The role of health belief model in improving construction artisans’ mental health intervention: Nigerian stakeholders' perspective Open Access

The construction industry comprises many stakeholders. This includes construction artisans, professional practitioners, contractors, suppliers, clients, manufacturers, users and financiers and/or sponsors. In most developing countries, including Nigeria, construction artisans are vital to the sector (Ebekozien et al., 2024a). They play a critical role because of the labour-intensive tasks and improve economic growth (Sanchez et al., 2017). For this study, construction artisans are skilled tradespeople who focus on specific tasks within a project. This includes masons, tilers, roofers, painters, electricians, aluminium fixers, plumbers, carpenters and steel fixers who bring expertise and precision to their work. The construction sector is a labour-intensive activity and creates employment for the prospects of young adults. The industry is dominated by youth. However, the increasing mental illness across most industries (Labinjo et al., 2020), including the construction sector (Vanderweyen et al., 2024), is of concern to many. Thompson and Doran (2024) asserted that physically demanding work and high-pressure environments have compounded the issue associated with mental ill health as it relates to construction artisans. Studies such as Sun et al. (2024) identified burnout, anxiety, depression and even suicide as outcomes of mental ill health. These may challenge construction workers’ health and well-being and threaten achieving Sustainable Development Goal 3 (SDG 3) (good health and well-being). SDG 3 is one of the 17 United Nations' SDGs and comprises 13 targets and 28 indicators (UN, 2015, 2018, 2022). This mental ill health, if not curbed, may affect the workforce’s well-being and significantly impact the construction firms’ outcomes (Duckworth et al., 2024), especially as it concerns artisans. Kamardeen and Hasan (2023) found elevated safety risks, higher turnover rates, increased absenteeism, reduced work quality and decreased productivity as outcomes of mental health challenges.

Thus, suggesting measures to address mental health problems in the sector, especially concerning construction artisans, is pertinent for the well-being and contracting companies’ operational success. Few scholars (Van der Ham et al., 2011; Ross et al., 2021; Duckworth et al., 2024; Vanderweyen et al., 2024) attempted to address mental health concerns. Besides the several issues hindering the progress from suggesting solutions within the sector, studies focusing on construction artisans in developing countries are limited. There is also an increasing rate of drug abuse among young adults, including construction artisans (Dong et al., 2020; Chapman et al., 2021; Nwaogu et al., 2022). This is one of the research’s motivations to raise awareness about mental health among construction artisans. Coppens et al. (2023) identified the absence of open discussion and acknowledgement of mental health challenges as one of the critical barriers in small and medium-sized enterprises. The majority of construction contracting firms belong to these groups. Mental health remains under-researched, especially in developing countries’ construction companies. This was corroborated by Nguyen (2023), who acclaimed it as the prioritised conventional concerns over safety and productivity. This may hinder awareness and understanding of mental health problems among construction artisans (Mensah et al., 2024). Ross et al. (2021) opined that the workplace culture and environment dampen workers from seeking assistance or conversing about their mental health challenges.

This study focuses on construction contracting artisans who are predominantly male and young adults. This compounds the issue of mental health based on the societal norms of making employees muscular and conform to ideals of toughness and invulnerability (Hanna et al., 2019; Neisa and Neil, 2020). This cultural perception may compound construction artisans not acknowledging mental health problems to evade being perceived as weak by their co-workers and supervisors. Doran et al. (2020) avowed that such attitudes influence negatively and increase the cycle of silence around mental health. This may discourage construction artisans from seeking the support they need and further complicate and hinder good health and well-being, threatening Goal 3 of the SDGs. This may threaten Goal 3. Thus, awareness and signs of possible mental health issues may mitigate some of these challenges. Winkle et al. (2024) stated that improving awareness can assist employees in identifying the signs of mental health problems in themselves and their contemporaries. Increased awareness is a form of mental health intervention. Jin et al. (2023) found that when construction employees develop an understanding of mental health problems, they are likely to engage in mental health initiatives and programmes. The interventions include stress management workshops, counselling and others tailored to improving mental well-being.

