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Espinosa-Montero J, Monterrubio-Flores E, Aguilar-Tamayo M, Macías-Morales N, Sanchez-Dominguez M, Campos-Nonato I. Indicators of Dietary Behavior and Physical Activity Change Associated with Metabolic Control of Obesity, Hypertension, and Type 2 Diabetes Mellitus in Mexican Adults: National Nutrition and Health Survey in Mexico, 2016. Metab Syndr Relat Disord 2024; 22:428-438. [PMID: 38683637 DOI: 10.1089/met.2023.0264] [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] [Indexed: 05/01/2024] Open
Abstract
Introduction: Obesity (OB), type 2 diabetes mellitus (T2D), and hypertension (HTN) are health issues in Mexico linked to unhealthy behaviors. This study investigates the relationship between behavior change indicators and metabolic control in Mexican adults with OB, T2D, and HTN. Methods: We used data from the 2016 National Health and Nutrition Survey Midway (ENSANUT MC-2016), representing ∼59.5 million Mexican adults aged 20-59 with these conditions. We assessed behavior change indicators, including stages of change, self-efficacy, and perceptions of benefits and barriers. In addition, we conducted descriptive analyses and used statistical tests, such as Pearson's chi-squared test and logistic regression models, adjusted for multiple variables. Results: We found that adults in the action and maintenance stages of physical activity (PA) were four times more likely to have adequate HTN control than those in the precontemplation stage. Self-efficacy for PA was related to better control in T2D and HTN. Self-efficacy for reducing the consumption of sugary beverages was positively associated with control in OB and T2D. No significant association was observed with self-efficacy for consuming fruits and vegetables. Conclusion: Behavior-change indicators are significantly linked to metabolic control in adults with HTN. These results support the importance of these indicators in managing chronic diseases such as HTN and their potential use in public health strategies.
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Affiliation(s)
- Juan Espinosa-Montero
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Eric Monterrubio-Flores
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Manuel Aguilar-Tamayo
- Institute of Education Sciences, Autonomous University of the State of Morelos, Mexico City, Mexico
| | - Nayeli Macías-Morales
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Mario Sanchez-Dominguez
- Health Equity Research Department, Center for Research in Health Systems, National Institute of Public Health, México City, Mexico
| | - Ismael Campos-Nonato
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
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Kha R, Wen Q, Bender N, Jones C, Gopinath B, Macniven R, Tang D. Understanding barriers and enablers to participation in a proposed online lifestyle intervention for older adults with age-related macular degeneration to guide programme implementation. J Health Psychol 2024; 29:317-331. [PMID: 37840275 PMCID: PMC10958751 DOI: 10.1177/13591053231204722] [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] [Indexed: 10/17/2023] Open
Abstract
Age-related macular degeneration (AMD) is a blinding condition associated with depression, loneliness and unhealthy lifestyle behaviours which drives AMD progression. We have proposed the first online lifestyle intervention for AMD, called Movement, Interaction and Nutrition for Greater Lifestyles in the Elderly (MINGLE) to promote positive lifestyle changes and reduce loneliness. This qualitative grounded-theory study explored enablers and barriers to future participation in MINGLE for older adults with AMD. Thirty-one participants were interviewed and thematic analysis revealed nine themes. Enablers to participation were: socialising and learning about AMD, motivation to improve health, programme accessibility and structure. Barriers were: lack of time, technology, limited knowledge regarding holistic interventions, vision-related issues, mobility and negative perception of group interactions. These factors must be considered when developing lifestyle interventions for AMD patients to maximise participation. Supporting technology use and raising awareness about benefits of healthy lifestyle behaviours for AMD may help overcome these barriers.
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Affiliation(s)
| | | | | | | | | | - Rona Macniven
- Macquarie University, Australia
- UNSW Sydney, Australia
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Lacey H, Jain N, Sugimoto M, Shimato M, Zhou SJ, Pirags V, Shakya R, Karmacharya RM, Baral PP. Advancing diabetes primary care education and knowledge in Nepal: A scoping review and case study discussion. Prim Care Diabetes 2024; 18:25-36. [PMID: 38061968 DOI: 10.1016/j.pcd.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/21/2023] [Accepted: 11/30/2023] [Indexed: 02/12/2024]
Abstract
AIMS Diabetes mellitus (DM) is a chronic disorder of insulin and glucose metabolism. It affects more than 463 million people worldwide and is expected to reach 700 million by 2045. In the Southeast Asian region, the prevalence of DM has tripled to 115 million due to rapid urbanization, unhealthy diet, sedentary lifestyles, and genetic factors. In Nepal, a developing country, DM affects 8.5% of adults, with an alarming increase in recent years. Lack of diabetes education and limited populational adoption of behavioural changes further hamper care. METHODS In the present study, we performed a scoping review to determine the status of awareness, attitudes, and knowledge about diabetes in the Nepalese population with a focus on the educational initiatives that have been implemented. We also conducted a two-week international case study discussion among medical students to brainstorm viable intervention strategies. RESULTS Our findings indicate that limited data is available on the level of education or initiatives to improve knowledge and practice among healthcare professionals and community members. Targeted studies of people with diabetes also present heterogeneous results due to differences in the sample population, geographic location, education, age, and gender. Accordingly, we propose five interrelated education-based strategies that leverage existing networks to expand community outreach and engagement, improve system resilience, and improve health outcomes. CONCLUSIONS Effective education for healthcare professionals, community, and patients with diabetes is vital in improving diabetes outcomes in Nepal and South Asia. Collaboration, funding, and evaluation are key areas needing reform.
