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Mukucha P, Jaravaza DC, Jaravaza N. Midwife gender proclivity: Differential effects of expectant mothers' demographic factors in Zimbabwe. Health Care Women Int 2024:1-21. [PMID: 38976803 DOI: 10.1080/07399332.2024.2373856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 06/25/2024] [Indexed: 07/10/2024]
Abstract
A survey of 300 expectant mothers, in their third trimester, was conducted in Bindura district of Zimbabwe. The causal study was done over a period of 6 months with the intention of determining the differential effects of various demographic factors of expectant mothers on midwife gender preferences. Data was collected using a short questionnaire on demographic factors and expectant mothers' preferences of male or female midwives. A binary logistics regression and odds ratios were used to analyse data. Our results revealed that specific demographics show preferences regarding the gender of midwives. Older women (aged 40 and above), who are married, having their first child, members of the African religion, and with less formal education, tend to prefer midwives of the same gender. Younger women (aged 18-39), those with prior pregnancy experience, Christians, and urban residents, generally were indifferent to midwife gender. Implications of the study were proffered.
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Affiliation(s)
- Paul Mukucha
- Department of Marketing, Faculty of Commerce, Bindura University of Science Education, Bindura, Zimbabwe
| | - Divaries Cosmas Jaravaza
- Department of Marketing, Faculty of Commerce, Bindura University of Science Education, Bindura, Zimbabwe
| | - Nomuhle Jaravaza
- Department of Marketing, Faculty of Commerce, Bindura University of Science Education, Bindura, Zimbabwe
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Ntanda GM, Sia D, Beogo I, Baillot A, Nguemeleu ET, Merry L, Ramdé J, Jean-Charles KP, Philibert L. Factors Influencing the Acceptance or Rejection of Dietary and Body Norm Systems Favorable to the Prevention and Control of Type 2 Diabetes Among Sub-Saharan Africa migrants: A Scoping Review. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02072-3. [PMID: 38969923 DOI: 10.1007/s40615-024-02072-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 06/18/2024] [Accepted: 06/23/2024] [Indexed: 07/07/2024]
Abstract
INTRODUCTION The systems of dietary and body that favor the prevention and control of type 2 diabetes (T2D) go against what is vital for most of the migrant population, exposing them to conflicts of norms that are difficult to reconcile. The purpose of this scoping review is to identify factors that may influence the acceptance or rejection of dietary and body norm systems favorable to the prevention and control of T2D by sub-Saharan Africa migrants living with T2D. METHODS An electronic search of studies from 2011 to 2022, published in English, Italian, French, or Portuguese was conducted in seven databases and in gray literature. The selection of articles was done independently and blindly by six teams of two researchers in accordance with the inclusion and exclusion criteria defined by the PICO. RESULTS Seven studies were included. The results show several factors influencing the acceptance or rejection of dietary and body norms systems favorable to the prevention and control of T2D among the migrants from sub-Saharan Africa, mainly social network, income, availability, and affordability of foods, among others. CONCLUSION Given the paucity of studies available on factors influencing the acceptance or rejection of body norm systems favorable to the prevention and control of T2D by sub-Saharan Africa migrants living with T2D, further studies are needed to better document these factors. A better understanding of these factors and their influence on the well-being of migrant people from sub-Saharan Africa living with T2D could help guide policy, research, and interventions so that they are better adapted to the realities of these populations.
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Affiliation(s)
- Gisèle Mandiangu Ntanda
- Department of Nursing, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada.
- Institut Universitaire Sherpa, Montréal, QC, Canada.
- Institut du Savoir de L'hôpital Montfort-Recherche, Ottawa, ON, Canada.
