1
|
Shin C, Belyea M. The Moderating Role of Collectivism on Physical Activity and Family Support: A Cross-Sectional Design. FAMILY & COMMUNITY HEALTH 2024; 47:108-116. [PMID: 38372328 DOI: 10.1097/fch.0000000000000396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND An important value among Korean Americans is collectivism or giving a group priority over the individual. This value, family support, and demographic characteristics have been reported to influence health behaviors among this group. Yet, no study has examined how collectivism, family support, and demographic characteristics interact with each other and then influence physical activity among Korean American adults. The purpose of the study was to examine the association between family support and physical activity, and the moderating role of demographic characteristics and collectivism on this association among Korean American adults. METHODS A descriptive, cross-sectional study was conducted with a sample of 110 Korean American adults 18 years and older, residing in a Southwestern city in the United States. Self-administered questionnaires were used to measure demographics, collectivism, family support, and physical activity. RESULTS Data analysis using a zero-inflated negative binomial regression model revealed a positive relationship between family support and physical activity, while age and gender were moderators of the relationship between family support and physical activity. Collectivism was positively related to physical activity and moderated the relationship between family support and physical activity. CONCLUSION These findings indicate the significance of collectivism and family support that influence Korean American adults' physical activity.
Collapse
Affiliation(s)
- Chanam Shin
- College of Nursing, Texas Woman's University, Denton (Dr Shin); and Edson College of Nursing and Health Innovation, Arizona State University, Phoenix (Dr Belyea)
| | | |
Collapse
|
2
|
Hassan S, Gujral UP, Quarells RC, Rhodes EC, Shah MK, Obi J, Lee WH, Shamambo L, Weber MB, Narayan KMV. Disparities in diabetes prevalence and management by race and ethnicity in the USA: defining a path forward. Lancet Diabetes Endocrinol 2023; 11:509-524. [PMID: 37356445 PMCID: PMC11070656 DOI: 10.1016/s2213-8587(23)00129-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 06/27/2023]
Abstract
Type 2 diabetes disparities in the USA persist in both the prevalence of disease and diabetes-related complications. We conducted a literature review related to diabetes prevention, management, and complications across racial and ethnic groups in the USA. The objective of this review is to summarise the current understanding of diabetes disparities by examining differences between and within racial and ethnic groups and among young people (aged <18 years). We also examine the pathophysiology of diabetes as it relates to race and ethnic differences. We use a conceptual framework built on the socioecological model to categorise the causes of diabetes disparities across the lifespan looking at factors in five domains of health behaviours and social norms, public awareness, structural racism, economic development, and access to high-quality care. The range of disparities in diabetes prevalence and management in the USA calls for a community-engaged and multidisciplinary approach that must involve community partners, researchers, practitioners, health system administrators, and policy makers. We offer recommendations for each of these groups to help to promote equity in diabetes prevention and care in the USA.
Collapse
Affiliation(s)
- Saria Hassan
- Department of Medicine, Emory University, Atlanta, GA, USA; Emory Global Diabetes Research Center, Emory University, Atlanta, GA, USA; Hubert Department of Global Health, Rollins School of Public Health, Atlanta, GA, USA.