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Affiliation(s)
- Hester Lacey
- Faculty of Medicine, Brighton and Sussex Medical School, 94 N - S Rd, Falmer, Brighton BN1 9PX, United Kingdom.
| | - Nityanand Jain
- Faculty of Medicine, Riga Stradinš University, 16 Dzirciema Street, Riga LV-1007, Latvia
| | - Mai Sugimoto
- Faculty of Medicine, Queen Mary University of London, Mile End Rd, Bethnal Green, London E1 4NS, United Kingdom
| | - Masako Shimato
- Faculty of Medicine, University College London, Gower St, London WC1E 6BT, United Kingdom
| | - Shi Jia Zhou
- Faculty of Medicine, Graduate School of Medicine, Kobe University, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
| | - Valdis Pirags
- Faculty of Medicine, University of Latvia, 3 Jelgavas Street, Riga LV-1004, Latvia; Department of Endocrinology and Rheumatology, Pauls Stradins Clinical University Hospital, 13 Pilsonu Street, Riga LV-1002, Latvia
| | - Rajani Shakya
- Research & Development Division, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel 45200, Nepal
| | - Robin Man Karmacharya
- Department of Surgery, Kathmandu University School of Medical Sciences, B.P.Highway, Panauti 45209, Nepal
| | - Phanindra Prasad Baral
- Non-Communicable Disease and Mental Health Section, Epidemiology and Disease Control Division (EDCD), Department of Health Services (DoHS), Ministry of Health and Population (MoHP), Government of Nepal, Kathmandu, Nepal
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Shrestha R, Pahari DP, Adhikari S, Khatri B, Majhi S, Adhikari TB, Neupane D, Kallestrup P, Vaidya A. Physical activity and its correlates among school teachers in a semi-urban district of Nepal. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002000. [PMID: 37870984 PMCID: PMC10593206 DOI: 10.1371/journal.pgph.0002000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 09/21/2023] [Indexed: 10/25/2023]
Abstract
Regular physical activity (PA) is one of the effective strategies for mitigating non-communicable diseases, promoting healthy ageing, and preventing premature mortality. In South Asia, up to 34.0% of adults are insufficiently active, and up to 44.1% of adults in Nepal. We sought to assess self-reported PA status and its correlates among teachers in the semi-urban district of Nepal. A cross-sectional descriptive study was conducted among teachers at randomly selected public secondary schools in Bhaktapur, Nepal, from November 2018-April 2019. PA status was assessed in Metabolic Equivalent to task minutes per week using the International Physical Activity Questionnaire (IPAQ)-Long Form. Point estimates and odds ratios were calculated at a 95% confidence interval, and a p-value <0.05 was considered statistically significant. Among the 360 participants, the mean (SD) age was 40.3 (10.2) years, with 52.5% female participation. A low level of PA was seen among 11.9% (95% CI: 8.4-15.2) of teachers, and more than half (56.0%) of the activity was only moderate intensity. Domestic and garden work was the main contributor (43.0%) of total PA, while leisure time was the least (14.0%). Among the socio-demographic factors, only sex was significantly associated (p = 0.005) with PA. Participants living in locations with walkable areas were 3.4 times (95% CI: 1.6-7.3) more likely to be engaged in moderate-to-high level PA than those without. In our study, the point prevalence of insufficient PA among teachers working at public secondary schools was higher than the national point prevalence. PA promotion programs targeting sedentary populations like school teachers should be developed to reduce the point prevalence of insufficient PA.
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Affiliation(s)
- Rajan Shrestha
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Durga Prasad Pahari
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Santoshi Adhikari
- Ethical Review, Monitoring and Evaluation Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Bijay Khatri
- Academic and Research Department, Hospital for Children Eye ENT and Rehabilitation Services, Bhaktapur, Nepal
| | - Sangita Majhi
- Academic and Research Department, Hospital for Children Eye ENT and Rehabilitation Services, Bhaktapur, Nepal
| | - Tara Ballav Adhikari
- Department of Public Health, Aarhus University, Aarhus C, Denmark
- COBIN Project, Nepal Development Society, Chitwan, Nepal
| | - Dinesh Neupane
- COBIN Project, Nepal Development Society, Chitwan, Nepal
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Per Kallestrup
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Abhinav Vaidya
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
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Amin M, Kerr D, Atiase Y, Yakub Y, Driscoll A. Understanding Physical Activity Behavior in Ghanaian Adults with Type 2 Diabetes: A Qualitative Descriptive Study. J Funct Morphol Kinesiol 2023; 8:127. [PMID: 37754960 PMCID: PMC10532145 DOI: 10.3390/jfmk8030127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023] Open
Abstract
Despite a relatively low prevalence rate, sub-Saharan Africa bears a substantial diabetes burden. Physical activity (PA) plays a crucial role in managing type 2 diabetes mellitus (T2DM). However, PA levels among this population remain suboptimal. This study aimed to explore patients' perspectives on the barriers and facilitators to PA participation among Ghanaian adults with T2DM. Thirteen adults with T2DM were recruited from Korle-Bu Teaching Hospital, Ghana, for this qualitative descriptive study. Semi-structured interviews were conducted, and the data were analyzed using thematic analysis. Two overarching themes (personal factors and socio-structural factors) and 10 sub-themes relating to PA barriers and facilitators were identified. Participants had limited awareness of the recommended PA guidelines for T2DM management. Chronic illness-related factors hindered exercise participation. Difficulty differentiating between PA and exercise impeded the achievement of PA targets. Socio-structural barriers include concerns about social ridicule or embarrassment, safety during outdoor activities, a lack of culturally appropriate exercise facilities, and high social and work demands. Despite these barriers, participants were motivated by their understanding of the health benefits of PA. They emphasized integrating PA into daily routines through walking, work-related tasks, and household chores. Motivation and PA education from healthcare professionals are valued supports in achieving PA targets. Our findings showed that PA behaviour in Ghanaian adults with T2DM is influenced by both personal and external factors. Tailored PA interventions for this population should address identified barriers while leveraging facilitators to implement successful PA programs.
