The percentage of hypertension among adults aged 18 is relatively high which is about 30% in Malaysia. Uncontrolled hypertension will increase the risk of diseases especially cardiovascular disease. However, adults still lack awareness about the importance of knowledge of hypertension. In between, online health information seeking and the use of social media to gather health information have been quite a norm among students. The wide use of this platform has been proven in various researches and studies.

This study will be conducted among the undergraduate students in FMHS, UPM to look at the various socio-demographic factors associated with their level of knowledge on hypertension. Therefore, this may lead to a need to plan awareness programs on hypertension and to increase the knowledge of hypertension among health science students in the future. A cross-sectional study design will be done for this study. All undergraduate students in FMHS, UPM will be selected through simple random sampling. Online questionnaires will be given via the selected student email platform.

However, there are limitations for this study where we only focus on the students of FMHS, UPM. Hence, the results of this study may be limited to them only. The causal relationship cannot be determined by this study design as well. The purpose of this study is to determine the social media use, online health information seeking practices with knowledge on hypertension among undergraduate students in FMHS, UPM, and its associated factors

BACKGROUND Hypertension is a medical condition that acts as an important public health problem worldwide. It contributes to the disease which is mostly seen in primary health care settings such as cardiovascular disease, stroke, kidney failure, and premature death if it is not diagnosed as soon as possible. The World Health Organization (WHO) significantly mentions that an estimation of 1.13 billion people worldwide from poor countries where the healthcare system is weak have been detected with hypertension. Hypertension also puts an enormous financial pressure towards individuals and medical services via utilizing limited resources . Hypertension is predisposed to multiple factors. Such factors vary from country to country and there is also a disparity between urban and rural areas of the same location.

In Malaysia, 30% of adults above 18 have hypertension. Based on another study, it was proven that adults with uncontrolled hypertensive portrayed a higher risk of CVD mortality when compared to normotensive adults. It was reported that there were 3550 of them all caused hypertensive death and based on that 1027 are caused by cardiovascular disease; 771 are caused by heart-specific diseases and 256 by a cerebrovascular specific disease. However, untreated hypertension was stated to be the high risk of all caused death.

Based on a study by Grad I. et al, global knowledge on hypertension among adults is relatively low which is almost 49.2%. Whereas for medium knowledge on hypertension has 38% and only reported that 13% has higher knowledge on hypertension

. Besides, adults also have insufficient knowledge on epidemiology, method of treatment, and avoidance of hypertension(6).In addition, a good understanding of hypertension has also been linked with enhanced compliance with medications and good control of blood pressure.

According to Loiselle (1995), health information behavior is basically defined as a self-regulatory technique used by patients to coordinate transactions between self-related and health-related settings with the goal of balancing instrumental benefits and informative subjective costs. The students use electronic health knowledge to take some essential health-related decisions and actions. Students reported using the health details gathered more as a guide for lifestyle changes (72.4%) and the rest is dealing with healthcare practitioners online about the change in medication and guide of lifestyle changes.

WHO states that many people, primarily in the developing world, have access to online medical information, engage in online groups, buy well-being goods and services.

From the other side, hospital reports are often linked up by health agencies. The search for online health information has been on the increase and the knowledge gained has diverse influences on the healthcare outcomes of human beings. Based on a study conducted on 4504 respondents about mobile health use and perception among Malaysians in Selangor, only 1 in 5 respondents reported using some health-related application or mobile health device. The analysis of the health details that Malaysia is pursuing is still limited. From the point of view of scientific research, not much study has been done on different problems that occurred in the sense of finding health knowledge.

One of the interventional strategies to the elimination of health inequalities is by utilizing social media as a popular way to get health information. Depending on the concepts of loyalty and mutuality, social media promotes the sharing of life-enhancing services, such as health-related knowledge and social ties. In fact, social media sites are activating feedback systems that result in an enhanced degree of self-efficacy, which is vital in sustaining healthier behaviors and adhering to treatment. It becomes a mixture of direct contact and mainstream media which is personalized and responsive. Social networking media, including Facebook, one of the social media networking platforms, has such connectivity features in their architecture. As of 2004, it has been extremely popular with more than 350 million users around the world.

Non-communicable diseases constitute a worldwide crisis that contributes to more than 36 million (63 %) of all mortality globally. Almost 29 million (80%) of such deaths arise in low-and middle-income nations. Increasing use of social media implies a strategy to achieve scalability or even overcome barriers that often impede public health measures. For example, a smartphone-based home glucose monitoring service has been implemented through which community health professionals have given clinical advice for diabetic patients through smartphones.

The social media use, health information seeking, and knowledge on hypertension in Malaysia are not well studied. It is beneficial to have an overview of the social media use, health information seeking and knowledge on hypertension among the students of Faculty of Medicine and Health Science (FMHS), UPM because they are individuals who will work in a healthcare setting in the near future.

In conclusion, knowledge of hypertension is relatively very important to reduce the prevalence of hypertension and to create more awareness among the public. Ways of getting knowledge and online health information like social media are important as it is becoming a popular form of information. This study will be conducted among the students in FMHS, UPM because of the variety of sociodemographic factors present that will be a platform to see the association between the factors and their level of knowledge on hypertension. Moreover, this may be a good start to plan an awareness program on Hypertension and also initiate programs to increase the knowledge of hypertension among the students.

STUDY OBJECTIVE General Objective To determine the social media use, online health information seeking and knowledge on hypertension among students in FMHS, UPM.

Specific Objective I. To determine the socio-demographic factors (age, gender, race, family income status, undergraduate course and year of study) of students of FMHS, UPM. II. To determine the social media use of students among FMHS, UPM. III. To determine the online health information-seeking behavior on hypertension among students of FMHS, UPM. IV. To determine the level of knowledge on hypertension among students of FMHS, UPM. V. To study the association of socio-demographic factors, social media use and online health information seeking on the knowledge of hypertension.

STUDY INSTRUMENTS Study instruments include a questionnaire adapted from a previously published questionnaire. The questionnaire to assess the social media use and health information seeking was adapted from a study about Health Information Seeking and Social Media Use on the Internet among people with Diabetes. The hypertension knowledge questionnaire was adapted from a tool developed to assess hypertension knowledge among urban patients. This questionnaire is prepared in English and is divided into four parts.

Inclusion Criteria:

All undergraduate students in the Faculty of Medicine and Health Science (FMHS), Universiti Putra Malaysia (UPM).

Exclusion Criteria:

1. Students who are on long leave
2. Students who have dropped out of the course.
3. Students who are acutely unwell

This study will take place at the Faculty of Medicine and Health Sciences, University Putra Malaysia in Serdang, Malaysia. This faculty is one of the 16 faculties in University Putra Malaysia and it has almost 1370 undergraduate health sciences and medical students. This number of students in each course offered is Doctor of Medicine (509), Biomedical Sciences (214), Environmental and Occupational Health (213), Dietetic (138), Nutrition and Community Health (196), Bachelor of Nursing (100).The duration of the study of each course varies from four to five years.

Sharing of information of students will be aligned with Universiti's rulings.