| | - Unjali P Gujral
- Emory Global Diabetes Research Center, Emory University, Atlanta, GA, USA; Hubert Department of Global Health, Rollins School of Public Health, Atlanta, GA, USA
| | - Rakale C Quarells
- Emory Global Diabetes Research Center, Emory University, Atlanta, GA, USA; Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Elizabeth C Rhodes
- Emory Global Diabetes Research Center, Emory University, Atlanta, GA, USA; Hubert Department of Global Health, Rollins School of Public Health, Atlanta, GA, USA
| | - Megha K Shah
- Department of Family and Preventive Medicine, Emory University, Atlanta, GA, USA; Emory Global Diabetes Research Center, Emory University, Atlanta, GA, USA
| | - Jane Obi
- Emory School of Medicine, and the Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University, Atlanta, GA, USA; Emory Global Diabetes Research Center, Emory University, Atlanta, GA, USA
| | - Wei-Hsuan Lee
- Department of Medicine, Emory University, Atlanta, GA, USA
| | - Luwi Shamambo
- Department of Medicine, Emory University, Atlanta, GA, USA
| | - Mary Beth Weber
- Emory School of Medicine, and the Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University, Atlanta, GA, USA; Emory Global Diabetes Research Center, Emory University, Atlanta, GA, USA; Hubert Department of Global Health, Rollins School of Public Health, Atlanta, GA, USA
| | - K M Venkat Narayan
- Department of Medicine, Emory University, Atlanta, GA, USA; Emory School of Medicine, and the Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University, Atlanta, GA, USA; Emory Global Diabetes Research Center, Emory University, Atlanta, GA, USA; Hubert Department of Global Health, Rollins School of Public Health, Atlanta, GA, USA
| |
Collapse
|
3
|
Rusowicz J, Serweta A, Juszko K, Idzikowski W, Gajda R, Szczepańska-Gieracha J. Factors Associated with Undertaking Health-Promoting Activities by Older Women at High Risk of Metabolic Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15957. [PMID: 36498030 PMCID: PMC9736211 DOI: 10.3390/ijerph192315957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The complexity of health problems concerning women aged ≥60 years makes it necessary to develop effective, low-cost strategies involving biopsychosocial interventions. The aim of this study is to identify the factors associated with undertaking health-promoting activities by older women at high risk of metabolic syndrome (MetS) with or without depressive symptoms. METHODS The study group consisted of 70 older women (62-84 years old) undertaking regular physical activity. A self-developed questionnaire (used to determine the living situation, selected lifestyle components and health problems), the Perceived Stress Questionnaire (PSQ) and the Geriatric Depression Scale (GDS) were used. RESULTS In the study group undertaking regular physical activity, 40% had increased symptoms of depression (D group), and 60% were classified as non-depressed (ND group). The D group had a higher general stress level (t = -6.18, p = 0.001). Improving and/or maintaining physical fitness was identified as the greatest motivation in both groups. Willingness to spend time with other people significantly differed between the two groups (χ2 = 4.148, p = 0.042). The sole factor significantly differentiating between both groups was lack of time (χ2 = 8.777, p = 0.003). CONCLUSIONS Motivations and barriers to undertaking health-promoting activities and levels of perceived stress were significantly different between the depressed and non-depressed groups. It is important to encourage primary care physicians to perform screening tests for late-life depression and to provide information on where therapeutic interventions are available for patients with symptoms of MetS and coexisting depressive symptoms.
Collapse
Affiliation(s)
- Jagoda Rusowicz
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Anna Serweta
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Karolina Juszko
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Wojciech Idzikowski
- Department of Physical Education and Sport Sciences, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Robert Gajda
- Gajda-Med District Hospital, 06-100 Pultusk, Poland
- Department of Kinesiology and Health Prevention, Jan Dlugosz University, 42-200 Czestochowa, Poland
| | | |
Collapse
|
4
|
Shin C, Oh KM, Lee M, An K, Sim J. A Technology-Enhanced Physical Activity Intervention: A Feasibility Study. Clin Nurs Res 2022; 31:1219-1224. [PMID: 35686393 DOI: 10.1177/10547738221102272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Using a single-group, pre-posttest design, we evaluated feasibility and acceptability of a technology-enhanced physical activity intervention in 43 midlife (aged 35-64) first-generation Korean American adults who were physically inactive. The intervention consisted of bi-weekly education sessions for 4 weeks, monthly small group walks for the following 8 weeks, and weekly reminder text messages during the entire intervention period. A 100% retention rate, 93% adherence, and 88.4% satisfaction supported the feasibility and acceptability of the intervention. Paired t-tests revealed the intervention was successful and effective as demonstrating a significant increase in self-efficacy and moderate physical activity and improved cardiometabolic health. This easy and motivation enhancing intervention has a wide potential applicability for other ethnic groups. Further intervention research is suggested in a large sample, multisite, for a longer-term with a randomized controlled trial design, which may lead us to narrow the gap in physical activity engagement and cardiometabolic health disparities.