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Affiliation(s)
- Mohammed Amin
- Centre for Quality and Patient Safety, Institute for Health Transformation, Faculty of Health, School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia; (D.K.); (A.D.)
| | - Debra Kerr
- Centre for Quality and Patient Safety, Institute for Health Transformation, Faculty of Health, School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia; (D.K.); (A.D.)
| | - Yacoba Atiase
- National Diabetes Management and Research Centre, Korle-Bu Teaching Hospital, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana;
| | - Yusif Yakub
- Faculty of Medicine and Health, The University of Sydney, Science Road, Sydney, NSW 2050, Australia;
| | - Andrea Driscoll
- Centre for Quality and Patient Safety, Institute for Health Transformation, Faculty of Health, School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia; (D.K.); (A.D.)
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Taylor LK, Nyakotey DA, Kwarteng A. Physical inactivity and barriers to physical activity among Type-2 diabetics in Kumasi, Ghana. Afr Health Sci 2023; 23:318-327. [PMID: 38357182 PMCID: PMC10862596 DOI: 10.4314/ahs.v23i3.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Background Although the benefits of physical activity (PA) in diabetes management are well documented, there insufficient data on physical activity levels and barriers to physical activity among Type-2 diabetics in Ghana. This study assessed physical activity and barriers to physical activity among Type-2 diabetics at Manhyia Hospital in Kumasi, Ghana. Methods The study recruited 97 participants (32% men, 68% women). Physical activity was assessed using the Global physical activity questionnaire and barriers to PA were assessed using the Barriers to being active Quiz. Anthropometry and sociodemographic data were also collected. Results Prevalence of overweight/ obesity was 63.9%. About 60% of participants were inactive. Social influence (60.8%) was the most prevalent PA barrier followed by lack of energy (59.8%) and lack of willpower (58.8%). Majority of participants (57.7%) reported at least 4 barriers to being active. There was a significant negative correlation between age and number of PA barriers (r = -0.214, p = 0.035). A significantly higher proportion of employed participants were active compared to the unemployed/ retired participants (p = 0.035). Conclusion This population of Type-2 diabetics needs urgent lifestyle interventions to improve physical activity and weight, considering that the main physical activity barriers were personal motivation related.
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Affiliation(s)
- Linda Kumah Taylor
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - David Adjatey Nyakotey
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alexander Kwarteng
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Tropical Infections and Non-Communicable Diseases Research Group, Kumasi Centre for Collaborative Research in Tropical Medicine, KNUST, Kumasi, Ghana
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Mondal R, Banik PC, Zaman MM. Low physical activity among middle-aged type-2 diabetic outpatients of two peripheral hospitals in Bangladesh. PLoS One 2023; 18:e0284392. [PMID: 37053202 PMCID: PMC10101379 DOI: 10.1371/journal.pone.0284392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
Physical activity (PA) is an important lifestyle recommendation for managing type-2 diabetes mellitus (T2DM). However, low PA among them is a global public health concern, including Bangladesh. We aimed to investigate the prevalence of low PA levels and its associated sociodemographic factors particularly among middle-aged T2DM subjects, which is quite limited globally and unknown in Bangladesh. In this cross-sectional study, we conveniently recruited 356 T2DM subjects (aged 40-60 years) from outpatient departments of the corresponding diabetic hospitals from Pirojpur and Dinajpur, the southern and northern districts, respectively. The primary outcome was low PA (via metabolic equivalents <600), using the Global Physical Activity Questionnaire. Univariable and multivariable binary logistic regression analyses were used to identify the factors associated with low PA. Among the participants (mean age 51.0±6.9 years), men and women were with almost equal proportions (48.9% and 51.1%, respectively). The prevalence (95% Confidence Intervals [CI]) of low PA was 34.8% (29.9-39.7). The median sitting or reclining time was 6 hours on a typical day. The odds (OR [95% CI]; P) of low PA was found to be significantly higher in respondents with primary or no education compared to the above-primary level, in unadjusted (1.6 [1.1-2.6]; 0.029) and adjusted (2.0 [1.1-3.7]; 0.028) associations both. In conclusion, over one-third of the middle-aged study subjects had a low PA level, which was associated with education. There is a high demand for designing and implementing PA enhancing interventions among them.
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Affiliation(s)
- Rajib Mondal
- Department of Public Health, Hamdard University Bangladesh, Gazaria, Munshiganj, Bangladesh
| | - Palash Chandra Banik
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
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Sharma A, Stuckey H, Mendez-Miller M, Cuffee Y, Juris AJ, McCall-Hosenfeld JS. The influence of patriarchy on Nepali-speaking Bhutanese women’s diabetes self-management. PLoS One 2022; 17:e0268559. [PMID: 36103470 PMCID: PMC9473401 DOI: 10.1371/journal.pone.0268559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 05/03/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction The Nepali-speaking Bhutanese (NSB) community is a rapidly growing population in Central Pennsylvania. A community-based diabetes education pilot program found a large gender disparity with fewer women in attendance; participants reported that primary household cooks and caretakers were women. This may be an indication of women’s status in the NSB community, their healthcare access, autonomy, and ability to manage their diabetes. Hence, this study aims to understand the manifestations of patriarchy and its impact on NSB women’s diabetes self-management employing a conceptual framework based on Walby’s structures of patriarchy. Methods An exploratory feminist qualitative inquiry was conducted. Fifteen NSB women with Type 2 Diabetes were interviewed about their diabetes self-management. Transcripts were coded for key concepts that emerged from the data. A thematic analysis was conducted. Themes were developed inductively through those categories as well as through an a priori approach using the conceptual framework. Results Cultural influences such as family structure, religious beliefs, traditional healthcare and gender roles determined NSB women’s patriarchal upbringing and lifestyle. Unpaid household production was largely dependent on women. Multiple immigrations led to poor socioeconomic indicators and marginalization of NSB women. Women’s access to healthcare (including diabetes) was entirely reliant on other family members due to poor autonomy. Women experienced adverse physical and emotional symptoms related to diabetes and their ability and attempts to maintain a healthy diabetes lifestyle was determined by their physical health condition, knowledge regarding good dietary practices and self-efficacy. Conclusion Patriarchal practices that start early on within women’s lives, such as child marriage, religious restrictions as well as women’s access to education and autonomy impacted NSB women’s access to healthcare, knowledge regarding their diabetes and self-efficacy. Future interventions tailored for diabetes prevention and self-management among NSB women should factor in patriarchy as an important social determinant of health.