| | - Drissa Sia
- Department of Nursing, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada
- Institut Universitaire Sherpa, Montréal, QC, Canada
| | - Idrissa Beogo
- Institut du Savoir de L'hôpital Montfort-Recherche, Ottawa, ON, Canada
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Aurélie Baillot
- Institut du Savoir de L'hôpital Montfort-Recherche, Ottawa, ON, Canada
- Department of Nursing, Université du Québec en Outaouais, Gatineau, QC, Canada
| | | | - Lisa Merry
- Institut Universitaire Sherpa, Montréal, QC, Canada
- Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Jean Ramdé
- Département des fondements et pratiques en éducation | Faculté des sciences de l'éducation, Université Laval, Québec, Canada
| | | | - Léonel Philibert
- Institut du Savoir de L'hôpital Montfort-Recherche, Ottawa, ON, Canada
- Pôle Pluralité Humaine, Université de L'Ontario Français, Toronto, Canada
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Mahama S, Weichold K, Fehmer N, Mvungu EN, Natsuaki MN. Pubertal status and body image: An inquiry into experiences of adolescents in Ghana and Kenya. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024; 34:257-271. [PMID: 38659355 DOI: 10.1111/jora.12953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 03/26/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
The current study uses a mixed method design to investigate Kenyan and Ghanaian adolescents' experiences of puberty, and the relations between gender, country of origin, pubertal status, and body image appraisals (N = 86; Ghana = 46, Kenya = 40, 52.9% female aged 13 and 14). Qualitative results revealed seven major themes; puberty means a universal period of growth and transition into adulthood but also evokes negative emotions of shame, anxiety, and embarrassment, being in sync with peers during puberty is important and knowing that others in their lives similarly experience puberty is reassuring. Quantitative results revealed significant gender and country differences in pubertal status and body image. Ghanaian adolescents had more advanced pubertal status and more positive body image appraisals compared to Kenyan adolescents. Moderation analysis results revealed that for the Kenyan sample, post-pubertal males had less favorable body image appraisals than their counterparts who were still pre pubertal whilst for females, post-pubertal girls had more favorable body images than their counterparts. No such effects were observed with the Ghanaian sample. The findings highlight the need for context considerations in understanding body image during the pubertal transition to help identify relevant protective factors for possible interventions. The results affirm the importance of positive body image promotions for adolescents within the African context and suggest the need for much more comprehensive sex education with gender-specific components to help allay fears about puberty, thus preventing the development of possible adaptation problems.
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Affiliation(s)
| | | | - Nora Fehmer
- Friedrich Schiller University of Jena, Jena, Germany
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Mohamed BAA, Idrees MHD. Body image dissatisfaction and its relation to body mass index among female medical students in Sudan: across-sectional study 2020-2021. BMC Womens Health 2023; 23:593. [PMID: 37950174 PMCID: PMC10638698 DOI: 10.1186/s12905-023-02748-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Body image is mainly determined by biological, social, psychological and cultural factors thus it is a multifaceted vigorous construct. Body image is an essential aspect of girls' self-definition and individual identity. Excessive concern about body image and body image misconceptions leads to dissatisfaction, disturbed eating patterns, affecting the nutritional status and also leading to depression and anxiety disorder. METHODS This is a descriptive cross-sectional university-based study aiming to investigate body image dissatisfaction and its relation to BMI among female medical students at the University of Khartoum, faculty of medicine. The study was carried out between December 2020 and January 2021. Simple random sampling was applied and a two-sectioned questionnaire was used. The first part consisted of socio-demographic data and the second part contained questions to assess body image the data was. A total of 277 participants were enrolled in the study. Data was analyzed using SPSS version 20. RESULTS We enrolled 277 female medical students the majority of participants (53%) were considered of normal weight according to BMI, 7% considered obese, and 18% underweight. Large number of participants thought that they are not in the ideal weight according to their height (62%). (21% to 17%) of participants always feel pressure from people or society to get to a certain weight. With respect to attitude towards weight, (29%) of participants always wear clothes that don't reveal their body shape, (35%) of them always tend to wear clothes that hide their excess weight. CONCLUSIONS The study concluded that participants who were overweight, obese or underweight have significant increase risk for poor body image perception with odd ratio of 39, 11, and 59 respectively. Thus early and proper interventions are necessary to circumvent the impact and future repercussion of body image distortion.