In the industry, artisans are significant, particularly in developing countries’ infrastructural development. Thus, the construction artisan’s mental well-being is critical to project productivity and efficiency. Mental health challenges thrive in today’s society, including alcohol and drugs in the construction industry (Contractor, 2025). However, a stigma has compounded issues for people working through therapy or medication. Many victims hide their illness and self-medicate or ignore the issues. The industry has one of the highest suicide rates among professions, especially the field workers where the artisans belong, as reported by the Centres for Disease Control and Prevention and cited in Contractor (2025). Thus, there is a perceived increase in construction artisans’ mental ill health (Omeje et al., 2021; Duckworth et al., 2024), which may threaten to improve the achievement of SDG 3 (good health and well-being). Identifying these factors is critical to shaping artisans’ understanding of mental ill health and offering an all-inclusive analysis of hindrances and ways to mitigate them via embracing the health belief model. Extant studies (Flannery et al., 2019; Chapman et al., 2021; Jin et al., 2023; Winkle et al., 2024; Tijani et al., 2023) principally focused on recognising the causes of mental health issues. This includes poor working conditions (Nwaogu et al., 2023), long working hours (Tijani et al., 2023) and excessive job demands (Winkle et al., 2024). Flannery et al. (2019) investigated attributing factors to substance misuse and suggested measures to reduce them via a sequential exploratory mixed-method research design. Chapman et al. (2021) focused on Australian construction employees using illicit drugs such as meth and/or amphetamine, cocaine and cannabis and how they affect their well-being. Little is known about how the role of the health belief model (HBM) can help construction artisans’ attitudes as a mental health intervention and improve awareness of mental health issues. This gap is a component of the research motivations. Thus, this study explored the factors hindering the adoption of interventions and suggested measures to improve managing Nigerian construction artisans’ mental health using the HBM and, by extension, improve the achievement of Goal 3. This study provided valuable insights into the knowledge gaps, promoted a more supportive and healthier working environment and accomplished the aim via the following:

1. To investigate the factors hindering the adoption of mental health interventions in the Nigerian construction artisan sector and

2. To suggest ways to improve managing Nigerian construction artisans’ mental health using the HBM and, by extension, improve the achievement of Goal 3.

Construction artisans are skilled professionals specialising in a particular trade through a special training set in the industry. The artisan is a skilled tradesperson specialising in crafts such as plumbing, screeding, carpentry, tiling, masonry or electrical work (Ebekozien et al., 2024a, c). They are usually engaged to complete one aspect of a construction project. The training is acquired through hands-on and on-the-job training for a specific period (Kotey and Shanmugapriya, 2024). Construction artisans include tilers, carpenters, steel fixers, plumbers, electricians, masons, bricklayers and excavators (Afolabi et al., 2019; Eze et al., 2020). The majority of these personnel are young adults who obtained their skills through specialised formal and informal apprenticeship programmes. Joseph (2022) emphasised that the role of artisans has impacted several generations with skills in performing their responsibilities. The construction artisans’ work includes physical and complex operations that offer essential services to the industry. This study focuses on Nigeria’s construction artisans. The construction artisans are perceived to be more exposed to mental health problems because many depend on illicit drug and substance misuse to enhance energy for site work (Nwaogu, 2022).

In many developing countries, mental health issues have been a growing concern across sectors, including the construction industry, because of their impacts on employees and contracting firms and, by extension, may threaten the achievement of Goal 3. The World Health Organisation (WHO) (2022) defined mental health as “a state of well-being in which every individual realises his or her potential, can cope with the normal stresses of life, can work productively and fruitfully and can contribute to her or his community.” The WHO defines mental health as social, psychological and emotional well-being. Any threat to individual mental health has negative implications for the person, family members, employer and society at large. This includes diminished quality of life, lower income, reduced productivity and efficiency and illness (Khalid and Syed, 2024). An estimated one billion individuals are affected by mental health illness, with about 60% of them fully employed (WHO, 2022). This is of concern because construction artisans are a component of the 60% employed. Kotera et al. (2019) reported that in Europe, nearly 30% of employees had mental health issues due to exposure to psychosocial risks. This happened between 1999 and 2007. In the USA, the National Centre for Chronic Disease Prevention and Health Promotion found that approximately 20% of adults experienced mental health disorders (Health, 2019). This includes depression, anxiety, feelings of being overwhelmed, headaches and stress. Managing these mental disorders may be alarming, especially in developing countries like Nigeria, which has scarce resources and is faced with economic challenges leading to local currency devaluation and fuel subsidy removal (Ebekozien et al., 2024b).