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Affiliation(s)
- Aditi Sharma
- Department of Urology, School of Medicine, Stanford University, Stanford, California, United States of America
- * E-mail:
| | - Heather Stuckey
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, United States of America
- Department of Medicine, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, United States of America
| | - Megan Mendez-Miller
- Department of Family and Community Medicine, Pennsylvania State College of Medicine, Hershey, Pennsylvania, United States of America
| | - Yendelela Cuffee
- Program in Epidemiology, College of Health Sciences, University of Delaware, Newark, Delaware, United States of America
| | - Aubrey J. Juris
- Pennsylvania Department of Health Office of Health Equity, Harrisburg, Pennsylvania, United States of America
| | - Jennifer S. McCall-Hosenfeld
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, United States of America
- Department of Medicine, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, United States of America
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Whipple MO, Pinto AJ, Abushamat LA, Bergouignan A, Chapman K, Huebschmann AG, Masters KS, Nadeau KJ, Scalzo RL, Schauer IE, Rafferty D, Reusch JE, Regensteiner JG. Sex Differences in Physical Activity Among Individuals With Type 2 Diabetes Across the Life Span: A Systematic Review and Meta-analysis. Diabetes Care 2022; 45:2163-2177. [PMID: 36044665 PMCID: PMC9472508 DOI: 10.2337/dc22-0576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/06/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Physical activity (PA) is a cornerstone of type 2 diabetes mellitus (T2DM) treatment. Sex differences in PA behavior or barriers/facilitators to PA among individuals with T2DM are unclear. PURPOSE To summarize the evidence related to sex differences in participation in PA and barriers/facilitators to PA among individuals with T2DM across the life span. DATA SOURCES Systematic searches (CRD42021254246) were conducted with Ovid MEDLINE, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), APA PsychInfo, and SPORTDiscus. STUDY SELECTION We included studies with assessment of PA, sedentary behaviors (SB), or barriers/facilitators to PA among individuals with T2DM by sex or gender. DATA EXTRACTION Participant characteristics, meeting PA guidelines, participation in PA and SB, and barriers/facilitators to PA were extracted by two independent reviewers. DATA SYNTHESIS A total of 53 articles (65,344 participants) were included in the systematic review and 21 articles in the meta-analysis. Sex differences were not observed in meeting of PA guidelines among adolescents (odds ratio 0.70 [95% CI 0.31, 1.59]), but males were more likely than females to meet PA guidelines among adults (1.65 [1.36, 2.01]) and older adults (1.63 [1.27, 2.09]). Males performed more moderate-to-vigorous PA (MVPA) than females across all age-groups. Common barriers to PA were lack of time (men) and lack of social support and motivation (women). LIMITATIONS Limitations include heterogeneity of measures used to assess PA and lack of stratification of data by sex. CONCLUSIONS Sex differences in meeting PA guidelines were not observed among adolescents but were apparent among adults and older adults with T2DM. Females consistently engaged in less MVPA than males across the life span.
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Affiliation(s)
- Mary O. Whipple
- School of Nursing, University of Minnesota, Minneapolis, MN
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Ludeman Family Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Ana J. Pinto
- Ludeman Family Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Layla A. Abushamat
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Section of Cardiovascular Research, Baylor College of Medicine, Houston, TX
| | - Audrey Bergouignan
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO
- Hubert Curien Pluridisciplinary Institute UMR7178, CNRS and Université de Strasbourg, Strasbourg, France
| | - Kristina Chapman
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Amy G. Huebschmann
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Ludeman Family Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kevin S. Masters
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO
- Clinical Health Psychology, Department of Psychology, University of Colorado Denver, Denver, CO
| | - Kristen J. Nadeau
- Ludeman Family Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
- Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO
- Children’s Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Rebecca L. Scalzo
- Ludeman Family Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Rocky Mountain Regional VA Medical Center, Aurora, CO
| | - Irene E. Schauer
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Rocky Mountain Regional VA Medical Center, Aurora, CO
| | - Deirdre Rafferty
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Jane E.B. Reusch
- Ludeman Family Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Rocky Mountain Regional VA Medical Center, Aurora, CO
| | - Judith G. Regensteiner
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Ludeman Family Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
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Paudel G, Vandelanotte C, Dahal PK, Biswas T, Yadav UN, Sugishita T, Rawal L. Self-care behaviours among people with type 2 diabetes mellitus in South Asia: A systematic review and meta-analysis. J Glob Health 2022; 12:04056. [PMID: 35916498 PMCID: PMC9346342 DOI: 10.7189/jogh.12.04056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background The burden of Type 2 Diabetes Mellitus (T2DM) in South Asian countries is increasing rapidly. Self-care behaviour plays a vital role in managing T2DM and preventing complications. Research on self-care behaviours among people with T2DM has been widely conducted in South Asian countries, but there are no systematic reviews that assess self-care behaviour among people with T2DM in South Asia. This study systematically assessed the studies reporting self-care behaviours among people with T2DM in South-Asia. Methods Adhering to the PRISMA guidelines, we searched six bibliographic databases (Scopus, PubMed, CINAHL, Embase, Web of Science, and PsychInfo) to identify the relevant articles published between January 2000 through March 2022. Eligibility criteria included all observational and cross-sectional studies reporting on the prevalence of self-care behaviours (ie, diet, physical activity, medication adherence, blood glucose monitoring, and foot care) conducted in South Asian countries among people with T2DM. Results The database search returned 1567 articles. After deduplication (n = 758) and review of full-text articles (n = 192), 92 studies met inclusion criteria and were included. Forward and backward reference checks were performed on included studies, which resulted in an additional 18 articles. The pooled prevalence of adherence to blood glucose monitoring was 65% (95% CI = 49-80); 64% for medication adherence (95% CI = 53-74); 53% for physical activity (95% CI = 39-66); 48% for diet (95% CI = 38-58); 42% for foot care (95% CI = 30-54). About a quarter of people with T2DM consumed alcohol (25.2%, IQR = 13.8%-38.1%) and were using tobacco products (18.6%, IQR = 10.6%-23.8%). Conclusions Our findings suggest that the prevalence of self-care behaviours among people with T2DM in South Asia is low. This shows an urgent need to thoroughly investigate the barriers to the practising of self-care and design and implement interventions to improve diabetes self-care behaviour among people with T2DM in South Asia.
