Psychosocial influences on hypertension in Southeastern Nigeria: A mixed-methods study protocol

Introduction The Southeastern region of Nigeria faces a severe public health challenge from hypertension due to its high prevalence. Psychosocial factors including perceived stress, anxiety, depression, coping mechanisms, and social support play essential roles in hypertension development and health behaviour, yet there has been limited scholarly attention to these determinants in Nigerian and international qualitative research. This study addresses this evidence gap by investigating the psychosocial determinants of hypertension-related health behaviour outcomes in adults living in Southeastern Nigeria. Materials and methods The sequential explanatory mixed methods study includes validated psychometric instruments assessing perceived stress, anxiety, depression, coping mechanisms, and social support. The primary quantitative outcome is the Health Behaviour Index, a composite measure of hypertension-related health behaviours. Regression analyses, correlation tests, and mediation/moderation models will be used to examine relationships among these variables. The research team will collect qualitative data through semi-structured interviews accessible to participants either online or in person. Thematic analysis following Braun and Clarke’s six-phase framework will be employed to explore participants’ lived experiences of stress, coping, and hypertension management. Findings will be disseminated at academic conferences and published in peer-reviewed journals and stakeholder meetings held in both the UK and Nigeria. The research aims to generate evidence to support the development of comprehensive psychosocial care plans that address both physical and mental aspects of hypertension treatment in areas with limited resources.