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Romo ML, Esber AL, Owuoth J, Maswai J, Sing'oei V, Iroezindu M, Bahemana E, Kibuuka H, Cavanaugh JS, Shah N, Ake JA, Crowell TA. Impact of weight gain with dolutegravir on antiretroviral adherence and viral suppression in four African countries. HIV Med 2023; 24:1066-1074. [PMID: 37232057 DOI: 10.1111/hiv.13501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/06/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE We hypothesized that total body weight (TBW) gain after switching antiretroviral therapy (ART) regimen to tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD) may negatively impact ART adherence and viral load (VL) and therefore sought to examine these associations. METHODS The ongoing African Cohort Study (AFRICOS) enrols people with HIV at 12 facilities in Kenya, Nigeria, Tanzania and Uganda supported by The US President's Emergency Plan for AIDS Relief. Among ART-experienced participants who switched to TLD, we used multivariable multinomial logistic regression to examine associations between pre-/post-TLD changes in percentage TBW (≥5% gain, <5% change, ≥5% loss) and changes in self-reported ART adherence (0, 1-2, ≥3 days missed doses in past 30 days) and VL [(<50 copies/mL (undetectable), 50-999 copies/mL (detectable, but suppressed), ≥1000 copies/mL (unsuppressed)]. RESULTS Among 1508 participants, median time from starting TLD to follow-up was 9 months (interquartile range: 7-11). Overall, 438 (29.1%) participants experienced a TBW gain ≥5%, which was more common among females than among males (32.2% vs 25.2%, p = 0.005) and participants switching from efavirenz [32.0% vs nevirapine (19.9%) and boosted protease inhibitor (20.0%); p < 0.001]. Compared with a TBW change <5% [950 (63.0%) participants], TBW gain ≥5% was not significantly associated with more days with missed ART doses [adjusted odds ratio (aOR) = 0.77, 95% confidence interval (CI): 0.48-1.23] or VL becoming detectable and/or unsuppressed (aOR = 0.69, 95% CI: 0.41-1.16). CONCLUSIONS Although a substantial proportion of participants experienced weight gain after switching to TLD, we did not identify a significant impact on adherence or virological outcomes.
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Affiliation(s)
- Matthew L Romo
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA
| | - Allahna L Esber
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA
| | - John Owuoth
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
- HJF Medical Research International, Kisumu, Kenya
| | - Jonah Maswai
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- U.S. Army Medical Research Directorate-Africa, Kericho, Kenya
| | - Valentine Sing'oei
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
- HJF Medical Research International, Kisumu, Kenya
| | - Michael Iroezindu
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- HJF Medical Research International, Abuja, Nigeria
| | - Emmanuel Bahemana
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- HJF Medical Research International, Mbeya, Tanzania
| | - Hannah Kibuuka
- Makerere University-Walter Reed Project, Kampala, Uganda
| | - J Sean Cavanaugh
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Neha Shah
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Julie A Ake
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Trevor A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA
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Daran B, Levasseur P, Clément M. Updating the association between socioeconomic status and obesity in low-income and lower-middle-income sub-Saharan African countries: A literature review. Obes Rev 2023; 24:e13601. [PMID: 37415279 DOI: 10.1111/obr.13601] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 07/08/2023]
Abstract
Globally, the literature tends to emphasize negative associations between socioeconomic status (SES) and bodyweight in countries improving their economic development. However, little is known about the social distribution of obesity in sub-Saharan Africa (SSA) where economic growth has been highly heterogeneous the last decades. This paper reviews an exhaustive set of recent empirical studies examining its association in low-income and lower-middle-income countries in SSA. Although there is evidence of a positive association between SES and obesity in low-income countries, we found mixed associations in lower-middle-income countries, potentially providing evidence of a social reversal of the obesity burden.