The International Labour Organisation (ILO) (2022) and the WHO (2022) estimated that nearly 12 billion workdays are lost yearly because of anxiety and depression. This translates to about $1 trillion (ILO, 2022). This includes the construction artisans. Khalid and Syed (2024) argued that mental ill-health issues cut across all sectors. However, Tijani et al. (2024) argued the challenges are unique to the construction industry. This is because the sector is characterised by physically demanding activities (Turner et al., 2020) and long hours (Gomez-Salgado et al., 2023), resulting in high levels of stress (Fordjour et al., 2021) and hazardous engagement conditions (Duckworth et al., 2024). Nwaogu et al. (2020) identified suicidality, job burnout, anxiety and alarming rates of depression as the prevalence of mental health issues among construction employees. Globally, research highlighted the prevalence of mental health challenges. In the UK, it was found that 82% of construction workers experience stress (Gerrard, 2018). In the Netherlands, it was discovered that psychological distress affected 7% of supervisors and 5% of bricklayers (Winkle et al., 2024). In Australia, 60% of remote construction employees experience psychological distress (Bowers et al., 2018). In developing countries, such as Malaysia, the prevalence of mental health issues has risen significantly, from 19% in 1996 to 29% in 2015 (Muneera et al., 2024). These studies revealed that mental health challenges are real and not confined to geographic and economic locations. This re-emphasises the call for an all-inclusive mental health awareness and intervention, especially as it concerns the artisans because of the severe consequences if not curbed. Nwaogu et al. (2022) argued that there is a connection between mental health problems and suicide. Winkle et al. (2024) corroborated Nwaogu et al. (2022) and reported that in the UK and New Zealand, the sector has the highest suicide rates compared to other sectors. This calls for feasible interventions. The HBM may play a critical role, especially regarding the construction artisans’ uniqueness. This is because the model posited that patients’ (artisans) beliefs, attitudes and understanding of the healthcare challenge or illness greatly influenced the likelihood that they would pursue preventive treatments and screening. The model will provide a structured framework to understand construction artisans’ health-related decision-making processes.

The HBM is a psychological model developed to explain and forecast.

Health-related behaviours uptake individuals' health services (Langley et al., 2021). In this instance, construction artisans in Nigeria are a case study. The HBM was developed in the 1950s by psychologists (Rosenstock, 1974) and became a foundational tool in public health research. The HBM theoretical constructs theorise that individuals' health behaviours are influenced by many constructs (Janz and Marshall, 1984): This includes perceived susceptibility (belief regarding the risk of experiencing a health challenge), perceived severity (belief regarding the severity of the health challenge and its possible consequences), perceived benefit (belief in the efficacy or value of the engaged health-promoting behaviour to mitigate disease risk), perceived barrier (belief regarding the encumbrances facing health-promoting behaviour to mitigate disease risk from taking action), cues to action (trigger or cue that prompt engaging in health-promoting behaviour) and self-efficacy (confidence to take action to effect change in outcomes successfully) (Zhou et al., 2021).

Janz and Marshall (1984) and Langley et al. (2021) avowed that HBM has gained support since its development and remains an effective model used to explain and predict health-related behaviour. The HBM showed how workers' beliefs regarding their vulnerability can shape their awareness and willingness to address their mental health issues (Zhou et al., 2021). Studies (Janz and Marshall, 1984; Langley et al., 2021) revealed that the model has been utilised to develop initiatives to change health-related behaviours by engaging the model’s key constructs. Some of these interventions have increased the perceived benefits and decreased the perceived hindrances. Thus, interventions based on the HBM may offer cues to improve engagement in health-promoting behaviours. Rosenstock et al. (1988) opined that interventions can be aimed at the individual or societal levels. Fear of professional repercussions, inadequate access to resources and stigma are perceived issues facing the model, especially in the context of developing countries (Adjei et al., 2024), including construction industries. Bromley et al. (2020) argued that by examining these encumbrances alongside the benefit of mental health interventions, the HBM offers insight into overcoming resistance and nurturing more substantial input in mental health initiatives and programmes. Moreover, by focusing on self-efficacy and cues regarding pro-health-promoting decisions, HBM can guide and enhance effective workplace initiatives to boost mental health awareness and empower construction artisans to seek assistance. The outcome will lead to mastery and excellence of work outputs because of good health and well-being and, by extension, improve productivity and economic growth of the individual, firms and society at large. Good health would enhance productive employment.