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Affiliation(s)
- Grish Paudel
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, Australia
| | - Corneel Vandelanotte
- Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia
| | - Padam K Dahal
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, Australia
| | - Tuhin Biswas
- The Australian Research Council Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - Uday N Yadav
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Tomohiko Sugishita
- Section of Global Health, Division of Public Health, Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Lal Rawal
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, Australia.,Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia.,Translational Health Research Institute (THRI), Western Sydney University, Sydney Australia
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11
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Adhikari C, Dhakal R, Adhikari LM, Parajuli B, Subedi KR, Aryal Y, Thapa AK, Shah K. Need for HTA supported risk factor screening for hypertension and diabetes in Nepal: A systematic scoping review. Front Cardiovasc Med 2022; 9:898225. [PMID: 35979024 PMCID: PMC9376353 DOI: 10.3389/fcvm.2022.898225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Health Technology Assessment (HTA) is a comprehensive and important tool for assessment and decision-making in public health and healthcare practice. It is recommended by the WHO and has been applied in practice in many countries, mostly the developed ones. HTA might be an important tool to achieve universal health coverage (UHC), especially beneficial to low-and-middle-income countries (LMIC). Even though the Package for Essential Non-communicable Diseases (PEN) has already been initiated, there is a clear policy gap in the HTA of any health device, service, or procedure, including the assessment of cardiovascular risk factors (CVRFs) in Nepal. Hence, we carried out the review to document the HTA supported evidence of hypertension and diabetes screening, as CVRFs in Nepal. Materials and methods We searched in PubMed, Cochrane, and Google Scholar, along with some gray literature published in the last 6 years (2016–2021) in a systematic way with a controlled vocabulary using a well-designed and pilot tested search strategy, screened them, and a total of 53 articles and reports that matched the screening criteria were included for the review. We then, extracted the data in a pre-designed MS-Excel format, first in one, and then, from it, in two, with more specific data. Results Of 53 included studies, we reported the prevalence and/or proportion of hypertension and diabetes with various denominators. Furthermore, HTA-related findings such as cost, validity, alternative tool or technology, awareness, and intervention effectiveness have been documented and discussed further, however, not summarized due to their sparingness. Conclusion Overall, the prevalence of DM (4.4–18.8%) and HTN (17.2–70.0%) was reported in most studies, with a few, covering other aspects of HTA of DM/HTN. A national policy for establishing an HTA agency and some immediately implementable actions are highly recommended.
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Affiliation(s)
- Chiranjivi Adhikari
- Department of Public Health, SHAS, Pokhara University, Pokhara, Nepal
- Indian Institute of Public Health Gandhinagar, Gandhinagar, India
- *Correspondence: Chiranjivi Adhikari
| | - Rojana Dhakal
- Department of Nursing, School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Lal Mani Adhikari
- Health Research and Social Development Forum International, Kathmandu, Nepal
| | - Bijaya Parajuli
- Ministry of Health and Population, Gandaki Province, Myagdi Health Office, Myagdi, Nepal
| | - Khem Raj Subedi
- Department of Economics, Far Western University, Tikapur Multiple Campus, Kailali, Nepal
| | | | - Arjun Kumar Thapa
- Department of Economics, School of Humanities and Social Sciences, Pokhara University, Pokhara, Nepal
| | - Komal Shah
- Indian Institute of Public Health Gandhinagar, Gandhinagar, India
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Khanal MK, Bhandari P, Dhungana RR, Gurung Y, Rawal LB, Pandey G, Bhandari M, Devkota S, de Courten M, de Courten B. Poor glycemic control, cardiovascular disease risk factors and their clustering among patients with type 2 diabetes mellitus: A cross-sectional study from Nepal. PLoS One 2022; 17:e0271888. [PMID: 35877664 PMCID: PMC9312399 DOI: 10.1371/journal.pone.0271888] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/01/2022] [Indexed: 02/06/2023] Open
Abstract
Background Cardiovascular disease (CVD) is the most common complication of diabetes mellitus (DM). To prevent morbidity and mortality among patients with type 2 diabetes mellitus (T2DM), optimization of glycemic status and minimizing CVD risk factors is essential. As Nepal has limited data on these CVD risk parameters, we assessed the prevalence of poor glycemic control, CVD risk factors, and their clustering among patients with T2DM. Methods Using a cross-sectional study design, we collected data of 366 patients with T2DM. We applied a multistage cluster sampling technique and used the WHO STEPS tools. Binary logistic and Poisson regression was applied to calculate odds and prevalence ratio of clustering of risk factors, considering P< 0.05 statistically significant. Results The mean age of participants was 54.5±10.7 years and 208 (57%) were male. The prevalence of poor glycemic control was 66.4% (95% C.I: 61.5–71.2). The prevalence of smoking, alcohol users, inadequate fruit and vegetables intake and physical inactivity were 18% (95% C.I:14 to 21.9), 14.8% (95% C.I:11.1 to 18.4), 98.1% (95% C.I: 96.7–99.4), and 9.8% (95% C.I:6.7–12.8), respectively. Overall, 47.3% (95% C.I: 42.1–52.4) were overweight and obese, 59% (95% C.I: 52.9–63) were hypertensive, and 68% (95% C.I: 63.2–72.7) had dyslipidemia. Clustering of two, three, four, five and more than five risk factors was 12.6%, 30%, 30%,19%, and 8.7%, respectively. Four or more risk factors clustering was significantly associated with gender, age, level of education, T2DM duration, and use of medication. Risk factors clustering was significantly higher among males and users of anti-diabetic medications with prevalence ratio of 1.14 (95% C.I:1.05–1.23) and 1.09 (95% C.I: 1.09–1.18)], respectively. Conclusions The majority of the patients with T2DM had poor glycemic control and CVD risk factors. Policies and programs focused on the prevention and better management of T2DM and CVD risk factors should be implemented to reduce mortality in Nepal.