Collapse
Affiliation(s)
| | | | - Moonju Lee
- University of Texas Health Science Center at San Antonio, USA
| | - Kyungeh An
- University of Texas Health Science Center at San Antonio, USA
| | | |
Collapse
|
5
|
Dorado Chaparro J, Fernández-Bermejo Ruiz J, Santofimia Romero MJ, del Toro García X, Cantarero Navarro R, Bolaños Peño C, Llumiguano Solano H, Villanueva Molina FJ, Gonçalves Silva A, López JC. Phyx.io: Expert-Based Decision Making for the Selection of At-Home Rehabilitation Solutions for Active and Healthy Aging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5490. [PMID: 35564884 PMCID: PMC9103419 DOI: 10.3390/ijerph19095490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 12/10/2022]
Abstract
While the importance of physical activity in older adults is beyond doubt, there are significant barriers limiting the access of older adults to physical exercise. Existing technologies to support physical activity in older adults show that, despite their positive impacts on health and well-being, there is in general a lack of engagement due to the existing reluctance to the use of technology. Usefulness and usability are two major factors for user acceptance along with others, such as cost, privacy, equipment and maintenance requirements, support, etc. Nevertheless, the extent to which each factor impacts user acceptance remains unclear. Furthermore, other stakeholders, besides the end users, should be considered in the decision-making process to develop such technologies, including caregivers, therapists and technology providers. In this paper, and in the context of physical rehabilitation and exercise at home, four different alternatives with incremental characteristics have been defined and considered: a software-based platform for physical rehabilitation and exercise (Alternative 1), the same software platform with a conventional RGB camera and no exercise supervision (Alternative 2), the same software platform with a convention RGB camera and exercise supervision (Alternative 3) and finally, the same software platform with a depth camera and exercise supervision (Alternative 4). A multiple attribute decision-making methodology, based on the ordinal priority approach (OPA) method, is then applied using a group of experts, including end users, therapists and developers to rank the best alternative. The attributes considered in this method have been usefulness, cost, ease of use, ease of technical development, ease of maintenance and privacy, concluding that Alternative 3 has been ranked as the most appropriate.
Collapse
Affiliation(s)
- Javier Dorado Chaparro
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Jesús Fernández-Bermejo Ruiz
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - María José Santofimia Romero
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Xavier del Toro García
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Rubén Cantarero Navarro
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Cristina Bolaños Peño
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Henry Llumiguano Solano
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Félix Jesús Villanueva Molina
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Anabela Gonçalves Silva
- Center for Health Technology and Services Research, Health Sciences School, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Juan Carlos López
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| |
Collapse
|
6
|
Choi J, Shin NM, Cooper B, Jih J, Janice T. A Pilot Study to Promote Active Living among Physically Inactive Korean American Women. J Community Health Nurs 2021; 38:24-37. [PMID: 33682553 DOI: 10.1080/07370016.2021.1869420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A 4-week lifestyle program called Women's Active Living for Koreans (WALK) was designed for Korean American women to promote physical activity (PA). In a pilot-controlled trial, 40 women were randomized to WALK-regular or WALK-plus. WALK-plus involved joining an online community via a social media app. WALK-plus performed significantly higher numbers of days of muscle-strengthening activities than WALK-regular at the post-intervention visit. Both groups increased vigorous activities and walking and decreased sedentary behaviors on weekdays. WALK program showed great potential in improving PA and decreasing sedentary behaviors. Online social networking may have an additional effect on PA among this population.