This research employed a phenomenology approach. The phenomenology approach is considered exploratory via interviewees’ data collection with experience (Jaafar et al., 2021). It is a type of research design that addresses the difficulty of a sizable scale (Ibrahim et al., 2022). Phenomenologists asserted that social and management sciences are subjective. Thus, what is studied cannot be unpretentious by the research process, and the researcher collects data in the form of observation and interviews (words) majorly (Ebekozien et al., 2025). This is opposed to statistical manipulation in the interpretation and is uniformly applied across all participant groups. The researchers adopted a convenient sampling method. It is a non-probability sampling method (Creswell and Creswell, 2018). This sampling technique involves reaching out to members of the public who are conveniently available and agree to participate. This study’s approach is suitable because of the nature of the topic. The researchers adopted semi-structured face-to-face interviews. Besides, the semi-structured interviews enable researchers to delve deeper into specific issues and allow participants to express their thoughts, feelings and experiences in detail. This is because it will enable the researchers to develop questions to address the study’s objectives, allow flexibility to generate questions within and permit the study to probe responses from the participants on their experience (Ebekozien et al., 2025). This method allows researchers to interpret the participant’s body language and assurance given that their identities would be concealed. The researchers engaged construction contracting firm staffers (management, artisans and medical), consultants, non-governmental organisation (NGO) experts in drug abuse and government agencies, as illustrated in Table 1. The participant’s background contributed to this study’s credibility. For example, P33 and P36 worked with construction contracting firms before they ventured into NGOs. Besides Table 1 revealing the participants’ location, staff strength, years of experience and rank, it shows they were selected from eight contracting companies. Participants P1 to P28 comprise construction contracting staff, P29 to P32 comprise consultants, P33 to P36 comprise NGO experts in drug abuse and P37 to P38 comprise government agency staff. The implications of the demographics revealed that major stakeholders were adequately represented and interviewed. The interviewees were from Lagos and Abuja. Ebekozien and Aigbavboa (2021) affirmed that these municipalities are top commercial and construction hubs in Nigeria.

In total, 38 participants willingly participated, and saturation was accomplished with the 33rd participant. This study also conducted a pilot face-to-face interview with six interviewees. The researchers slightly modified Question 11 based on the feedback from the pilot study. The main interviews were conducted on June 17th to 21st, July 17th and 18th, August 12th to 16th, and September 23rd to 27th, 2024, respectively. First, the researchers invited prospective participants in writing, and 38 interviewees were interviewed. The interview lasted 55 minutes. Concerning ethical matters, the researchers communicated this study’s aim, and participants agreed to participate (Aigbavboa et al., 2023a). The researchers also concealed the interviewees’ identities as part of the ethical considerations in reporting the findings. This aligns with Ebekozien et al. (2025), who affirmed the need for participants’ clarification to be sorted. The researchers analysed the collected data manually using the six steps in line with Braun and Clarke (2012). First, the researchers familiarised themselves with the collected data via their separate reading of the 38 transcripts. Next was the generated open coding, which identified the keywords (Lune and Berg, 2016). The researchers paid attention to keywords. Third, the researchers utilised axial coding to convert the formerly constituted open sub-themes into themes. Next was the selective coding, which identified and affirmed the most pertinent text in the 38 documents (Braun and Clarke, 2021). Next, the researchers compared the themes they had generated with what they had heard throughout the face-to-face interviews and contacted key interviewees to check the emerging main results. Finally, the researchers concluded that factors hindering the adoption of mental health interventions in the Nigerian construction artisan sector threaten achieving Goal 3. Finally, measures to improve managing Nigerian construction artisans’ mental health using the HBM and, by extension, improve the achievement of Goal 3 align with the HBM that emphasised the efficacy or value of the engaged health-promoting behaviour to mitigate disease risk.

This study’s inter-rater reliability was 75% and conducted manually. It became necessary in line with Kouner’s approach (Burns, 2014) because two researchers were involved in the data collection and coding. This study adopted themeing, in vivo, narrative and emotion coding methods (Corbin and Strauss, 2015). The researchers developed 96 codes. These codes were re-clustered based on reference, occurrence and frequency. In total, 10 categories emerged from the 96 codes and were reconvened into 2 main themes. It aligned with Aigbavboa et al.'s (2023b) approach that the researchers triangulated the data to mitigate the fears of the findings’ validity and credibility. To further enhance the study’s validation, Table 2 is explained in a tabulated pattern (Yin, 2014), with words such as reliability, validity, generalisability, transferability, credulity and dependability. This study employed researcher reflexivity, member checking and triangulation as the validity techniques of the collected data. It aligned with Ibrahim et al. (2022), who adopted the same techniques. Regarding the member checking, Participants P6, P12, P17, P20, P25, P28, P32 and P38 were approached to check their transcripts and were satisfied. For the triangulation, the researchers search for convergence among multiple and different sources of information to form the study’s categories and main themes. This study adopted a manual technique to analyse the 38 documents and was guided by semi-structured questions, as illustrated in the  Appendix. The manual technique allows the researchers to become more familiar with the text. The researchers’ experience mitigated the time-consuming aspects associated with manual analysis. The reported findings in the next section were based on the perspectives of the 38 participants.

