Cardiovascular risk factors and motivation for a healthy life-style in a German community--results of the GP-based Oestringen study

Measuring stages of change, perceived barriers and self efficacy for physical activity in Saudi Arabia

BACKGROUND

The benefits of physical activity are well established and recognized to prevent adults from many chronic diseases and particularly some forms of cancers.

OBJECTIVES

The present study was conducted to investigate the present status of physical activity among Saudi adults in Al-Ahsa, and to examine the association between the stages of change for physical activity and perceived barriers, and self efficacy.

METHODS

A cross- sectional study of 242 subjects (118 males and 124 females) attending health centers aged between 20-56 years, were personally interviewed for demographic data, anthropometric measurement, physical activity level, stages of change for physical activity, self efficacy and perceived barriers.

RESULTS

Forty eight percent of the females were overweight and 16.9% of the males were obese with no significant difference between the genders for BMI categories. More than half of the females were inactive and 39% of the males were physically active with a significant difference (P=0.007). Twenty percent of the males were in maintenance stage, while similar percentage of the females were in contemplation stage. However the majority of the subjects were in pre-contemplation stage with a significant difference across the stages. Males had a higher mean score of self efficacy and less external barriers of physical activity. The major barrier among the females was lack of time (7.2±1.4) and in the males, lack of motivation (7.7±1.4). The females had less internal (21.2±3.8) barriers comparable to the males (23.08±4.7). Both genders had a significant relationship between stages of changes of physical activity and perceived barriers (internal and external), but in the females no significant difference across the stages was observed for self efficacy unlike the males who had a significant difference for self efficacy and self efficacy categories.

CONCLUSION

The present study provided useful data on stages of change for physical activity and some psychosocial factors (self efficacy and perceived barriers) that can help to tailor strategies aiming at increasing physical activity level according to self efficacy and to the barriers detected, to prevent many chronic diseases including certain types of cancer in Saudi Arabia.

Gender differences in health education needs and preferences of Saudis attending Riyadh Military Hospital in the Kingdom of Saudi Arabia

Background and Aim:

Health reforms that tend to increase the participation of clients in decision-making requires them to be health-literate; hence, the importance of health education. However, not much research has been done to investigate the differences in health education needs according to demographic characteristics of the clients. The aim of this study was to find out any possible gender differences there may be in health education needs and preferences.

Subjects and Methods:

This cross-sectional study was conducted at Riyadh Military Hospital, Saudi Arabia, on a convenience sample of adult Saudis attending its clinics. Data was collected from April 2009 to May 2010 using a self-administered questionnaire covering demographic data, history and needs of health education, methods, and preferred educator.

Results:

Of the 1300 forms distributed, 977 were returned completed (75.2% response). Most men (74.0%) and women (77.9%) had had health education, but more women reported that it had been helpful (P = 0.014). More men mentioned health education needs relating to primary prevention (P = 0.027), and unhealthy practices (P = 0.003), and considered the different language a barrier (P = 0.002) even after adjustment for age and education. The one-to-one method was the most preferred health education method for men (72.7%) and women (67.9%). More women preferred group health education (P = 0.02) after adjustment for age and education. Significantly more men preferred pharmacists and dietitians as health educators.

Conclusion:

The results point to a few significant differences between men and women regarding their health education needs, barriers, and preferences. These must be taken into consideration when planning health education programs.

The effects of a cardiovascular disease prevention program on knowledge and adoption of a heart healthy lifestyle in Jordanian working adults

BACKGROUND

Improving cardiac related knowledge to further healthy lifestyles is the best preventive strategy against coronary heart diseases (CHD). Previous studies revealed a critical shortage in all-around cardiac related knowledge, plus an overall shortage in adopting healthy lifestyle behaviors.

AIMS

To evaluate the effectiveness of an education, counseling and behavioral skill-building program in Jordanian working adults' knowledge, attitudes, and beliefs about CHD and adoption of a healthy lifestyle.

