Development of a Theory-Driven Community Physical Activity Intervention for Reducing Hypertension in Semi-Urban Communities in North West Nigeria

Community-based physical activity interventions targeting hypertension prevention represent a population-level public health strategy, yet evidence-based, theory-driven programmes adapted to the semi-urban North West Nigerian context do not exist in the published literature. This dissertation develops and pilot tests an original theory-driven community physical activity intervention for hypertension reduction in semi-urban communities in North West Nigeria, applying intervention mapping as the systematic development methodology. Development proceeds through a comprehensive needs assessment encompassing epidemiological data review, formative qualitative research with 80 community members in Kano and Kaduna States, and health behaviour theory selection. Theory integration combines social cognitive theory, the transtheoretical model, and community-based participatory research principles to construct the intervention logic model. The resulting 24-week programme incorporates group walking clubs facilitated by trained community health workers, hypertension screening and blood pressure monitoring, dietary behaviour education, and religious community champion engagement. Pilot randomised controlled trial with 120 participants demonstrates feasibility, high acceptability, and preliminary evidence of blood pressure reduction, with mean systolic blood pressure reductions of 9.3 mmHg in the intervention arm. Implementation fidelity assessment, cost analysis, and participant exit interviews inform a refined programme manual. The dissertation contributes an original intervention development and evaluation framework applicable to physical activity-based chronic disease prevention in semi-urban Nigerian communities. Keywords: community physical activity intervention, hypertension, intervention mapping, North West Nigeria, theory-driven