In line with the HBM theoretical constructs, this theme focuses mostly on perceived susceptibility, perceived severity, perceived benefit and the perceived barrier. Despite the benefits of mental health interventions in the industry, such as reduced absenteeism, better collaboration, improved job performance, less spending on medication, improved contracting company profit, improved workplace safety, encouraged greater awareness among staffers, improved employee morale to work and increased household income (P5, P12, P22, P28, P30, P35 and P38), there are low mental health intervention initiatives in the construction industry (majority), particularly for construction artisans in most contracting firms (P1, P25, P29, P35 and P37). For this study, “majority” implies that more than half of the participants identify the word and/or construct as analysed. Regarding the benefits, Hsu (2023) found improved safety, productivity and employee morale, among others, as the benefits of implementing mental health initiatives in the construction industry. However, it was from a different perspective than improving the achievement of Goal 3 in the life of a construction artisan in developing countries such as Nigeria. Findings show that gaining insights into the perceived hindrances facing the adoption of mental health interventions can help in emerging measures to improve managing Nigerian construction artisans’ mental health using the HBM and, by extension, improve the achievement of Goal 3 (majority). One novelty from this study is re-classifying the hindrances into government-related, construction firm-related and construction artisan-related, as presented in Table 3. Findings identified 31 hindrances. From the 31 hindrances, 23 were construction firm-related, 21 were artisan-related and 8 were government-related, as presented in Table 3. Table 3 reveals that a few hindrances cut across the three groups. This includes high costs associated with mental health care, lack of funding, unfriendly working conditions, low pay and the absence of health and safety global best practices on construction sites.

Global best practices on construction sites emerged as top-ranked regarding government-related hindrances, high costs associated with mental health care, low pay, lax government support and legislation and the absence of health and safety. Participant P33 says, “[…] the majority of legislative and policymakers in Nigeria are less concerned about the health and well-being, including the mental healthcare services accessible to the construction artisans. Their direct siblings or children can’t belong to this category […].” The outcome is epileptic legislation and policy development tailored toward integrating mental health care into primary health care. Findings agree with Wada et al. (2021), who found integrating mental health care into primary health care, training, research, financing and policy development and legislation are the major challenges facing mental health services. Findings reveal that the absence of health and safety global best practices on construction sites, particularly sites managed by indigenous contracting firms, has compounded the problems and increased the cultural perceptions and lack of understanding, including institutional neglect and widespread stigma (majority). Participant P4 says, “[…] many early signs of mental health issues can be managed but concealed because of the supernatural perceived causes such as divine punishment, witchcraft, sorcery, and evil spirits […].” The findings agree with Labinjo et al. (2020), who found that most Nigerians, including construction stakeholders, held supernatural beliefs as the root cause of mental health issues. This may threaten to achieve good health and well-being for construction artisans because culture and religion are significant aspects for Africans.

For the construction firm-related hindrances, inadequate training facilities, high cost associated with mental health care, low pay, lax government support and legislation, absence of health and safety global best practices on construction sites, absence of mental health awareness at the workplace, hired construction artisans, lax evaluation of artisan’s mental health fitness and poor health and safety monitoring and/or supervision systems emerged as top-ranked. For others, refer to Table 3. “[…] I acquired mason/bricklaying skills from a multinational construction company and spent five years as an artisan apprentice. We had a safety morning drill there. I joined this firm four years ago, and in several sites where we worked, there is no safety officer nor a morning safety drill to discuss health matters. At this site entrance, you will see women hacking illicit drugs and concentrated unregulated alcohol drinks patronised by some construction workers. I’m concerned because of the low awareness of mental health issues and possible aftermath of what they consume […]” queried P12. Findings agree with Duckworth et al. (2024), who identified many encumbrances that hinder the adoption of mental health interventions in the industry. This includes the employers not sensitising the employees regarding mental health issues.

