3.

Materials and methods:

3.1. Study design:
A descriptive Cross-sectional study was performed among general population in
Bahawalpur, Pakistan from March to June 2017.we select this design because of several benefits.
I. Not costly to perform and does not require a lot of time.
II. One time data is required.
III. Captures a specific point in time.
IV. Contains multiple variables at the time of the data snapshot.
V. The data can be used for various types of research.
VI. Used to prove and or disprove assumptions.
VII. Many findings and outcomes can be analyzed to create new theories/studies.

3.2. Study settings:

This study includes general population of Bahawalpur.

3.2.1 Study site: The Bahawalpur city is located in the desert area of Punjab province of
Pakistan at an altitude of 293961North and 716979east that is locally called as
cholistan(Google). The Bahawalpur is an administrative district and a divisional headquarter.

3.2.2. Population: According to the national census data that was performed year back in
1998, the population of Bahawalpur was reported as 7.518million(Masood et al., 2016).
According to that data, the Bahawalpur city accounted almost 10% of Total population of the
Punjab province, Pakistan and the majority of the people were found living in semi-urban and
rural areas of Bahawalpur.

3.3. Objectives:
3.3.1. General Objective:
The Purpose of the study is to assess the determinants of awareness.
Attitude in a hypertensive population.
Minimize the problems due to hypertension in future.
The result of this study to encourage further research to resolves problems in
hypertension patients.

3.3.2. Specific Objective:

To evaluate hypertension awareness among general population of Bahawalpur,
Pakistan.
3.4. Study Variables:
Study variables are

3.4.1 Dependent Variables:

Awareness Perception.

3.4.2. Independent Variables:

Socio-demographic data.

3.5. Study Population:

A Total of 383 members included in our study. These members includes
general Population of Bahawalpur region. These includes Students in different education
institutes, Job holders either government or private, Housewives and some elders.

3.5.1. Sample Size:

o We calculate a universal sample size 383 calculated on the basis of estimated population
using an online sample size calculator RAOSOFT with a confidence of 95% and
marginal error of 5%(Raosoft).
o 10% additional sample size was included in order to compensate while excluding
improperly and partially filled questionnaires during the data cleaning process. Hence the
effective sample size was calculated as 420.
o For the calculation of sample size a formula is used which is
o For population more than 10,000.
n=Z2pq/d2
Where
n= sample size.
Z= standard normal deviate; usually set at 1.96 which correspond to 95%confidance
interval.
P= proportion in the target population estimated to have a particular characteristic, If
there is no estimate, 50% (0.5).
q=1-p (proportion in the target population that has no specific characteristic).
d= degree of accuracy required, usually set at 0.05 (occasionally at two).
For the Purpose of data collection, respondents were approached via convenience

Sampling method.

3.5.2. Sampling method and procedure:

We were select the convenient sampling method.
 This sampling method involves getting participants where you can find and
typically where is covenient.in this method no inclusion criteria identified prior
to the selection of subjects. All subjects are invited to participate.
This method relies on data collection from population members who are
conveniently available to participate in study.

3.5.2.1. Inclusion Criteria:

All of the respondents who were of at least or above 18 year of age,
regardless of their Gender, cast, religion or socioeconomic status, and
voluntarily willing to participate were included in our study.
Only healthy individuals were included in this study.

3.5.2.2. Exclusion criteria:

People suspected with any cognitive and/or psychiatric impairment were
excluded from our study.

3.6. Data Collection:

We distributed Self-administered questionnaire among general population of
Bahawalpur region. Written or verbal consent was obtained before handling over The Self-
administered questionnaire to the respondent as per respondents choice. The name of the
respondents or any personal identification details were not asked intentionally. Furthermore,
respondents who were unable to read English were provided with an Alternative Urdu (National
language of Pakistan) version of the questionnaire. All those Respondents who were unable to read
either English or Urdu were face to face interviewed by one of the author using that questionnaire.

3.6.1. Data Collection instrument/tool:

The Data collection tool/Instrument was a Semi structured questionnaire. The
Questionnaire consisted of 35 questions which were used to analyze the awareness of Hypertension
among general population.

3.6.2. Development of Questionnaire:

The 35-itemed study instrument that consisted of total four sections (A, B, C and D) was
Developed after extensive literature review. Section-A contained 7-questions that were
Related to respondents demography (age, gender, education, residence, marital status and
Family income were independent variables of the study).Section-B contained 12 questions
That were used to evaluate the general knowledge regarding hypertension. Section-C
Contained 10 questions that were used to evaluate the knowledge regarding the prevention
 Management of hypertension. Lastly Section-E contained 6 questions that were used to
Analyze the preference and sources of knowledge of respondents regarding future
Hypertension awareness programs. All of the questions from section A and B were in
Multiple choice format while response of section C and D were measured using a
Nominal scale [yes/no].For the purpose of achieving optimum results both English
and Urdu (National language of Pakistan) version of questionnaires were developed.
To evaluate the awareness of respondents, Scoring was performed for Section B & C.
Each correct answer was awarded with Score 1 and each wrong answer with 0.The
Minimum possible Score was 1 and the maximum possible score was 22 for whole
Questionnaires.

3.6.3. Validity of tool:

Expert opinion and Piloting were used for face and content validity testing of
questionnaire. Cohns alpha was applied to determine internal consistency of the data collection
tool. Below, for conceptual purposes, we show the formula for the standardized Cronbachs
alpha(Stephanie, 2014):

Where N is equal to the number of items, c-bar is the average inter-item covariance among the
items and v-bar equals the average variance(Stephanie, 2014).

To check the content validity and structure of questionnaire, pilot study was also conducted on a
random sample size of 40 people for the evaluation of the validity and reproducibility of the data,
and the Cronbachs alpha value 0f 0.615 for English version and 0.64 for Urdu (National language
of Pakistan) version of questionnaire was obtained accordingly. The alpha value confirmed the
validity of the instrument because an alpha value of above 0.6 is considered acceptable.
Furthermore, the results of the pilot study were not included in our final findings and corrections
were made to raise Cronbachs value.

3.6.4 Data management, Processing & analysis:

 After the data collection, data cleaning and data coding were performed.SPSS (Statistical
package for the social sciences) version 20 was used for data analysis. Data were entered into
SPSS, version and statistics were applied. Descriptive Statistics (Frequencies, %ages, means,
median, standard deviation) were applied to summarize the data. Various inferential statistics tests
(Cronbachs test, Chi-square test, Mann-Whitney U test, Kruskal Wallis test) were applied. As
inferential statistics to evaluate associations and difference between various independent and
dependent variables. Chi-square tests was applied where association was desired b/w dependent
and independent variable both being Categorical, this was used for almost all of the parameters.
Mann-Whitney U test was applied where difference of occurrences were needed b/w dependent
and independent variable & between two group or mean rank values.Kruskal-wallis tests was
applied where evaluation of more than two variables was required. We applied Mann-Whitney U
test and Kruskal-Wallis test. The level of significance set as p<0.05.

3.6.5. Research ethics:

There is no such requirement of approval from ministry of health Pakistan for conducting
cross-sectional surveys in general populations. Hence, the study protocols were approved by the
ethical committee of the Faculty of pharmacy and Alternative Medicine, the Islamia University of
Bahawalpur, Pakistan.

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RAOSOFT. Raosoft [Online]. Available: http://www.raosoft.com [Accessed 19-05-2017 2017].
STEPHANIE. 2014. Statistics How To [Online]. Available: http://www.statisticshowto.com [Accessed
17th-05-2017 2017].