EFFECT OF SOCIAL MEDIA HEALTH COMMUNICATION ON KNOWLEDGE, ATTITUDE AND INTENTION TO ADOPT HEALTH-ENHANCING BEHAVIOUR AMONG UNDERGRADUATES IN LEAD CITY UNIVERSITY AND TAI SOLAR IN UNIVERSITY OF EDUCATION, NIGERIA

ABSTRACT

Studies have shown that the burden of non-communicable diseases such as diabetes, cancer, and hypertension is on the increase in Nigeria. Adequate knowledge, positive attitude and intention to adopt health-enhancing behaviour as espoused in NEWSTART (Nutrition, Exercise, Water, Sunlight, Temperance, Air, Rest and Trust in God) can reduce the incidence. Social media are increasingly being utilised by individuals, health professionals and organisations for health communication as they offer significant potentials.  In Nigeria, the usage of social media is high however their utilisation for health communication is arguably low. This study examined the effects of social media health communication on knowledge, attitude and intention to adopt health-enhancing behaviour among undergraduates in Lead City University and Tai Solarin University of Education, Nigeria.

The study adopted quasi-experimental design. Study population was 26,000 undergraduates of Lead City University and Tai Solarin University of Education. Sample size of 200 undergraduates were purposively selected and assigned 25 each to the 4 experimental groups and 4 control groups.  A validated questionnaire was used for data collection at baseline and endline from the experimental groups and control groups. The reliability test yielding Cronbach’s Alpha coefficients: knowledge of health-enhancing behaviour = .733; attitude to health-enhancing behaviour = .741; subjective norms=.825; perceived behavioural control =.914; intention to adopt health-enhancing behaviour=.933 and the composite Cronbach’s Alpha result was 0.940. Baseline data of students’ knowledge, attitude and intention to adopt health-enhancing behaviour were collected. This was followed by the exposure of NEWSTART messages via Facebook and WhatsApp to the experimental groups for five weeks, after which endline data were collected. Data were analysed using inferential (paired samples T-test and multiple linear regression) statistics.

Findings revealed that there was a significant difference (t=-2.303; p<0.05) in students’ knowledge of health-enhancing behaviour before and after the social media health communication intervention. No significant difference was observed (t=-.323; p>0.05) in students’ attitude to health-enhancing behaviour before and after the social media health communication intervention. There was no significant difference (t=1.73; p>0.05) in students’ intention to adopt health-enhancing behaviour before and after the intervention. For the theory of planned behaviour, attitude was not a significant predictor (R²=0.0031, β=0.056, p>0.05) of intention to adopt health-enhancing behaviour while subjective norms (R²=0.0481, β=0.220, p<0.05) and perceived behavioural control (R²=0.2916, β=0.540, p<0.05) significantly predicted intention to adopt health-enhancing behaviour with perceived behavioural control being a better predictor.

The study concluded that social media health communication intervention was effective in increasing students’ knowledge of health-enhancing behaviour but not effective in influencing attitude and generating intention to adopt health-enhancing behaviour. Attitude does not predict intention to adopt health-enhancing behaviour but subjective norms and perceived behavioural control predict intention to adopt health-enacting behaviour. It was recommended that health communicators should use social media for health communication if the goal is to increase knowledge but other communication channels should be used where the goals are to influence attitude and behavioural intention.

Keywords:     Social media, Attitude, Knowledge, Intention to adopt, Health communication, Subjective norms, Perceived behavioural control

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

     Health concerns globally are shifting from infectious diseases to non-communicable diseases (NCDs) as they are becoming the leading cause of mortality even in developing countries. (Adogu, Ubajaka, Emelumadu, &Alutu, 2015; Mahmood, Ali and Islam, 2013; WHO, 2008).  Scholars have advanced that most non-communicable diseases are linked to lifestyle patterns and choices of individuals and thus they are termed ‘lifestyle diseases’ (Chandola, 2012; Sharma & Majumdor, 2009). The occurrence of these diseases are associated with the neglect of health-enhancing behaviours such as proper nutrition, exposure to sunlight, exercise, adequate sleep, adequate water intake as espoused in NEWSTART health regimen.  Mahmood, Ali and Islam (2013) affirms this noting that “the leading global risks for mortality are high blood pressure (responsible for 13% of deaths globally), tobacco use (9%), high blood glucose (6%), physical inactivity (6%), and overweight and obesity (5%).”(p. 38).   Examples of lifestyle diseases are heart diseases, stroke, diabetes, and cancer. The World Health Organisation (WHO)(2014a) reports that NCDs present a new challenge for the Nigerian health system and they accounted for 24% of total deaths in the country (World Health Organisation, 2014b).

     Lifestyle disease or NCDs are avoidable with right information and adoption of healthy practices even from early stages of life.  Mahmood, Ali and Islam (2013) assert that the key to controlling non-communicable disease is “primary prevention through promotion of healthy life style which is necessary during all phase of life” (p. 37). NEWSTART is a total wellness/health regimen that promotes health-enhancing behaviours aimed at achieving optimal health and body function which in turn reduces the likelihood of lifestyle diseases. NEWSTART is an acronym for Nutrition, Exercise, Water, Sunlight, Temperance, Air, Rest and Trust in God.  It is health regimen targeted at complete physical, mental, physiological and spiritual wellbeing (Aja, 2001; Ashley & Cort, 2007).  Health promotion philosophies like NEWSTART has to first be communicated and individuals encouraged to adopt these behaviours, so as to positively impact their health. This is one of the major task of health communication, which according to Rimal and Lapinski (2009), is concerned with health promotion, wellbeing and improved quality of life among people.    Parrott (2004) explains that “health communication is the art and technique of informing, influencing and motivating institutional and public audiences about important health issues” (p. 751).  The basic objective of health communication is to increase public’s knowledge of health issues, influence their attitude and behaviour for optimal health by disseminating information on healthy living and practices, prevention and treatment of diseases.  Given the health challenges and increasing incidence of non-communicable diseases in Nigeria which are associated with lifestyle choices and practices, there is the need to employ as many communication tools as possible, including social media, for health communication to really influence the adoption of healthy practices among the populace.  Alluding to the need for using social media for health-related purposes, Oyelami, Okuboyejo and Ebiye (2013) maintain that the health situation can be different in Nigeria if the populace are aware of the availability of health information on the new media and take advantage of it.