentially contaminated personal items, occupational and healthcare-related risks, prevention of mother-to-child transmission, misconceptions, stigma, and available prevention and treatment services. Hepatitis B prevention practices will be assessed using indicators such as hepatitis B vaccination uptake or completion where applicable, hepatitis B testing, safer sexual practices, avoidance of sharing personal items that may be contaminated with blood, appropriate handling of blood or body-fluid exposure, use of appropriate protective measures where relevant, seeking healthcare after potential exposure, and use of reliable hepatitis B information when making health decisions. Data will be collected using structured questionnaires, standardized hepatitis B knowledge and prevention-practice assessment tools, scenario-based questions, vaccination or testing records where ethically and practically accessible, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize students' demographic and academic characteristics, previous exposure to hepatitis B information, sources of information, vaccination and testing awareness, knowledge levels, and prevention practices. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of hepatitis B education on hepatitis B prevention practices. Where a quasi-experimental design is adopted, prevention-practice scores before and after the educational intervention may be compared with those of a comparison group 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 hepatitis B education has a significant positive effect on hepatitis B prevention practices among university students in Nigeria. Students exposed to structured, evidence-based, practical, and culturally appropriate hepatitis B education are expected to demonstrate stronger prevention practices than students without comparable exposure. Education may improve students' understanding of HBV transmission, vaccination, testing, safer sexual practices, blood and body-fluid precautions, and appropriate responses to potential exposure. It may also correct misconceptions and reduce stigma toward people living with hepatitis B, thereby encouraging students to seek testing and vaccination where appropriate. Practical education may strengthen students' ability to distinguish reliable health information from misinformation obtained through peers, social media, and other informal sources. However, vaccine costs or availability, limited access to testing services, stigma, misinformation, perceived low personal risk, financial constraints, and limited availability of student-friendly healthcare services may reduce the effectiveness of education alone. The study therefore expects accessible, evidence-based, sustained, and university-integrated hepatitis B education, supported by appropriate vaccination, testing, and healthcare services, to contribute significantly to improved hepatitis B prevention practices among university students in Nigeria. The study is expected to contribute to the literature on hepatitis B prevention, hepatitis B education, vaccination, infectious disease prevention, university student health, sexual health, health literacy, health education, stigma reduction, 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, National Hepatitis Control Programme, universities, university health centres, state ministries of health, healthcare professionals, community health workers, student organizations, development partners, and policymakers regarding strategies for strengthening hepatitis B prevention among young adults. The study will also provide evidence-based recommendations for integrating hepatitis B education into university health programmes, improving students' access to vaccination and testing services, strengthening awareness of HBV transmission and prevention, addressing misinformation and stigma, promoting safer health and sexual practices, strengthening referral and follow-up systems, and developing sustainable university-based interventions that support hepatitis B prevention and early healthcare-seeking across Nigeria.

Keywords: Hepatitis B education, hepatitis B prevention practices, university students, hepatitis B virus, HBV vaccination, hepatitis B testing, infectious disease prevention, health education, health literacy, university health, Nigeria, public health.