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Affiliation(s)
- Mahesh Kumar Khanal
- Provincial Ayurveda Hospital, Ministry of Health, Population and Family Welfare, Dang, Lumbini Province, Nepal
- * E-mail:
| | | | - Raja Ram Dhungana
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Yadav Gurung
- Child and Youth Health Research Center, Auckland University of Technology, Auckland, New Zealand
| | - Lal B. Rawal
- School of Health, Medical and Applied Sciences, College of Science and Sustainability, Central Queensland University, Sydney, Australia
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Sydney, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, Australia
| | | | - Madan Bhandari
- Provincial Ayurveda Hospital, Ministry of Health, Population and Family Welfare, Dang, Lumbini Province, Nepal
| | - Surya Devkota
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Maximilian de Courten
- Mitchell Institute for Education and Health Policy, Victoria University, Melbourne, Australia
| | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
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13
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Zavala GA, Ainscough TS, Jimenez‐Moreno AC. Barriers to a healthy diet and physical activity in Mexican adults: results from the Mexican Health and Nutrition Survey. NUTR BULL 2022; 47:298-306. [DOI: 10.1111/nbu.12568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/29/2022]
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Perera M, Arambepola C, Gillison F, Peacock O, Thompson D. Perceived barriers and facilitators of physical activity in adults living in activity-friendly urban environments: A qualitative study in Sri Lanka. PLoS One 2022; 17:e0268817. [PMID: 35653333 PMCID: PMC9162315 DOI: 10.1371/journal.pone.0268817] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
Background Despite reforming health policies to create more enabling environments, insufficient physical activity in Sri Lanka remains a major public health issue. Socio-culture specific determinants underlying the physical activity of adults living in such environments need to be identified. The aim of this study was to explore the barriers and facilitators for physical activity, as perceived by adult urban dwellers in activity-friendly environments in Colombo District, Sri Lanka. Methods A qualitative study using in-depth interviews was conducted among adults aged 20–60 years living in an urban area which has been recently re-designed for recreational and rejuvenating purposes in Sri Lanka. Recruitment targeted varying socio-economic status and risk of non-communicable diseases; and was continued until the data saturation point was reached. Interviews were conducted in homes, primary healthcare units and fitness centres, and were transcribed verbatim and analysed using framework analysis. Results A total of 31 eligible and consenting adults were interviewed. Of the reported barriers to physical activity, lack of time was very common. Other frequently reported barriers included unpleasant experiences following exercise and misconceptions about exercise, whereas physical environmental factors, weather and road safety were reported less frequently. All participants reported at least one facilitator for engaging in exercise. Expectations of preventing diseases, improving health, physical fitness, psycho-social wellbeing, optimising body functions and increasing lifespan were frequently cited as reasons to be active, while social factors such as positive attitudes of family members and the influence of peers were found to be motivating. Conclusions The study showed that while participants valued the health benefits of physical activity and refurbished activity-friendly urban environments, these were not sufficient to support them to overcome key perceived barriers to being physically active.
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Affiliation(s)
- Madhawa Perera
- Department of Gynaecology and Obstetrics, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
- * E-mail:
| | - Carukshi Arambepola
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Fiona Gillison
- Department for Health, University of Bath, Bath, United Kingdom
| | - Oliver Peacock
- Department for Health, University of Bath, Bath, United Kingdom
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, United Kingdom
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15
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The relationship between sleep quality, neck pain, shoulder pain and disability, physical activity, and health perception among middle-aged women: a cross-sectional study. BMC Womens Health 2022; 22:186. [PMID: 35597981 PMCID: PMC9124008 DOI: 10.1186/s12905-022-01773-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/18/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Sleep quality is an important physical requirement for a healthy life, and good sleep quality has been recognized as a significant component in physical and mental health and well-being. The purpose of this study was to identify the factors that affect sleep quality as well as the relationship between sleep quality and neck pain, shoulder pain and disability, physical activity, and health perception. METHODS We conducted surveys on 494 women between the age of 35 and 64 years. The study evaluated neck pain, shoulder pain and disability, physical activity, self-health perception and sleep quality with self-reported questionnaires in middle-aged women. Data were analyzed using SPSS 23.0. RESULTS The results showed that the more severe the neck pain and shoulder pain and disability, the worse the sleep quality was in middle-aged women and the better the health perception, the lower the sleep quality score was, indicating good sleep quality. Shoulder pain, self-perceived task difficulty, and health perception were identified as variables that affected the sleep quality in middle-aged women. The explanatory power of the model in explaining sleep quality was 22.9%. CONCLUSIONS Worsened shoulder pain, self-perceived task difficulty, and negative health perception can affect poor sleep quality; therefore, it is necessary to develop health interventions for pain management and emotional and social support for improving daily sleep quality. To improve the sleep quality in middle-aged women, healthcare workers should consider the subjects' pain and functional disability, in accordance with their health perception.