Concerning artisan-related hindrances, fear of judgement from colleagues, high costs associated with mental health care, low pay, absence of health and safety global best practices on construction sites, lack of mental health awareness at the workplace, educational qualifications of most construction artisans, fear of stigma, hired construction artisans, peer pressure to discard mental health interventions and exposure to local unregulated alcoholic herbs and illicit drugs within site environment emerged as top-ranked. For others, refer to Table 3. “[…] the issue of local unregulated alcoholic herbs and illicit drugs within construction sites is a major concern, and stakeholders, including contracting firm management staff, approach to curb this menace is lax […]” said P37. Regarding fear of stigma, absence of health and safety global best practices on construction sites, absence of mental health awareness at the workplace, educational qualification of most construction artisans and peer pressure to discard mental health interventions, findings agree with Turner and Holdsworth (2023), who found that these hindrances enhance the artisan’s jaggedness and resilience to mental health issues because of the culture of silence.

Theme two presents feasible measures to improve managing Nigerian construction artisans’ mental health using the HBM and, by extension, improve the achievement of Goal 3. In line with the HBM theoretical constructs, this theme focuses on cues to action and self-efficacy (Zhou et al., 2021). Improving the awareness and sensitisation of construction artisans regarding good health and well-being has become pertinent. This is because of the significant role of the group in the sector and to improve the achievement of Goal 3 and its targets (majority). Findings reveal that achieving SDG 3 implies improved good health and well-being through mental health interventions such as the HBM (Janz and Marshall, 1984; Langley et al., 2021). Findings grouped the measures into government, construction firm and artisan measures, as presented in Table 4.

The role of government in promoting mental health interventions using HBM to achieve SDG 3 cannot be overemphasised. “[…] A play out of recent government support is the signing into law of the Mental Health Bill 2021 on the 5th day of January 2023 by the Nigerian President to replace the obsolete 65-year-old Lunacy Act […].” However, resources to enhance implementation are a challenge and should be drastically addressed to mitigate the increasing mental health issues in Nigeria. Findings agree with Saied (2023), who affirmed that more than 25% of the population have mental issues. This is debatable. Findings reveal that the government should do more regarding mental health awareness and sensitisation, including collaboration with traditional and religious institutions. “[…] these institutions (religious and traditional) are powerful and can influence the mindset of many Nigerians, especially those with weak educational backgrounds. This is where the majority of the construction artisans belong […].” The study’s results align with Ugochukwu et al. (2020) and Saied (2023). Saied (2023) suggested awareness campaigns as one of the mental health interventions to support the rights of people, in this context, the construction artisans. This aligns with HBM with an outcome to the likelihood of engaging in mental health-promoting behaviour of construction artisans based on the awareness and earlier signs from the sensitisation programmes to achieve SDG 3. For others, refer to the first column, Table 4.

The role of a contracting firm in managing artisans’ mental health using the HBM and, by extension, improving the achievement of SDG 3 and its targets cannot be overstated. Regarding tailoring construction artisans toward the likelihood of engaging in mental health-promoting behaviour, findings show that contracting firms (employers of artisans) have critical roles besides the relevant government institutional policies to develop a work-safe environment. This includes embracing mental health interventions through HBM (majority). The era of emphasis on profit to the detriment of workers’ mental health, basic tips to curb future health illness, and work-related health issues should be opposed (P25, P32, P36 and P38). “[…] contracting firms should have a mental health policy mission statement derived from the National Mental Health Act 2021. This is pertinent to curb future mental health issues facing artisans and create project productivity and excellence […],” said Participant P38. Relevant authorities should do mental health intervention programmes intensively right from the first day of employment, and pre-employment drug testing should be encouraged (majority). This would signal to the new employee that the organisation has zero tolerance regarding illicit drugs and unregulated local alcoholic drinks during working hours (P1, P5, P13, P23, P29, P31 and P36). This will enhance the cues to action and self-efficacy, two constructs from the HBM, emerging as measures. Regarding self-efficacy, the company’s actions will caution the artisan against unhealthy behaviours and effect change in outcomes. P13 says, “[…] no smoking policy enforced, and mental health awareness programmes changed one of our artisans from smoking illicit cigarettes for life. He has to stop to retain the job […].” The study’s results align with Langley et al. (2021), who revealed that the model had been utilised to develop interventions to change health-related behaviours by engaging the model’s key constructs. Some of these interventions have increased the perceived benefits and decreased the perceived hindrances, as reflected here. For others, refer to the 2nd column in Table 4. These feasible suggestions can help develop interventions through HBM to improve engagement in health-promoting behaviours.

