Project – Community Health Education and Prevention of Lifestyle-Related Diseases among Adults: A Study of Selected Communities in Port Harcourt City Local Government Area, Rivers State

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Lifestyle-related diseases constitute an important public health challenge because many of them are associated with modifiable behaviours and conditions that develop gradually over the life course. These diseases are largely represented by non-communicable diseases (NCDs), including cardiovascular diseases, diabetes mellitus, cancers and chronic respiratory diseases. The World Health Organization (WHO) reports that NCDs accounted for at least 43 million deaths globally in 2021, representing about 75% of deaths not associated with pandemics. The major behavioural risk factors include tobacco use, physical inactivity, unhealthy diets and harmful use of alcohol, while these behaviours contribute to metabolic conditions such as hypertension, overweight and obesity, raised blood glucose and abnormal blood lipids. Consequently, prevention of lifestyle-related diseases requires interventions that enable individuals and communities to understand risk factors and adopt healthier behaviours (World Health Organization [WHO], 2025).

Community health education is an important strategy for addressing lifestyle-related diseases because it provides individuals and groups with information, skills and motivation needed to make informed health decisions. Health education is not limited to the transmission of information; it can involve developing practical knowledge concerning nutrition, physical activity, tobacco avoidance, responsible alcohol use, weight management, screening and early healthcare seeking. The WHO emphasizes that many NCDs are preventable or can be delayed through interventions addressing common behavioural risk factors and through supportive environments that make healthy choices possible. This makes health education particularly important at community level, where social norms, economic circumstances, food environments, occupation and access to healthcare can influence the choices made by adults (WHO, 2024).

The importance of community health education is further supported by evidence from Nigeria. Ozoemena et al. (2019), in a quasi-experimental study involving Nigerian retirees, found that a community-based health education intervention significantly improved hypertension-related knowledge and several prevention and self-care practices, including physical activity, healthy diet and substance-use abstinence. The intervention group demonstrated significant improvements compared with the control group, suggesting that structured health education can contribute to behavioural changes relevant to chronic disease prevention. Although the study focused on older adults and hypertension, its findings provide useful evidence for the broader proposition that health education can be used as a public health tool to improve knowledge and preventive behaviours relating to lifestyle-related diseases (Ozoemena et al., 2019).

Lifestyle-related diseases are increasingly relevant in Nigeria because changes in urbanization, occupation, dietary patterns and physical activity have created environments in which unhealthy behaviours may become more common. The WHO African Region identifies unhealthy diet, physical inactivity, tobacco use and harmful alcohol use as major modifiable risk factors for NCDs, while elevated blood pressure, obesity and high blood glucose constitute important metabolic risk factors. Nigeria’s NCD profile also indicates that NCDs represented approximately 28% of deaths in 2021, with an estimated 467,800 NCD deaths. These figures demonstrate that NCD prevention is not exclusively a clinical issue but also a community health issue requiring sustained public awareness, behavioural interventions and preventive services (WHO, 2024; WHO, 2025).

The Rivers State context further demonstrates the importance of addressing lifestyle-related diseases through health education and prevention. The Rivers State Ministry of Health identifies cardiovascular diseases, chronic respiratory diseases, cancers and diabetes among the state’s priority NCDs and recognizes unhealthy diet, sedentary lifestyle, tobacco use, harmful alcohol consumption and environmental pollution as important shared risk factors. The Ministry’s NCD programme is specifically responsible for prevention and control activities in the state. The existence of a dedicated NCD programme illustrates the public health importance attached to these diseases and the need for community-level approaches capable of reducing exposure to modifiable risk factors (Rivers State Ministry of Health, n.d.).