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Boro B, Saikia N. Association of multimorbidity and physical activity among older adults in India: an analysis from the Longitudinal Ageing Survey of India (2017-2018). BMJ Open 2022; 12:e053989. [PMID: 35580974 PMCID: PMC9115039 DOI: 10.1136/bmjopen-2021-053989] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To examine the association of multimorbidity and physical activity among older adults in India. DESIGN A cross-sectional study was conducted using large representative survey data. SETTING AND PARTICIPANTS The study used data from the nationally representative 'Longitudinal Ageing Study in India (LASI),' conducted during 2017-2018. The study included a total sample of 65 336 older adults aged 45 years and above in India. METHODS Moderate and vigorous physical activities were measured separately by self-reported questionnaires. Physical activity was calculated as minutes of metabolic equivalent tasks per week. The outcome variable was a categorical variable where 2=the prevalence of more than one morbidity, 1=presence of one morbidity and 0=none. Bivariate analysis and multinomial logistic regression were applied to fulfil the objectives. RESULTS 27.39% of older adults in India had multimorbidity. 31.02% of older adults did not engage in any moderate physical activities. Also, 59.39% of older adults did not engage in any vigorous physical activities. Older adults reporting low (adjusted relative risk ratio (A RRR): 1.10, 95% CI 1.03 to 1.18) and moderate (A RRR): 1.05, 95% CI 0.98 to 1.13) level of moderate physical activity were significantly more likely to suffer from multimorbidity compared with no involvement in moderate physical activity. However, older adults who reported high (A RRR: 0.79, 95% CI 0.75 to 0.84), moderate (A RRR: 0.88, 95% CI 0.80 to 0.98) and low level of vigorous physical activity (A RRR: 0.94, 95% CI 0.86 to 1.02) had significantly less multimorbidity in comparison to those who never engaged in vigorous physical activity. CONCLUSION Lack of physical activity is associated with multimorbidity among older adults. Physical activity promotion should be adopted as a primary strategy in reducing the burden of morbidity and multimorbidity.
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Affiliation(s)
- Bandita Boro
- Centre for the Study of Regional Development, Jawaharlal Nehru University, New Delhi, Delhi, India
| | - Nandita Saikia
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Al-Sheyab NA, Alyahya MS, Alqudah JA. Effectiveness of theory-based Multimedia Messaging Service (MMS) on exercise benefits and barriers among patients with type 2 diabetes. HEALTH EDUCATION RESEARCH 2022; 36:646-656. [PMID: 34761258 DOI: 10.1093/her/cyab038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/26/2021] [Accepted: 10/26/2021] [Indexed: 06/13/2023]
Abstract
The current study aimed to examine the effectiveness of multimedia messaging service (MMS) education on exercise benefits and barriers in patients with type 2 diabetes. A quasi-experimental, pretest-post-test design recruited 98 patients with type 2 diabetes. The intervention group received MMS education to improve perceived exercise benefits and decrease exercise barriers over two months, and the control group received routine care. All patients completed a survey at three time points (baseline, 4 and 8 weeks post-intervention). The results showed that there was an improvement in both perceived life enhancement and physical performance domains in the intervention group. The exercise context barriers decreased after the first follow-up but increased during the second follow-up in the intervention group. Cohen's d values indicated a medium effect size in life enhancement (0.502) and physical performance (0.525) subscales. A small effect size was found in psychological outlook (0.196) and exercise context (0.132) subscales. However, there was no significant effect of the intervention in time expenditure (-0.244) and physical exertion (-0.119) subscales. In conclusion, theoretically based MMS health education targeting perceived exercise benefits and barriers was feasible and cost-effective in changing patients with diabetes' perceptions and intended behaviors about regular physical activity.
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De Silva Weliange S, Perera M, Gunatilake J. Perceived social and built environment associations of leisure-time physical activity among adults in Sri Lanka. BMC Res Notes 2021; 14:391. [PMID: 34670605 PMCID: PMC8527713 DOI: 10.1186/s13104-021-05810-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Although perceived neighbourhood environment is considered a predictor of leisure-time physical activity (LTPA), evidence for this is limited in South Asia. Thus, the aim was to determine the association between neighbourhood social and built environment features in carrying out LTPA among adults in Colombo District, Sri Lanka. A cross-sectional study among 1320 adults was carried out using validated questionnaires for physical activity (PA) and built environment data collection. Multiple logistic regression analysis was conducted to assess the associations between environment characteristics and LTPA after adjusting for gender, age, employment status, income level and sector of residence. RESULTS A total of 21.7% of adults participated in some LTPA. The commonest type of LTPA was walking; carried out by 14.5%. Moderate and vigorous activity at leisure was carried out by 10.3% and 3.9% respectively. Perceived social acceptance for PA was positively associated with LTPA. Out of the built environment characteristics perceived infrastructure for walking, and recreational facilities for PA were negatively associated with LTPA. Self-efficacy emerged as an important positive correlate of LTPA. The participants were positively influenced by the self-efficacy and perceived social environment which should be addressed when promoting LTPA.