The construction artisan has a role in the mental health interventions through HBM to achieve SDG 3. Achieving good health and well-being, especially for construction artisans, is all-inclusive (majority). The mindset of the artisan is critical to the failure or success of mental health intervention programmes. Participant P32 says, “[…] the perception among many that illicit drugs give the energy to perform better in the industry should be discouraged through collaborative sensitisation and implications of illicit drug consumption […].” Findings reveal that regular mental health interventions such as counselling, training programmes to identify early signs and what to do, safety drills, and HBM constructs, especially cues to action and self-efficacy, can change the narrative for good and achieve the likelihood of engaging health-promoting construction artisans’ behaviour (majority). This will mitigate many hindrances such as colleagues’ perceptions, stigma, low workers’ morale, high absenteeism, resistance to the training programme and religious and traditional beliefs. Findings agree with Thompson and Doran (2024), who found that workers' knowledgeability of the consequences of mental health abandonment will result in regular mental health checks and workshops. For others, refer to the 3rd column in Table 4. The outcome will improve construction artisans’ engagement and productivity and, by extension, improve the achievement of SDG 3.

This study explored the hindrances facing construction artisan mental health interventions through HBM awareness programmes. It offered feasible measures to improve managing Nigerian artisans’ mental health using the HBM and, by extension, improve the achievement of Goal 3. This study identified 31 hindrances and re-grouped, as presented in Table 3. Table 4 also shows the summarised and re-grouped ways to accomplish SDG 3. Table 4 reveals the independent constructs. This includes construction artisan-related, construction contracting firm-related and government-related measures. The dependent construct is the improved likelihood of engaging artisan’s mental health-promoting behaviour through HBM mechanism awareness and training to achieve SDG 3. The emerged items and/or dimensions in Tables 3 and 4, including the main constructs, form part of the theoretical implications to this study.

The interviewees offer ways to improve managing Nigerian construction artisans’ mental health using the HBM and, by extension, improve the achievement of Goal 3. Findings also reveal that to achieve SGD 3, SDGs such as 1 and 2 are connected with artisans through the HBM mechanism. This study’s findings intend to stir up construction contracting firms’ management staffers, policymakers and other stakeholders concerning artisans’ mental health awareness and sensitisation programmes through HBM to achieve SDG 3. Thus, crucial parties are concerned about the mental health of the youths because of their propensity to drug abuse. The outcome will create a safe workplace environment to engage in health-promoting behaviour for the individual, firm and sustainable society. This research’s findings will help in appraising the hindrances facing artisans’ mental health interventions. This forms a component of the study’s contributions because the main results support the HBM concept. The HBM recommends that people’s (artisans) beliefs about mental health issues, perceived gains of action and hindrances to action and self-efficacy describe involvement in health-promoting behaviour (Janz and Marshall, 1984). This forms the foundation of the study. Hence, this model constructs (independent and dependent) support the results, as discussed. This study’s findings involve engaging in health-promoting behaviour through HBM for individual gain, employer’s gain and society’s gain and, by extension, to achieve good health and well-being for the construction artisan. These suggested solutions, if implemented, would yield job security, higher pay, increased awareness of early mental health signs and how to manage them, creativity and improved technical skills as a result of good health and well-being, mitigated safety risks, higher job satisfaction, decreased absenteeism and increased work quality, as well as improved productivity as outcomes of mental health intervention benefits through HBM.

This study collected data from Abuja and Lagos, Nigeria. To overcome this limitation, the researchers conducted an in-depth review of the literature and a robust discussion of the study’s findings. Regarding suggested research in the future, the adopted research approach may be utilised in other countries with similar hindrances regarding mental health intervention through HBM to accomplish SDG 3. This study’s dimensions and constructs can be employed in future research as measurement items using a mixed-method approach with wider coverage.