Port Harcourt City Local Government Area provides a relevant setting for investigating community health education and lifestyle-related disease prevention because previous research has documented a significant burden of NCDs within Port Harcourt. An earlier study of medical admissions in Port Harcourt found that NCDs accounted for 56.2% of total medical admissions examined, with cardiovascular, endocrine and renal diseases representing major categories; hypertension, diabetes mellitus and chronic renal failure were among the common conditions identified. The researchers emphasized the need for adequate health education and lifestyle modification to reduce the burden of NCDs in Nigeria. Although hospital-based evidence does not represent the entire community population, it demonstrates that lifestyle-related diseases constitute an important health concern within the Port Harcourt environment (Onwubere et al., 2008).

Evidence concerning specific lifestyle risk factors in Port Harcourt also supports the need for preventive community health education. Research among adults in Port Harcourt has identified obesity, sedentary lifestyle and cardiovascular risk factors as relevant concerns. For example, a study of Nigerian adults attending family medicine clinics in Rivers State found obesity in both rural and Port Harcourt participants and reported associations between obesity and cardiovascular risk factors, with sedentary lifestyle and family history identified as important considerations. More recently, research involving long-distance drivers in Port Harcourt found low perception of modifiable hypertension risk factors and inadequate regular health checks, leading the researchers to recommend targeted health education. These findings suggest that the presence of health services does not necessarily ensure adequate knowledge, risk perception or preventive behaviour among adults (Eze et al., 2008; Olorunfemi et al., 2024).

The need for sustained community health education is also reinforced by recent evidence concerning lifestyle and chronic disease management in the wider Rivers State and Port Harcourt setting. A recent community-based study in Rivers State reported a substantial burden of type 2 diabetes among adults and identified obesity, physical inactivity, hypertension and family history among factors associated with the disease. Similarly, research on type 2 diabetes care in Port Harcourt identified poor eating and exercise habits as important contextual concerns and highlighted the need for approaches adapted to the local setting. These findings indicate that prevention should not begin only after disease diagnosis; adults need accessible and continuous education that enables them to recognize risk factors, make healthier choices and seek screening before complications develop (Briggs & Nwadiuto, 2026; Odili et al., 2024).

Community health education therefore represents an important link between public health knowledge and prevention of lifestyle-related diseases. Effective education can help adults understand the relationship between their daily behaviours and chronic disease risk, while community-based interventions can address barriers that individual education alone may not overcome. Evidence from Nigeria demonstrates that health education can improve knowledge and preventive practices, while evidence from Port Harcourt and Rivers State shows the presence of significant NCD-related risk factors and disease burdens. It is therefore necessary to investigate the level of community health education received by adults, their knowledge of lifestyle-related diseases, the preventive practices they adopt and the relationship between health education and disease-prevention behaviour in selected communities in Port Harcourt City Local Government Area (Ozoemena et al., 2019; Rivers State Ministry of Health, n.d.; WHO, 2025).

1.2 Statement of the Problem

Lifestyle-related diseases have become a significant public health concern in Nigeria and constitute an increasing burden on individuals, families, healthcare institutions and the wider economy. Cardiovascular diseases, diabetes, cancers and chronic respiratory diseases are responsible for a substantial proportion of illness and premature mortality, while many of their major risk factors are modifiable. Despite this preventable component, adults continue to experience exposure to unhealthy diets, physical inactivity, tobacco, harmful alcohol use, overweight and obesity. The persistence of these risk factors raises concerns about the adequacy of existing health education and community prevention efforts directed at helping adults make informed and sustainable lifestyle choices (WHO, 2025).

A related problem is that awareness of a disease or its risk factors does not necessarily translate into appropriate preventive practices. Evidence from Nigeria demonstrates that health education interventions can improve knowledge and behaviours, but poor lifestyle practices can persist where health information is inadequate, inaccessible or not translated into practical action. Ozoemena et al. (2019) demonstrated that structured community-based health education improved knowledge, physical activity, healthy diet and other preventive practices among Nigerian retirees. Conversely, research among hypertensive adults in Nigeria found that only 24.3% demonstrated good knowledge of lifestyle practices and only 11.8% were engaged in good lifestyle practices, suggesting a substantial knowledge-to-practice gap (Ozoemena et al., 2019; recent Nigerian hypertension lifestyle study, 2024).