Collapse
Affiliation(s)
- JiWon Choi
- Institute for Health & Aging/Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, California, USA
| | - Nah-Mee Shin
- College of Nursing, Korea University, Seoul, Korea
| | - Bruce Cooper
- School of Medicine, UCSF, San Francisco, California, USA
| | - Jane Jih
- School of Medicine, UCSF, San Francisco, California, USA
| | - Tsoh Janice
- Department of Psychiatry, School of Medicine, UCSF, San Francisco, California, USA
| |
Collapse
|
7
|
Lightfoot CJ, Wilkinson TJ, Song Y, Burton JO, Smith AC. Perceptions of exercise benefits and barriers: the influence on physical activity behaviour in individuals undergoing haemodialysis and peritoneal dialysis. J Nephrol 2021; 34:1961-1971. [PMID: 33770396 PMCID: PMC8610943 DOI: 10.1007/s40620-021-01024-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 03/07/2021] [Indexed: 11/29/2022]
Abstract
Background Despite growing evidence about the benefits of physical activity and exercise in patients receiving dialysis, physical inactivity is highly prevalent. This may be due to uncertainty and lack of appropriate guidance about exercise, or driven by the relative barriers and benefits that patients perceive. Understanding these perceptions in dialysis patients may inform interventions aimed to increase exercise participation. Methods Perceived benefits and barriers to exercise were measured by the ‘Dialysis Patient-perceived Exercise Benefits and Barriers Scale’ (DPEBBS). Self-reported physical activity status was assessed by the ‘General Practice Physical Activity Questionnaire’. Barriers and benefits to exercise were classed as binary variables (i.e. yes and no). Frequency analyses and chi-squared tests were conducted to compare the differences perceived by people on haemodialysis (HD) and peritoneal dialysis (PD). Binominal logistical regression was performed to determine which perceived barriers and benefits had the biggest impact on physical activity status. Results One thousand twenty-two HD and 124 PD patients completed the DPEBBS. A greater proportion of HD than PD patients reported ‘reduces body pain’ (P = 0.013), ‘delays decline in body function’ (P = 0.01), and ‘improves quality of life’ (P = 0.033) as benefits of exercise. No differences in barriers were observed. Tiredness was the most reported barrier to exercise. Patients who perceived ‘other comorbidities’ (OR 3.389, P < 0.001) or ‘burden of family’ (OR 3.168, P < 0.001) as barriers were 3 times more likely to be inactive. Conclusions Dialysis patients perceive several barriers which may prevent them from engaging in physical activity. Addressing these barriers may be key to increasing participation in physical activity and exercise. Graphic abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s40620-021-01024-y.
Collapse
Affiliation(s)
- Courtney J Lightfoot
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, LE17RH, UK. .,Leicester NIHR Biomedical Research Centre, Leicester, UK.
| | - Thomas J Wilkinson
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, LE17RH, UK.,Leicester NIHR Biomedical Research Centre, Leicester, UK
| | - Yan Song
- Medical School, Nantong University, Nantong, China
| | - James O Burton
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Alice C Smith
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, LE17RH, UK.,Leicester NIHR Biomedical Research Centre, Leicester, UK
| |
Collapse
|
8
|
Morais NS, Viana RB, Silva WF, Santos DA, Costa TG, Campos MH, Vieira CA, Vancini RL, Andrade MS, Gentil P, DE Lira CA. Effect of both dance exergame and a traditional exercise on state anxiety and enjoyment in women. J Sports Med Phys Fitness 2021; 62:560-567. [PMID: 33721985 DOI: 10.23736/s0022-4707.21.12237-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Anxiety disorders affect many people around the world and women are more affected than men. Physical exercise might be an important nonpharmacological tool to ameliorate these disorders. The aim of this study was to compare state anxiety level and enjoyment between a dance exergame session and a traditional aerobic exercise. METHODS Twenty healthy young women completed 3 visits, on separate days. At the first visit, participants performed a graded exercise testing and familiarization procedures. In other two visits, participants completed two exercise sessions (dance exergame and traditional aerobic exercise), with similar intensities and duration. Each session lasted approximately 45 minutes. State anxiety level was evaluated before, immediately post- and 10 minutes post sessions. Enjoyment was evaluated immediately post sessions. RESULTS There was a significant interaction between session and time (p<0.001), a main effect of time (p=0.007) but no significant main effect of session (p=0.057) on state anxiety level. State anxiety level immediately post (p<0.001) and 10 minutes post-session (p<0.001) were significantly lower than pre-dance exergame session. There were no significant changes between pre-, immediately post and 10 minutes post-traditional aerobic exercise session (p>0.05). State anxiety level at immediately post dance exergame session was significantly lower than immediately post traditional aerobic exercise session (p=0.026). Dance exergame session was significantly more enjoyable than traditional aerobic exercise session (p<0.0001). CONCLUSIONS Dance exergames might be used as a tool to reduce anxiety level in young women.