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Affiliation(s)
- Bertille Daran
- PSAE, INRAE, AgroParisTech, Université Paris-Saclay, Palaiseau, France
| | - Pierre Levasseur
- SADAPT, INRAE, AgroParisTech, Université Paris-Saclay, Palaiseau, France
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Boxer B, Trübswasser U, Lesi V, Naika A, Dahal P, Sagan S, Joshi K, Irache A, Singh P, Nand D, Kama A, Deo A, Goudet S. Rapid review of factors influencing dietary behaviors in Fiji. Front Nutr 2023; 10:1164855. [PMID: 37621737 PMCID: PMC10445140 DOI: 10.3389/fnut.2023.1164855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/20/2023] [Indexed: 08/26/2023] Open
Abstract
Introduction In Fiji, multiple burdens of malnutrition including undernutrition, overweight/obesity, and micronutrient deficiencies coexist at the individual, household, and population levels. The diets of children, adolescents, and adults are generally unhealthy. The objective of this review was to understand how the dietary behaviors of children, adolescents, and women in Fiji are influenced by individual, social, and food environment factors. Methods This rapid review was conducted to synthesize existing evidence, identify research gaps in the evidence base, and make recommendations for future research. The Cochrane Rapid Reviews Methods and the updated guideline for reporting systematic reviews were used. The search strategy for this rapid review was based on the Population Context Outcome [P(E)CO] framework, including search terms for population (children, adolescents, and adults), context (Fiji), and outcome (dietary behaviors). Searches were conducted in PubMed, Scopus, PsycINFO, and Google Scholar. Results The 22 studies included in this review identified different factors influencing dietary behaviors in Fiji. Individual preferences for processed and imported foods, especially of younger generations, and social dynamics, especially gender norms and social pressure, to serve meat and overeat appeared to be prominent in driving dietary habits. The ongoing nutrition transition has led to increasing availability and affordability of ultra-processed and fast foods, especially in urban areas. Concerns about food safety and contamination and climate change and its effect on local food production also appear to influence dietary choices. Discussion This review identified different dynamics influencing dietary behaviors, but also research gaps especially with regard to the food environment, calling for an integrated approach to address these factors more systemically.
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Affiliation(s)
| | | | - Viola Lesi
- Nutrition Research, Dikoda, London, United Kingdom
| | - Asaeli Naika
- Nutrition Research, Dikoda, London, United Kingdom
| | | | | | | | - Ana Irache
- Nutrition Research, Dikoda, London, United Kingdom
| | - Pragya Singh
- School of Public Health and Primary Care, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - Devina Nand
- Ministry of Health and Medical Services, Suva, Fiji
| | - Ateca Kama
- Ministry of Health and Medical Services, Suva, Fiji
| | - Alvina Deo
- National Food and Nutrition Centre, Suva, Fiji
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Pencil A, Matsungo TM, Hongu N, Hayami N. Prevalence of Obesity and the Factors Associated with Low Obesity Awareness among Urban Adolescents in Harare, Zimbabwe. Nutrients 2023; 15:nu15102302. [PMID: 37242185 DOI: 10.3390/nu15102302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Obesity is a global health problem. In developing countries such as Zimbabwe, obesity is both an emerging health problem and a grey area, particularly among adolescents. This study assessed the prevalence of obesity and factors associated with low obesity awareness among adolescents. METHOD A cross-sectional survey was performed using an interviewer-administered questionnaire. The participants were 423 adolescents aged 14-19 years recruited from 10 schools in Harare using a stratified random sampling technique. Data were analyzed using SPSS software (version 23) and binary logistics regression was used to examine the factors associated with low obesity awareness. The level of significance was set at p < 0.05. RESULTS The median± IQR age was 16 (14-18) years, and overweight and obesity affected 15.8% of the participants with higher proportions among girls (73.1%, p = 0.002). Low obesity awareness was observed in 27.1% of the adolescents with a higher proportion among girls (67.0%, p = 0.001), 14-16-year-olds (51.3%, p = 0.317), and obese adolescents (56.7%, p = 0.001). Significant factors associated with low obesity awareness were household heads lacking formal education [OR = 9.41 (2.20-40.36), p = 0.003] and inadequate (poor) food habits [OR = 2.58 (1.33-5.01), p = 0.005]. CONCLUSIONS Our study showed that adolescents had different obesity awareness levels and diverse perceptions in terms of obesity causes, and a range of potential solutions. Obesity awareness and nutrition education should address adolescents' poor eating habits while taking cognizance of the different education levels of household heads.
