Knowledge and Attitudes of Healthcare Workers Toward the Integration of Environmental Epigenetics into Clinical Practice in Ilorin Metropolis, Kwara State, Nigeria: A Cross-Sectional Study

Abstract

Environmental epigenetics heritable, potentially reversible changes in gene expression caused by environmental exposures such as pollution, diet, chemicals, and stress, without alteration of the underlying DNA sequence is increasingly recognised as a mechanism linking environmental exposures to disease risk. Healthcare workers are central to translating this evidence into preventive counselling and patient care, yet their readiness to do so, particularly in low-resource settings, is poorly documented. A descriptive cross-sectional study was conducted among healthcare workers in public health facilities across the three Local Government Areas of Ilorin Metropolis, Kwara State, Nigeria, using a multistage sampling technique. Data were collected with a structured, self-administered questionnaire covering socio-demographic characteristics, knowledge, attitudes, perceived barriers, and willingness to train. Of 275 questionnaires distributed, 250 were valid for analysis (90.9% response rate). Data were analysed descriptively and inferentially (chi-square test, Pearson correlation, point-biserial correlation) at p < 0.05. Most respondents (69.2%) demonstrated adequate knowledge of environmental epigenetics, while an overwhelming majority (98.4%) held a positive attitude toward its integration into clinical practice. Knowledge was significantly associated with educational qualification (χ² = 13.856, p = 0.001) and professional cadre (χ² = 20.225, p = 0.003), and was strongly correlated with attitude (r = 0.672, p < 0.001). Higher knowledge and more favourable attitude were significantly associated with fewer perceived barriers (r = -0.318, p = 0.002; r = -0.285, p = 0.004) and with greater willingness to receive training (χ² = 8.419, p = 0.015; r = 0.341, p = 0.001). Only 33.2% had previously received related training, yet 85.2% expressed willingness to attend future training. Healthcare workers in Ilorin Metropolis hold favourable attitudes toward environmental epigenetics that considerably outpace their technical knowledge of the field, and the principal constraints on fuller integration into practice appear to be gaps in training, clinical guidance, and institutional support rather than unwillingness. Structured, cadre-specific training and facility-level clinical guidance are recommended.