Collapse
Affiliation(s)
- Naiane S Morais
- Laboratório de Avaliação do Movimento Humano, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil
| | - Ricardo B Viana
- Laboratório de Avaliação do Movimento Humano, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil
| | - Wellington F Silva
- Laboratório de Avaliação do Movimento Humano, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil
| | - Douglas A Santos
- Laboratório de Avaliação do Movimento Humano, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil.,Colegiado de Educação Física, Bahia Universidade Estadual da Bahia, Campus X, Teixeira de Freitas, Brazil
| | - Thalles G Costa
- Laboratório de Avaliação do Movimento Humano, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil
| | - Mário H Campos
- Laboratório de Avaliação do Movimento Humano, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil
| | - Carlos A Vieira
- Laboratório de Avaliação do Movimento Humano, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil
| | - Rodrigo L Vancini
- Centro de Educação Física e Desporto, Universidade Federal do Espírito Santo, Vitoria, Brazil
| | - Marilia S Andrade
- Departamento de Fisiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Paulo Gentil
- Laboratório de Avaliação do Movimento Humano, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil
| | - Claudio A DE Lira
- Laboratório de Avaliação do Movimento Humano, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil -
| |
Collapse
|
9
|
Lim RBT, Wee WK, For WC, Ananthanarayanan JA, Soh YH, Goh LML, Tham DKT, Wong ML. Correlates, facilitators and barriers of physical activity among primary care patients with prediabetes in Singapore - a mixed methods approach. BMC Public Health 2020; 20:1. [PMID: 31898494 PMCID: PMC6941241 DOI: 10.1186/s12889-019-7969-5] [Citation(s) in RCA: 477] [Impact Index Per Article: 119.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 11/19/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Primary care patients with prediabetes is a priority group in the clinical, organisational and policy contexts. Engaging in regular physical activity is crucial to prevent diabetes for this group. The objectives of the study were to assess factors associated with meeting the recommendation of at least 150 min of moderate/vigorous physical activity weekly, and to explore facilitators and barriers related to the behaviour among primary care patients with prediabetes in Singapore. METHODS This was a mixed methods study, consisting of a cross-sectional survey involving 433 participants from 8 polyclinics, and in-depth interviews with 48 of them. Adjusted prevalence ratios (aPR) were obtained by mixed effects Poisson regression model. The socio-ecological model (SEM) was applied, and thematic analysis performed. RESULTS The prevalence of meeting the recommendation was 65.8%. This was positively associated with being male (aPR 1.21, 95%CI 1.09-1.34), living in 4-5 room public housing (aPR 1.19, 95%CI 1.07-1.31), living in executive flat/private housing (aPR 1.26, 95%CI 1.06-1.50), having family members/friends to exercise with (aPR 1.57, 95%CI 1.38-1.78); and negatively associated with a personal history of osteoarthritis (aPR 0.75, 95%CI 0.59-0.96), as well as time spent sitting or reclining daily (aPR 0.96, 95%CI 0.94-0.98). The recurrent themes for not meeting the recommendation included lacking companionship from family members/friends, medical conditions hindering physical activity (particularly osteoarthritis), lacking knowledge/skills to exercise properly, "no time" to exercise and barriers pertaining to exercise facilities in the neighbourhood. The recurrent themes for meeting the recommendation included family/peer influence, health/well-being concerns and education by healthcare professionals. CONCLUSIONS Much more remains to be done to promote physical activity among primary care patients with prediabetes in Singapore. Participants reported facilitators and barriers to physical activity at different levels of the SEM. Apart from the individual and interpersonal levels, practitioners and policy makers need to work together to address the organisational, community and policy barriers to physical activity.
Collapse
Affiliation(s)
- Raymond Boon Tar Lim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore, Singapore city, 117549, Singapore.