The problem is also relevant to Port Harcourt City Local Government Area because local studies have identified lifestyle-related risk factors and chronic diseases among adults. Research in Port Harcourt has reported substantial NCD-related medical admissions, while studies among adults have identified obesity, physical inactivity, poor dietary practices and inadequate risk perception as concerns. A 2024 study of hypertensive patients in Port Harcourt found that more than half of the participants had uncontrolled blood pressure and identified physical inactivity and body mass index among significant factors associated with poor blood pressure control. These findings suggest that disease management and prevention require stronger attention to health education, lifestyle modification and early risk identification within the community (Onwubere et al., 2008; Oyan et al., 2024).

The specific problem addressed by this study is the insufficient community-level evidence on the extent to which health education is associated with prevention of lifestyle-related diseases among adults in selected communities in Port Harcourt City Local Government Area. Existing studies have examined individual diseases, hospital admissions, specific occupational groups and patients already diagnosed with chronic conditions, but these findings do not fully establish whether community health education is reaching adults before disease develops or whether such education is reflected in preventive practices. There is therefore a need to determine the level of community health education received by adults, assess their prevention practices regarding lifestyle-related diseases, examine the relationship between community health education and prevention practices, and identify factors that may hinder effective health education and disease prevention in the selected communities. Evidence from such a study may assist public health practitioners and health authorities in designing more context-specific community interventions for Port Harcourt (Rivers State Ministry of Health, n.d.; Ozoemena et al., 2019).

1.3 Purpose of the Study

The main purpose of this study is to examine community health education and prevention of lifestyle-related diseases among adults in selected communities in Port Harcourt City Local Government Area of Rivers State.

Specifically, the study seeks to:

1. determine the level of community health education received by adults concerning lifestyle-related diseases in selected communities in Port Harcourt City Local Government Area;
2. assess the level of preventive practices regarding lifestyle-related diseases among adults in selected communities in Port Harcourt City Local Government Area;
3. examine the relationship between community health education and prevention practices regarding lifestyle-related diseases among adults in selected communities in Port Harcourt City Local Government Area; and
4. identify the major factors affecting effective community health education and prevention of lifestyle-related diseases among adults in the selected communities.

1.4 Research Questions

The following research questions will guide the study:

1. What is the level of community health education received by adults concerning lifestyle-related diseases in selected communities in Port Harcourt City Local Government Area?
2. What is the level of preventive practices regarding lifestyle-related diseases among adults in selected communities in Port Harcourt City Local Government Area?
3. What relationship exists between community health education and prevention practices regarding lifestyle-related diseases among adults in selected communities in Port Harcourt City Local Government Area?
4. What are the major factors affecting effective community health education and prevention of lifestyle-related diseases among adults in the selected communities?

1.5 Research Hypothesis

The following null hypothesis will be tested at the 0.05 level of significance:

H₀: There is no significant relationship between community health education and prevention practices regarding lifestyle-related diseases among adults in selected communities in Port Harcourt City Local Government Area of Rivers State.

1.6 Significance of the Study

The study is expected to be beneficial to the following groups:

Adults and Community Residents: The findings may increase awareness of lifestyle-related diseases and their modifiable risk factors. It may encourage adults to adopt healthier dietary habits, participate in regular physical activity, avoid tobacco and harmful alcohol use, maintain healthy body weight and undertake appropriate health checks.

Community Health Workers: The findings may assist community health workers in identifying knowledge gaps and misconceptions concerning lifestyle-related diseases. The information may also help them design appropriate health talks, outreach programmes and behaviour-change activities.

Primary Healthcare Providers: Primary healthcare workers may use the findings to strengthen preventive services, health education, screening, counselling and early identification of adults at increased risk of lifestyle-related diseases.

Rivers State Ministry of Health: The study may provide community-level evidence useful for strengthening the state’s existing non-communicable disease prevention programme. It may assist in developing targeted community health education programmes addressing diet, physical inactivity, tobacco, alcohol, obesity and screening.