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Affiliation(s)
- Ashleigh Pencil
- Graduate School of Human Life Science, Osaka City University, 3 Chome-3-138 Sugimoto, Sumiyoshiku, Osaka 558-8585, Japan
| | - Tonderayi M Matsungo
- Department of Nutrition, Dietetics and Food Sciences (DNDFS), University of Zimbabwe, Mt Pleasant, Harare P.O. Box MP167, Zimbabwe
| | - Nobuko Hongu
- Graduate School of Human Life and Ecology, Osaka Metropolitan University, 3 Chome-3-138 Sugimoto, Sumiyoshiku, Osaka 558-8585, Japan
| | - Naomi Hayami
- Graduate School of Human Life and Ecology, Osaka Metropolitan University, 3 Chome-3-138 Sugimoto, Sumiyoshiku, Osaka 558-8585, Japan
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Mensah Bonsu I, Brandt C, Ajidahun AT, Omoniyi M, Myezwa H. Physical activity, lifestyle, sociocultural factors and prevalence of excess weight gain among postmenopausal women: A cross-sectional study. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231184508. [PMID: 38099449 PMCID: PMC10725110 DOI: 10.1177/17455057231184508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Most women experienced postmenopausal symptoms during the menopause transition, and they are a common reason for seeking medical attention and lifestyle modification during this phase of life. OBJECTIVE This study assessed the physical activity, lifestyle, and sociocultural levels-associated prevalence of excess weight (overweight and obesity) among postmenopausal women (PW) in Bono-East (Techiman) region, Ghana. DESIGN This is cross-sectional study. METHOD This was a cross-sectional study conducted at Bono-East regional capital, Techiman in Ghana over 5 months. Self-administered questionnaires were used to obtain sociodemographic data, physical activity, lifestyle, and sociocultural associated prevalence of excess weight. Anthropometric indices including ((body mass index (BMI), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR)) were assessed. RESULTS A total of 393 postmenopausal women with a mean age of 60.09 ± 6.24 years participated in the study. When reporting prevalence, obesity, and overweight were distinguished. Using the anthropometric parameters (BMI, WHtR, and WHR) as measured for being overweight, the prevalent rates were 35.7%, 21.7%, and 9.0% respectively. Also, when using obesity, the prevalent rate was 37.8%, 70.1%, and 82.0% using BMI, WHtR, and WHR, respectively. Over 55 (55.2%) of the study participants engaged in moderate physical activities, 23.1% were low and 21.7% with high physical activities. Housewives and unemployed participants are shown to have a higher risk of gaining weight (obese) especially when assessed with WHR and WHtR. Most participants responded that cultural beliefs prevent them from losing weight. Most participants had a poor attitude toward their eating habits. CONCLUSION According to the findings, postmenopausal Ghanaian women showed a high level of obesity and a moderate level of being overweight. The cultural perception of beauty influences Ghanaian postmenopausal women's physical activity level and dietary habits.
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Affiliation(s)
- Isaac Mensah Bonsu
- Department of Physiotherapy, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Corlia Brandt
- Department of Physiotherapy, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Adedayo Tunde Ajidahun
- Department of Physiotherapy, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Moses Omoniyi
- Department of Physiotherapy and Sports Science, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Hellen Myezwa
- Department of Physiotherapy, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Assessing community readiness for overweight and obesity prevention among Ghanaian immigrants living in Greater Manchester, England. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01777-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Abstract
Aim
This study assesses community readiness to prevent overweight/obesity among Ghanaian immigrants in Greater Manchester, England.
Subject and method
The Community Readiness Model (CRM) was applied using a semi-structured interview tool with 13 key informants (religious and other key community members) addressing five readiness dimensions. A maximum of 9 points per dimension (from 1 = no awareness to 9 = high level of community ownership), was assigned, alongside qualitative textual thematic analysis.
Results
The mean readiness score indicated that the study population was in the “vague awareness stage” (3.08 ± 0.98). The highest score was observed for community knowledge of the issue (4.42 ± 0.99) which was in the pre-planning phase, followed by community climate (vague awareness; 3.58 ± 0.62). The lowest scores were seen for resources (denial/resistance; 2.70 ± 0.61) and knowledge of efforts (no awareness; 1.53 ± 0.44). Findings identified structural barriers, including poor living conditions as a result of poorly paid menial jobs and high workload, contributing to the adoption of unhealthy lifestyle behaviours. Socio-cultural factors such as fatalism, hereditary factors, and social status were associated with acceptance of overweight.
Conclusion
Despite recognising overweight/obesity as an important health issue in these communities, especially among women, it is not seen as a priority for targeting change. To help these communities to become more ready for interventions that tackle overweight/obesity, the focus should initially be to address the structural barriers identified, including reducing poverty, alongside designing interventions that work with these structural barriers, and thereafter focus on the socio-cultural factors.