| | - Wei Keong Wee
- Health Promotion & Preventive Care, National Healthcare Group Polyclinics, 3 Fusionopolis Link, Nexus@one-north, South Tower, #05-10, Singapore, Singapore city, 138543, Singapore
| | - Wei Chek For
- Health Promotion & Preventive Care, National Healthcare Group Polyclinics, 3 Fusionopolis Link, Nexus@one-north, South Tower, #05-10, Singapore, Singapore city, 138543, Singapore
| | - Jayalakshmy Aarthi Ananthanarayanan
- Health Promotion & Preventive Care, National Healthcare Group Polyclinics, 3 Fusionopolis Link, Nexus@one-north, South Tower, #05-10, Singapore, Singapore city, 138543, Singapore
| | - Ying Hua Soh
- Health Promotion & Preventive Care, National Healthcare Group Polyclinics, 3 Fusionopolis Link, Nexus@one-north, South Tower, #05-10, Singapore, Singapore city, 138543, Singapore
| | - Lynette Mei Lim Goh
- Clinical Services, National University Polyclinics and National University Health System, 1 Jurong East Street 21, Singapore, Singapore city, 609606, Singapore
| | - Dede Kam Tyng Tham
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore, Singapore city, 117549, Singapore
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore, Singapore city, 117549, Singapore
| |
Collapse
|
10
|
A Study of Physical Activity Determinants among High-Risk Hypertensive Filipino and Korean Americans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071156. [PMID: 30935110 PMCID: PMC6479917 DOI: 10.3390/ijerph16071156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/27/2019] [Accepted: 03/27/2019] [Indexed: 01/24/2023]
Abstract
Physical activity (PA) serves a critical role in maintaining health and preventing chronic diseases, though its influence on high-risk Asian American populations is unclear. The purpose of this study was to determine PA levels among Filipino and Korean Americans at high risk of hypertension and to identify sociodemographic and health-related factors associated with PA levels in these populations. A cross-sectional survey was administered to 137 participants in the Greater Philadelphia Area. Data was collected on PA levels, sociodemographic factors, and health factors. Multinomial logistic regression was conducted to determine predictors associated with low, moderate, and high PA and predictive probabilities were calculated for interaction terms, incorporating ethnicity and blood pressure variables. Overall, 42.33% of participants belonged to the moderately active PA group and 21.90% belonged to the highly active group. In the final multinomial regression model, it was found that having gone to college increased the odds of being in the moderately active PA group (coef. = 1.96, p = 0.034), while having high blood pressure reduced the odds of being in the moderately active PA group (coef. = -2.21, p = 0.022). Lastly, being Korean versus Filipino reduced the odds of being in the highly active category (coef. = -2.89, p = 0.035). Based on predictive probabilities, Koreans and Filipinos with high blood pressure were more likely to belong in the low active PA category (52.31% and 46.33%). These findings highlight the need for culturally relevant PA interventions for promoting and increasing PA levels to prevent and manage hypertension among these populations.
Collapse
|
11
|
Lee SY, Lee E, Natipagon-Shah B, Toyama J. Factors Associated with Breast Cancer Screening among Korean American Women in California: Results from the California Health Interview Survey 2015–2016. Asian Pac J Cancer Prev 2018; 19:3271-3277. [PMID: 30486631 PMCID: PMC6318411 DOI: 10.31557/apjcp.2018.19.11.3271] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 10/19/2018] [Indexed: 11/25/2022] Open
Abstract
Background: Few studies have examined preventive lifestyle behaviors and breast cancer (BC) screening behaviors simultaneously to determine whether BC screening behaviors are associated with preventive lifestyle behaviors. The purposes of this study are to (a) describe BC screening utilization and preventive lifestyle behaviors and (b) examine factors associated with BC utilization among Korean American (KA) women. Methods: Data from the 2015–2016 California Health Interview Survey were analyzed. Survey-weighted adjusted logistic regressions were used to determine whether preventive lifestyle behaviors and characteristics of KA women 50 years of age and older at the time of the survey were associated with obtaining mammograms. Results: Most participants were born outside of the US and had lived in the US for 15 years or more at the time of the survey. This study found that KA women who were 50–64 years old had 38 times greater odds of having ever had a mammogram and a 13 times greater odds of having a recent mammogram than those 65 and older. KA women who walked at least 10 minutes per week for transportation and leisure purposed were 61 times more likely to have ever had a mammogram than those who did not walk. Conclusion: This study provides important perspectives on associations of BC screening behaviors and preventive life-style behaviors, especially walking. Future research should be conducted to better understand the association between BC screening and preventive life-style behaviors and to develop feasible interventions to improve BC screening behaviors among KA women, particularly elderly and physically inactive ones.