Public Health Practitioners: The findings may provide evidence concerning the relationship between health education and preventive practices. This may support the design of interventions that combine health information with practical behaviour-change strategies.

Community Leaders and Community-Based Organizations: The findings may help community leaders and organizations identify local health priorities and support health-promotion activities such as community screening, exercise programmes, health talks and healthy-lifestyle campaigns.

Researchers and Students: The study may serve as reference material for future research on community health education, lifestyle-related diseases, health promotion, health behaviour and non-communicable disease prevention in Port Harcourt, Rivers State and Nigeria.

1.7 Scope of the Study

The study is delimited to community health education and prevention of lifestyle-related diseases among adults in selected communities in Port Harcourt City Local Government Area of Rivers State.

The content scope covers community health education concerning lifestyle-related diseases, including information about risk factors, symptoms, complications, prevention, screening and appropriate health-seeking behaviour. The study will particularly consider lifestyle-related diseases such as hypertension, diabetes mellitus, cardiovascular diseases, obesity and other common non-communicable conditions associated with modifiable behavioural risk factors.

The prevention-practice component will cover dietary practices, physical activity, weight management, tobacco avoidance, responsible alcohol behaviour, regular health checks, screening and other relevant preventive behaviours.

Geographically, the study will be restricted to selected communities in Port Harcourt City Local Government Area of Rivers State. The respondents will comprise adults aged 18 years and above residing in the selected communities.

1.8 Operational Definition of Terms

Community: A group of people living within a defined geographical area and sharing certain social, environmental, cultural or administrative characteristics.

Community Health Education: A planned process of providing individuals and groups within a community with relevant health information, skills and motivation to enable them to make informed decisions and adopt behaviours that promote health and prevent disease.

Lifestyle: The pattern of behaviours, habits and choices through which an individual conducts everyday life, including dietary practices, physical activity, tobacco use, alcohol consumption, sleep and health-seeking behaviour.

Lifestyle-Related Diseases: Diseases whose occurrence or progression is substantially associated with behavioural, environmental or metabolic risk factors linked to lifestyle. In this study, emphasis is placed on hypertension, diabetes mellitus, cardiovascular diseases, obesity and related non-communicable diseases.

Prevention: Actions taken by individuals, communities or health systems to reduce the occurrence, progression or complications of disease.

Prevention Practices: Specific behaviours adopted by adults to reduce their risk of lifestyle-related diseases, including healthy eating, physical activity, weight control, avoidance of tobacco, responsible alcohol use and regular health checks.

Health Education: A process through which individuals and communities acquire knowledge, skills and motivation to improve health and prevent disease.

Adults: For the purpose of this study, persons aged 18 years and above who reside in the selected communities in Port Harcourt City Local Government Area.

Non-Communicable Diseases: Chronic diseases that are generally not transmitted directly from person to person and include cardiovascular diseases, cancers, diabetes and chronic respiratory diseases.

1.9 Organisation of the Study

The study will be organized into five chapters.

Chapter One presents the introduction, background to the study, statement of the problem, purpose of the study, research questions, research hypothesis, significance of the study, scope of the study, operational definition of terms and organisation of the study.

Chapter Two will review relevant literature on community health education, lifestyle-related diseases, risk factors, health promotion, preventive practices, theoretical perspectives and previous empirical studies.

Chapter Three will present the research methodology, including the research design, area of the study, population of the study, sample size, sampling technique, instrument for data collection, validity of the instrument, reliability of the instrument, method of data collection and method of data analysis.

Chapter Four will present the analysis and interpretation of data collected from respondents. The research questions will be answered using appropriate descriptive statistics, while the hypothesis will be tested at the 0.05 level of significance.

Chapter Five will present the discussion of findings, conclusion, recommendations, limitations of the study, implications of the findings and suggestions for further studies.

Project – Community Health Education and Prevention of Lifestyle-Related Diseases among Adults: A Study of Selected Communities in Port Harcourt City Local Government Area, Rivers State