METHODS

A non-equivalent quasi-experimental design was used to evaluate the effectiveness of the intervention program that is based on Pender's Health Promotion Model. The Response Questionnaire and HPLP-II were used to measure subjects' knowledge, attitudes, beliefs and adoption of healthy lifestyle.

RESULTS

One hundred six subjects completed the posttest questionnaires. Experimental group showed significantly better cardiac related knowledge, better scores for attitudes, and better scores for the health responsibility, nutritional behaviors, interpersonal relationships and total HPLP-II score. Subject's beliefs, physical activity, spiritual growth and stress management were not improved significantly. Men had better scores in beliefs and women had better scores for health responsibility.

CONCLUSION

Individual commitment to healthier lifestyles should be encouraged, and researchers have to design and apply more specific interventions that are directed toward improving factors that are not significantly improved through traditional programs.

Impact on clinical practice of the Joint British Societies' cardiovascular risk assessment tools

OBJECTIVES

The aim of this study was to evaluate the Joint British Societies' (JBS 2) Factfile, cardiovascular risk assessment paper charts and electronic risk calculator posted to health professionals in general practice.

DESIGN

Phase one: surveys on use of the JBS 2 charts and calculator; views on improving use and acceptability. Phase two: six focus groups and two semi-structured interviews on use of the JBS 2 charts and calculator; views on expression of risk, communication of risk and risk management.

PARTICIPANTS

Phase one: general practitioners (GPs) and practice nurses. Phase two: GPs, practice nurses and nurse practitioners recruited via the survey; eligible patients invited by GPs.

SETTING

Primary care.

RESULTS

A high response rate (81.3%, 825/1015) was obtained to a national on-line survey of GPs using Pearl Medical Blackberries((R)). The JBS 2 charts were used by around 1 in 5 GPs and the electronic risk calculator by around 1 in 6. Patients and health professionals found the concept of risk difficult, preferred relative to absolute risk and liked the JBS 2 electronic risk thermometer and its ability to illustrate how changes in risk factors affect risk levels. Communication of risk in visual terms was a key to understanding the concept. The most important factor was risk management; how to motivate and support patients to maintain healthy lifestyles and concordance with medication was as important as communication of risk. Health professionals need training in both aspects.

CONCLUSIONS

To maximise the use of cardiovascular risk assessment tools, multiple approaches are needed; it is not sufficient to distribute them in the post. Communicating and managing cardiovascular risk is difficult; to be effective more time is needed than is available in a routine GP appointment. Practice nurses may be well suited for this role. Costs of training and continuing support need to be built into the overall costs of the national programme for cardiovascular screening now known as NHS Health Checks.

Barriers to a healthy lifestyle among patients attending primary care clinics at a university hospital in Riyadh

BACKGROUND AND OBJECTIVES

The occurrence and progress of chronic non-communicable diseases (NCDs) is associated with unhealthy lifestyles and behaviors. Modification of barriers to healthy lifestyle can produce great benefits. The objective of this study was to identify barriers to physical activity and healthy eating among patients attending primary health care clinics in Riyadh city.

PATIENTS AND METHODS

A cross-sectional study was conducted at King Khalid University Hospital (KKUH) in Riyadh city. Four hundred and fifty participants attending primary health care clinics (PHCC) from 1 March to 30 April 2007 were randomly selected. A questionnaire about barriers to physical activity and healthy eating was adapted from the CDC web site.

RESULTS

The prevalence of physical inactivity among the Saudi population in the study was 82.4% (371/450). Females were more physically inactive (87.6%, 268/306) compared to males (71.5%, 103/144) (P<.001). The most common barrier to physical activity was lack of resources (80.5%, 326/405), which was significantly higher among females than males and among the lower income versus the higher income group. The most common barrier to healthy diet was lack of willpower. More than four-fifths (80.3%, 354/441) of the study group stated that they did not have enough will to stick to a diet.

CONCLUSION

Lack of resources was the most important barrier for physical activity, while lack of willpower and social support were both barriers for adherence to physical activity and a healthy diet.