Neighbourhood Walkability as a Moderator of the Associations between Older Ghanaians’ Social Activity, and the Frequency of Walking for Transportation: A Cross-Sectional Study with Sensitivity Analyses

Sedentary behaviour among older adults residing in flat and hilly neighbourhoods and its association with frailty and chronic disease status

BACKGROUND

Living in hilly neighbourhoods can be associated with sedentary behaviour, but no study has compared sedentary behaviour and its associations with frailty, chronic diseases, and poor health between flat and hilly neighbourhoods among older adults. This study, therefore, compared older adults' sedentary behaviour and its association with frailty, poor health, and chronic disease status between low and hilly neighbourhoods.

METHODS

This study utilised a STROBE-compliant cross-sectional design with sensitivity analyses and a common methods bias assessment. The participants were 1,209 people aged 50+ years who resided in flat (Ablekuma North, n = 704) and hilly (Kwahu East, n = 505) neighbourhoods in Ghana. The data were analysed with the independent samples t-test and hierarchical linear regression.

RESULTS

Older adults in the hilly neighbourhood were more sedentary than those in the flat neighbourhood. The association between sedentary behaviour and chronic disease status was significant in both neighbourhoods, but this relationship was stronger in the hilly neighbourhood. Older adults in the flat neighbourhood reported lower sedentary behaviour at higher frailty (β = -0.18; t = -3.2, p < 0.001), but those in the hilly neighbourhood reported higher sedentary behaviour at higher frailty (β = 0.16; t = 3.54, p < 0.001).

CONCLUSIONS

Older adults living in the hilly neighbourhood reported higher sedentary behaviour. In the hilly neighbourhood, sedentary behaviour was more strongly associated with frailty and chronic disease status. Older adults in hilly neighbourhoods may need extra support to avoid sedentary behaviour.

Associations between vigorous physical activity, social ties, social support, and self-reported health among older adults in Accra, Ghana

Meeting recommended vigorous physical activity (VPA) levels represents a hallmark for healthy living, but VPA in older populations is likely to lead to casualties that may compel older adults to underscore their health. This study examined the associations between VPA, social ties, social support, and self-reported health in an African sample of older adults. This study adopted the cross-sectional design. The study population was community-dwelling older adults aged 60 years or higher in Accra, Ghana. A total of 686 older adults responded to self-reported questionnaires. Data were analysed with the Pearson's chi-square test and binary logistic regression. The study found that older adults who had above 5 children were 3 times (AOR = 3.169; p = .002) more likely to participate in VPA for 30 minutes or more a day compared with their peers without children. Having social support from between 1 and 5 people was 28 times (AOR = 28.215; p = .000) more likely to result in good health compared to not having anyone to source social support from. Older adults who participated in VPA for 30 minutes or more were less likely (AOR = 0.129; p = 0.000) to report good health compared with those who participated in VPA for less than 30 minutes. We conclude that when social ties and other personal characteristics are adjusted for, prolonged VPA does not necessarily enhance self-reported health, and not all social ties contribute to VPA and self-reported health.

Older Adults' Vigorous Occupational Physical Activity Levels in Six Countries Are Explained by Country and 'Having Multiple Jobs'

Several studies have compared physical activity (PA) levels between countries, but none of these studies focused on older adults and occupational PA. This study aimed to assess potential inequalities in older adults' occupational PA across six countries and to ascertain whether having multiple jobs is a factor that interacts with country of residence to modify inequalities. This study adopted a cross-sectional design with a statistical technique screening for potential covariates. Older adults (mean age = 64 years; range = 50-114 years) from six countries (Russia, Mexico, China, India, Ghana, and South Africa) participated in the study. We utilised data from the first wave of the Study on Global AGEing and Adult Health (SAGE). These data were collected from 2007 to 2010. A random sample of 34,114 older adults completed the survey. We analysed the data with a two-way multivariate analysis of variance after screening for the ultimate covariates. There were differences in occupational PA levels (i.e., vigorous and moderate PA) among the six countries. Occupational PA levels were not significantly associated with having multiple jobs. However, having multiple jobs interacted with country of residence to influence vigorous occupational PA. Older adults from most countries who had more than one job reported more vigorous occupational PA. Older adults' occupational PA differed among the six countries, and having multiple jobs was associated with more vigorous occupational PA. Older adults who keep multiple jobs at a time may be more active than their counterparts who had one job or were unemployed.

The association between nurses’ physical activity counselling and patients’ perceptions of care quality in a primary care facility in Ghana

Many countries including Ghana and Australia have adopted physical activity (PA) counselling in healthcare as a public health improvement strategy. Even so, more evidence is needed to improve clinical PA counselling among clinicians, including nurses. This study examined the association between nurses’ physical activity counselling (NPAC) and patients’ perceptions of care quality. The study adopted a cross-sectional design with a sensitivity analysis against potential confounding. The setting of the study was a public primary care facility in Darkuman, Accra. Participants were 605 patients in wards and the Outpatient Department of the facility. Data were collected using a self-reported questionnaire and analyzed using structural equation modeling. A sensitivity analysis was conducted to select potential confounding variables for the study. The study found that higher care quality was associated with larger scores of NPAC (β = 0.34; CR = 8.65; p = 0.000). NPAC has no significant direct association with patient satisfaction (β = 0.01; CR = 0.22; p > 0.05) and loyalty (β = 0.05; CR = 1.21; p > 0.05), but care quality and patient satisfaction fully mediate the association between NPAC and patient loyalty. It is concluded that NPAC in healthcare can improve care quality and indirectly increase patient satisfaction and loyalty through care quality. The incorporation of PA counselling into clinical nursing may, therefore, be consistent with the core mission of hospitals.