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Dade E, Metz M, Pierre JL, Rouzier V, Sufra R, Fox E, Preval F, St-Preux S, Zephir JR, Ariste W, Rasul R, Sabwa S, Roberts N, Deschamps MM, Severe P, Fitzgerald D, Pape JW, Yan LD, McNairy ML. High prevalence of obesity among women in urban Haiti: Findings from a population-based cohort. Front Public Health 2022; 10:976909. [PMID: 36276356 PMCID: PMC9581236 DOI: 10.3389/fpubh.2022.976909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/23/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Obesity is associated with increased risk of non-communicable diseases and death and is increasing rapidly in low- and middle-income countries, including Haiti. There is limited population-based data on body mass index (BMI) and waist circumference (WC) and associated risk factors in Haiti. This study describes BMI and WC, and factors associated with obesity using a population-based cohort from Port-au-Prince. Methods Baseline sociodemographic and clinical data were collected from participants in the Haiti CVD Cohort Study between March 2019 and August 2021. Weight was categorized by BMI (kg/m2) with obesity defined as ≥30 kg/m2. Abdominal obesity was defined using WC cutoffs of ≥80 cm for women and ≥94 cm for men based on WHO guidelines. Sociodemographic and behavioral risk factors, including age, sex, educational attainment, income, smoking status, physical activity, fat/oil use, daily fruit/vegetable consumption, and frequency of fried food intake were assessed for their association with obesity using a Poisson multivariable regression. Results Among 2,966 participants, median age was 41 years (IQR: 28-55) and 57.6% were women. Median BMI was 24.0 kg/m2 (IQR: 20.9-28.1) and 508 (17.1%) participants were obese. Women represented 89.2% of the population with BMI ≥30 kg/m2. A total of 1,167 (68.3%) women had WC ≥80 cm and 144 (11.4%) men had WC ≥94 cm. BMI ≥30 kg/m2 was significantly more prevalent among women than men [PR 5.7; 95% CI: (4.3-7.6)], those 40-49 years compared to 18-29 years [PR 3.3; 95% CI: (2.4-4.6)], and those with income >10 USD per day compared to ≤1 USD [PR 1.3; 95% CI: (1.0-1.6)]. There were no significant associations with other health and behavioral risk factors. Discussion In Haiti, women have an alarming 6-fold higher obesity prevalence compared to men (26.5 vs. 4.3%) and 89.2% of participants with obesity were women. Abdominal obesity was high, at 44.3%. Haiti faces a paradox of an ongoing national food insecurity crises and a burgeoning obesity epidemic. Individual, social, and environmental drivers of obesity, especially among women, need to be identified.
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Affiliation(s)
- Eliezer Dade
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Miranda Metz
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Jean Lookens Pierre
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Vanessa Rouzier
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Rodney Sufra
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Elizabeth Fox
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY, United States
| | - Fabyola Preval
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Stephano St-Preux
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Jean Ronald Zephir
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Wilson Ariste
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Rehana Rasul
- Institute for Implementation Science in Population Health, City University of New York, New York, NY, United States
| | - Shalom Sabwa
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Nicholas Roberts
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Marie Marcelle Deschamps
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Patrice Severe
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Daniel Fitzgerald
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Jean William Pape
- Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Lily Du Yan
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Margaret L. McNairy
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
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12
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Direct and Indirect Determinants of Body Mass Index in Both Major Ethnic Groups Experiencing the Nutritional Transition in Cameroon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106108. [PMID: 35627645 PMCID: PMC9141336 DOI: 10.3390/ijerph19106108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/24/2022]
Abstract
In the context of rapid nutritional transitions in Africa, few studies have analyzed the etiology of obesity by considering the driver pathways that predict body mass index (BMI). The aim of this study is to innovatively identify these driver pathways, including the main sociodemographic and socioecological drivers of BMI. We conducted a rural–urban quantitative study in Cameroon (n = 1106; balanced sex ratio) to explore this issue. We recruited participants and reported several sociodemographic characteristics (e.g., marital status, socioeconomic status (SES), and ethnicity). We then assessed three main socioecological drivers of BMI (body weight perception, dietary intake, and physical activity) and conducted bioanthropometric measurements. We identified several driver pathways predicting BMI. In Cameroon, Bamiléké ethnicity, higher SES, being married, and older age had positive effects on BMI through overweight valorization and/or dietary intake. Accordingly, we found that being Bamiléké, married, and middle-aged, as well as having a higher SES, were factors that constituted at-risk subgroups overexposed to drivers of obesity. As such, this study highlights the necessity of investigating the complex driver pathways that lead to obesity. Therefore, better identification of the subgroups at risk for obesity will help in developing more targeted population health policies in countries where this burden is a major public health issue.