Collapse
Affiliation(s)
- Shin-Young Lee
- Department of Nursing at Chosun University 309 Pilmun-daero, Dong-gu, Gwangju, Republic of Korea.
| | | | | | | |
Collapse
|
12
|
Shin CN, Lee YS, Belyea M. Physical activity, benefits, and barriers across the aging continuum. Appl Nurs Res 2018; 44:107-112. [PMID: 30389054 DOI: 10.1016/j.apnr.2018.10.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 09/24/2018] [Accepted: 10/14/2018] [Indexed: 01/29/2023]
Abstract
BACKGROUND A growing body of evidence indicates the importance of physical activity during midlife period linked to the likelihood of healthy aging, while the likelihood of an individual engaging in physical activity depends largely on their perceived benefits and barriers to being physically active. AIM This study was to examine physical activity levels of midlife Korean American adults and their perceived benefits and barriers to physical activity compared with young and older adults. METHODS We conducted a secondary analysis of data collected for a larger descriptive, cross-sectional study that was conducted with a sample of 517 Korean American adults in a Midwestern city. Data were collected using a survey questionnaire. RESULTS A little more than half of the sample were women (57.1%), with a mean age of 41.6 (± 13.4). The study sample met the current guidelines for physical activity far less than the general U.S. population (30.4% -34.6 vs. 51.7%). Less midlife adults met the guidelines for moderate-intensity physical activity than older adults (34.2% vs. 57.4%), while less midlife adults met the guidelines for vigorous-intensity physical activity than young adults (24.8% vs. 40.6%). Midlife adults perceived fewer benefits than did young and older adults. CONCLUSION The findings indicate that midlife adults are less likely to engage in physical activity and probably more at risk for unhealthy ageing than young and older adults. Understanding benefits and barriers of target population is the first step in developing culturally and age-appropriate intervention to promote physical activity.
Collapse
Affiliation(s)
- Cha-Nam Shin
- College of Nursing and Health Innovation, Arizona State University, United States of America.
| | - Young-Shin Lee
- School of Nursing, San Diego State University, United States of America.
| | - Michael Belyea
- College of Nursing and Health Innovation, Arizona State University, United States of America.
| |
Collapse
|
13
|
Caballero AE. The "A to Z" of Managing Type 2 Diabetes in Culturally Diverse Populations. Front Endocrinol (Lausanne) 2018; 9:479. [PMID: 30233490 PMCID: PMC6127640 DOI: 10.3389/fendo.2018.00479] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 08/02/2018] [Indexed: 12/15/2022] Open
Abstract
Type 2 diabetes affects racial/ethnic minorities at an alarming rate in the US and in many countries around the world. The quality of health care provided to these groups is often suboptimal, resulting in worse patient-related outcomes when compared to those in mainstream populations. Understanding the complex biological elements that influence the development and course of the disease in high-risk populations is extremely important but often insufficient to implement effective prevention and treatment plans. Multiple factors must be addressed in routine diabetes clinical care. This paper discusses various key factors, organized in alphabetical order. These are acculturation, biology, clinician's cultural awareness, depression and diabetes-specific emotional distress, educational level, fears, group integration, health literacy, intimacy and sexual dysfunction, judging, knowledge of the disease, language, medication adherence, nutritional preferences, other forms of medicine (alternative), perception of body image, quality of life, religion and faith, socio-economic status, technology, unconscious bias, vulnerable groups, asking why?, exercise, "you are in charge" and zip it! Considering these factors in the development of type 2 diabetes prevention and treatment programs will help improve diabetes-related outcomes in culturally diverse populations and reduce health care disparities.