This study aimed to explore factors hindering the adoption of mental health interventions and suggest ways to improve managing Nigerian construction an artisans’ mental health using the HBM and, by extension, improve the achievement of Goal 3. This research has revealed that crucial stakeholders are important in artisan’s mental health intervention through HBM to achieve SDG 3. This study identified 31 hindrances and re-grouped them into government-related, construction contracting firm-related and artisan-related hindrances. Findings revealed that achieving SDG 3 may be threatened if it is not curbed. Therefore, this study suggested ways to improve artisans’ mental health intervention through HBM to accomplish SDG 3. This study recommended feasible ways to improve artisan mental health interventions through HBM to accomplish SDG 3. The goal is to achieve SDG 3 via the following recommendations:

1. The role of government is significant in promoting mental health intervention for construction artisans via HBM to achieve SDG 3. It birthed Nigeria’s National Mental Health Act 2021. First, the government should review existing approaches and develop an implementation framework to integrate mental health care and treatment in primary health care facilities. Second, through the proposed implementation framework, improve cost-effectiveness, affordability and accessibility to advance human rights. Third, the implementation framework should integrate community-based rehabilitation centres in sub-urban with a viable primary care coordinating system and be supported with secondary and tertiary care facilities.

2. Besides providing training and retraining regarding mental health interventions and early signs via HBM, contracting firms should develop an all-inclusive monitoring and/or supervisory mechanism for construction artisans, including restriction and consumption of unregulated local alcoholic herbs and illicit drug policies during and after working hours. Also, employers can conduct unplanned on-site drug testing to ensure the workers are conscious and managing their mental health with the support of the health facilities. Funding and investment are critical and should be encouraged by construction contracting firms to achieve positive mental health intervention outcomes, particularly in Nigeria, which has weak primary health care services.

3. Stakeholders, especially artisans, should refrain from taking the role of construction artisan in ensuring the likelihood of engaging in health-promoting behaviour through HBM to improve the achievement of SDG 3 for granted. The mindset and willingness to embrace mental health interventions through HBM awareness and health-promoting behaviour to enrich self-efficacy should be encouraged to enhance proficiency and productivity toward competency in the workplace for individuals, companies and society at large.

The authors specially thank the participants for providing scholarly contributions to enhance the findings of this study and also thank Dr S. S. Umar (Rector, Auchi Polytechnic) and his team for creating an enabling environment to contribute to this research. The authors appreciate the comments, suggestions and recommendations provided by the anonymous reviewers, which honed and strengthened the quality of this manuscript during the blind peer-review process.

Funding: The research was funded by the Faculty of Engineering and the Built Environment and CIDB Centre of Excellence (No: 05-35-061890), University of Johannesburg, South Africa.

Dear Participant,

Request for Interview.

In the construction industry, artisans are important, especially in developing countries’ infrastructural development. Thus, the construction artisan’s mental well-being is critical to project productivity and efficiency. There is a perceived increase in construction artisan mental ill health, which may threaten to improve the achievement of SDG 3 (good health and well-being). Therefore, the paper’s title is Appraising the Role of the Health Belief Model in Nigeria’s Construction Artisans’ Mental Health Interventions. Specifically, the researchers will achieve the stated aim through the following:

1. To investigate the factors hindering the adoption of mental health interventions in the Nigerian construction artisan sector and

2. To suggest ways to improve managing Nigerian construction artisans’ mental health using the health belief model and, by extension, improve the achievement of Goal 3.

Note that the interview questions will be within the stated objectives. Your responses will be collated and analysed together with those of other interviewees. It will make up the value and contribution to achieving the success of this work. The researchers will treat the information provided with the greatest secrecy.

Hence, this study will highly cherish your valuable time and other answers to the questions.

With regards.

Yours faithfully,

(Research Coordinator)

1. For record purposes, what is your organisation’s name and location?

2. What is your position in the organisation?

3. Please tell us your years of work experience.

4. Are you knowledgeable about mental health interventions and Goal 3?

5. If yes to question 4, how can you describe the role of health interventions in improving Nigerian construction artisans’ mental health in the workplace?

6. As a stakeholder in the built environment sector, how can you evaluate the awareness and practice of current mental health interventions through the health belief model?

7. Do you think there are perceived encumbrances facing artisan mental health interventions via the health belief model?

8. If yes to question 7, what are the possible hindrances?

9. If no to Question 7, why do you think so?

10. Can understanding the perceived hindrances facing the adoption of mental health interventions help in emerging measures to improve managing Nigerian construction artisans’ mental health using the health belief model and, by extension, improve the achievement of Goal 3?

11. As a follow-up to question 10, can you discuss this in more detail?

12. Please, what role can key stakeholders (government, contracting firms' management and employees and/or artisans) play in improving Nigerian construction artisans’ mental health using the health belief model and, by extension, improving the achievement of Goal 3?

Source(s): Authors’ work