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Abstract
AbstractThe rapid rise in the prevalence of overweight and obesity, and the associated health problems, is an emerging challenge in Ghana, and for women in particular. This study contributes to the understanding of this emerging phenomenon in Ghana by analyzing it from a community perspective, applying the Community Readiness Model in two small cities in Ghana. A series of Key Informant Interviews were undertaken and analyzed, using the model’s scoring structure and supplementary textual analysis. We find that communities are aware of overweight and obesity as a health issue, but that it is not prioritized or championed. Furthermore, the diet counseling and keep-fit programs put the responsibility on individuals to address, rather than considering the upstream and structural causes and solutions.
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14
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Burns JE, Stirrup O, Waters L, Dunn D, Gilson R, Pett SL. No overall impact on rate of weight gain with integrase inhibitor-containing regimens in antiretroviral-naïve adults. HIV Med 2021; 23:294-300. [PMID: 34634168 DOI: 10.1111/hiv.13186] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/19/2021] [Accepted: 09/22/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Integrase strand transfer inhibitors (INSTIs) are commonplace in modern antiretroviral therapy (ART). Increased weight gain with their use is increasingly scrutinized. We evaluated weight changes in treatment-naïve adults with HIV-1 attending a UK centre who started regimens including raltegravir or dolutegravir. METHODS A retrospective cohort study of adults prescribed an INSTI between January 2015 and March 2020 were categorized as having started an ART regimen containing raltegravir, dolutegravir, a protease inhibitor or a nonnucleoside reverse transcriptase inhibitor. Individuals with one or more weight measurement ≤ 5 years both pre- and post-ART initiation, who started a three-drug regimen with ≥ 6 months duration and achieved virological suppression (< 50 copies/mL) within 6 months were included. A random effects model with linear slope pre- and post-ART was used, adjusting for age, gender, ethnicity, ART regimen, backbone and year of initiation. RESULTS The cohort included 390 adults; 88.7% were male, 66.4% were of white ethnicity, their median age was 40 years, there was a median of six weight measurements, 2.2 years from diagnosis to ART initiation, 2.9 years from ART to the last weight measurement, and weight and body mass index at initiation were 75 kg and 24.1 kg/m2 respectively. Of these, 254 (65%) started an INSTI. The average pre-ART rate of weight gain was 0.44 kg/year [95% confidence interval (CI): 0.19-0.70], increasing to 0.88 kg/year (0.63-1.10, p = 0.04) after ART initiation. Our adjusted model found no evidence of an association between ART regimen and rate of weight gain. CONCLUSIONS Weight increased in the cohort both pre- and post-ART. We found no evidence of a higher rate of weight gain following ART initiation with an INSTI compared with other regimens.
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Affiliation(s)
- James E Burns
- Centre for Clinical Research in Infection and Sexual Health, Institute for Global Health, University College London, London, UK.,Central and North West London NHS Foundation Trust, London, UK
| | - Oliver Stirrup
- Centre for Clinical Research in Infection and Sexual Health, Institute for Global Health, University College London, London, UK
| | - Laura Waters
- Central and North West London NHS Foundation Trust, London, UK
| | - David Dunn
- Centre for Clinical Research in Infection and Sexual Health, Institute for Global Health, University College London, London, UK.,Medical Research Council Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Richard Gilson
- Centre for Clinical Research in Infection and Sexual Health, Institute for Global Health, University College London, London, UK.,Central and North West London NHS Foundation Trust, London, UK
| | - Sarah L Pett
- Centre for Clinical Research in Infection and Sexual Health, Institute for Global Health, University College London, London, UK.,Central and North West London NHS Foundation Trust, London, UK.,Medical Research Council Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
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