Collapse
Affiliation(s)
- A. Enrique Caballero
- Office for External Education, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
14
|
Barnett DW, Barnett A, Nathan A, Van Cauwenberg J, Cerin E. Built environmental correlates of older adults' total physical activity and walking: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2017; 14:103. [PMID: 28784183 PMCID: PMC5547528 DOI: 10.1186/s12966-017-0558-z] [Citation(s) in RCA: 359] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/31/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Identifying attributes of the built environment associated with health-enhancing levels of physical activity (PA) in older adults (≥65 years old) has the potential to inform interventions supporting healthy and active ageing. The aim of this study was to first systematically review and quantify findings on built environmental correlates of older adults' PA, and second, investigate differences by type of PA and environmental attribute measurement. METHODS One hundred articles from peer-reviewed and grey literature examining built environmental attributes related to total PA met inclusion criteria and relevant information was extracted. Findings were meta-analysed and weighted by article quality and sample size and then stratified by PA and environmental measurement method. Associations (p < .05) were found in relation to 26 individual built environmental attributes across six categories (walkability, residential density/urbanisation, street connectivity, access to/availability of destinations and services, infrastructure and streetscape, and safety) and total PA and walking specifically. Reported individual- and environmental-level moderators were also examined. RESULTS Positive environmental correlates of PA, ranked by strength of evidence, were: walkability (p < .001), safety from crime (p < .001), overall access to destinations and services (p < .001), recreational facilities (p < .001), parks/public open space (p = .002) and shops/commercial destinations (p = .006), greenery and aesthetically pleasing scenery (p = .004), walk-friendly infrastructure (p = .009), and access to public transport (p = .016). There were 26 individual differences in the number of significant associations when the type of PA and environmental measurement method was considered. No consistent moderating effects on the association between built environmental attributes and PA were found. CONCLUSIONS Safe, walkable, and aesthetically pleasing neighbourhoods, with access to overall and specific destinations and services positively influenced older adults' PA participation. However, when considering the environmental attributes that were sufficiently studied (i.e., in ≥5 separate findings), the strength of evidence of associations of specific categories of environment attributes with PA differed across PA and environmental measurement types. Future research should be mindful of these differences in findings and identify the underlying mechanisms. Higher quality research is also needed.
Collapse
Affiliation(s)
- David W. Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | - Anthony Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | - Andrea Nathan
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | - Jelle Van Cauwenberg
- Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
- Research Foundation Flanders, Egmontstraat 5, 1000 Brussels, Belgium
| | - Ester Cerin
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
- School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong, Special Administrative Region China
- Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004 Australia
| | - on behalf of the Council on Environment and Physical Activity (CEPA) – Older Adults working group
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
- Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
- Research Foundation Flanders, Egmontstraat 5, 1000 Brussels, Belgium
- School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong, Special Administrative Region China
- Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004 Australia
| |
Collapse
|
15
|
Barnett DW, Barnett A, Nathan A, Van Cauwenberg J, Cerin E. Built environmental correlates of older adults' total physical activity and walking: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2017. [PMID: 28784183 DOI: 10.1186/sl2966-017-0558-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Identifying attributes of the built environment associated with health-enhancing levels of physical activity (PA) in older adults (≥65 years old) has the potential to inform interventions supporting healthy and active ageing. The aim of this study was to first systematically review and quantify findings on built environmental correlates of older adults' PA, and second, investigate differences by type of PA and environmental attribute measurement. METHODS One hundred articles from peer-reviewed and grey literature examining built environmental attributes related to total PA met inclusion criteria and relevant information was extracted. Findings were meta-analysed and weighted by article quality and sample size and then stratified by PA and environmental measurement method. Associations (p < .05) were found in relation to 26 individual built environmental attributes across six categories (walkability, residential density/urbanisation, street connectivity, access to/availability of destinations and services, infrastructure and streetscape, and safety) and total PA and walking specifically. Reported individual- and environmental-level moderators were also examined. RESULTS Positive environmental correlates of PA, ranked by strength of evidence, were: walkability (p < .001), safety from crime (p < .001), overall access to destinations and services (p < .001), recreational facilities (p < .001), parks/public open space (p = .002) and shops/commercial destinations (p = .006), greenery and aesthetically pleasing scenery (p = .004), walk-friendly infrastructure (p = .009), and access to public transport (p = .016). There were 26 individual differences in the number of significant associations when the type of PA and environmental measurement method was considered. No consistent moderating effects on the association between built environmental attributes and PA were found. CONCLUSIONS Safe, walkable, and aesthetically pleasing neighbourhoods, with access to overall and specific destinations and services positively influenced older adults' PA participation. However, when considering the environmental attributes that were sufficiently studied (i.e., in ≥5 separate findings), the strength of evidence of associations of specific categories of environment attributes with PA differed across PA and environmental measurement types. Future research should be mindful of these differences in findings and identify the underlying mechanisms. Higher quality research is also needed.
Collapse
Affiliation(s)
- David W Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | - Anthony Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | - Andrea Nathan
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | - Jelle Van Cauwenberg
- Department of Public Health, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
- Research Foundation Flanders, Egmontstraat 5, 1000, Brussels, Belgium
| | - Ester Cerin
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia.
- School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong, Special Administrative Region, China.
- Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia.
| |
Collapse
|