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Affiliation(s)
| | - Madhawa Perera
- Department of Gynaecology and Obstetrics, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Jagath Gunatilake
- Postgraduate Institute of Science, University of Peradeniya, Peradeniya, Sri Lanka.,Department of Geology, University of Peradeniya, Peradeniya, Sri Lanka
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Mwimo JL, Somoka S, Leyaro BJ, Amour C, Mao E, Mboya IB. Knowledge, attitude and practice of physical activity among patients with diabetes in Kilimanjaro region, Northern Tanzania: a descriptive cross-sectional study. BMJ Open 2021; 11:e046841. [PMID: 34588238 PMCID: PMC8483038 DOI: 10.1136/bmjopen-2020-046841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Diabetes mellitus is one of the most common non-communicable diseases and is the fifth leading cause of death in most developing countries. Regular physical activity (PA) is strongly recommended for individuals with diabetes for its beneficial effects in improving blood glucose control and insulin sensitivity, prevention and reduction of morbidities and complications, and its cardiovascular benefits. OBJECTIVE To assess the knowledge, attitude and practices of PA among patients with diabetes in the Kilimanjaro region, Northern Tanzania. RESEARCH DESIGN AND METHODS A cross-sectional study was conducted from June to September 2020 among 315 patients with diabetes aged 18 years and above receiving care from diabetic clinics in the Kilimanjaro region, Northern Tanzania. A systematic random sampling technique was used to select study participants who were interviewed using a modified version of the WHO-STEPS Survey for non-communicable diseases. Data were analysed using SPSS V.20. Categorical variables were summarised using frequencies and percentages, and continuous variables using means and SDs. The Χ2 test was used to compare the proportion of PA across participant characteristics. RESULTS The vast majority (94.3%) of the participants were physically active, and from our findings, most of it was contributed by work (70%) and transport-related (20%) activities. Participants had high levels of knowledge (98.4%) and positive attitudes (95.6%) towards PA. These were mainly contributed by a healthcare provider or doctors' advice (96%) on PA benefits to patients with diabetes. There was a strong statistical association (p<0.001) between knowledge and attitude towards PA with PA practice. CONCLUSION The vast majority of the participants were physically active. High levels of PA were associated with a high level of knowledge and positive attitudes towards PA. Healthcare provider or doctors' advice in diabetic clinics is essential in promoting PA practice in this population and in diabetes management.
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Affiliation(s)
- Julius Lucas Mwimo
- Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
| | - Suzana Somoka
- Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
| | - Beatrice J Leyaro
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
| | - Caroline Amour
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
| | - Experansa Mao
- Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
| | - Innocent B Mboya
- Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
- School of Mathematics, Statistics, and Computer Science, University of KwaZulu-Natal-Pietermaritzburg Campus, Pietermaritzburg, KwaZulu-Natal, South Africa
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Paudel S, Owen AJ, Smith BJ. Socio-ecological influences of leisure-time physical activity among Nepalese adults: a qualitative study. BMC Public Health 2021; 21:1443. [PMID: 34294069 PMCID: PMC8296660 DOI: 10.1186/s12889-021-11484-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 07/06/2021] [Indexed: 01/01/2023] Open
Abstract
Background With economic and social changes, participation in occupational and transport-related physical activity is declining among Nepalese adults, highlighting the growing importance of leisure-time physical activity. However, limited information is available to guide public health policies and interventions to promote leisure-time physical activity in Nepal. This study aimed to qualitatively explore the socioecological influences of participation in leisure-time physical activity among Nepalese adults aged 40 years and above. Methods A total of 51 adults (30 females and 21 males) participated in one of the nine focus groups conducted in Kathmandu, Nepal. A semi-structured guide based on the social-ecological model of physical activity was used to facilitate these focus groups. Data were analysed using a reflexive thematic analysis approach in NVivo 12. Results Participation in leisure-time physical activity was minimal and leisure time was mostly spent resting, socialising, or engaging in sedentary activities such as watching television. Walking was the most common form of leisure-time physical activity, and men reported being more active than women. Individual-level barriers included lack of knowledge, lack of skill, lack of motivation, considering oneself as sufficiently active and engagement in sedentary screen activities. Family and household responsibilities, lack of support and fear of being judged constituted the interpersonal barriers while environmental barriers included an absence of a supportive social norm, lack of open spaces, weather conditions and perceived lack of safety. Health benefits, prioritising physical activity, social support, provision of group-based activities and age-appropriate public exercise facilities were identified as major facilitators. Conclusion Critical issues that need to be addressed to increase leisure-time physical activity among Nepalese adults include traditional gender roles, family and social support, and social norms. Modifications of the built environment, such as public exercise facilities, offer further opportunities and will require coordination beyond the health sector. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11484-3.
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Affiliation(s)
- Susan Paudel
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Ben J Smith
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, Australia
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Adhikari M, Devkota HR, Cesuroglu T. Barriers to and facilitators of diabetes self-management practices in Rupandehi, Nepal- multiple stakeholders' perspective. BMC Public Health 2021; 21:1269. [PMID: 34187461 PMCID: PMC8243465 DOI: 10.1186/s12889-021-11308-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/17/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Self-management of diabetes is associated with glycaemic control and adherence to medication and healthy lifestyle practices. There is lack of information on the barriers to and facilitators of diabetes self-management practices in low income country, Nepal. This study aimed to explore the barriers to and facilitators of Type 2 diabetes self-management practices taking multiple stakeholders' perspectives in Nepal. METHODS Four focus group discussions and 16 semi-structured interviews with people with Type 2 diabetes, caregivers, health care providers and health managers were conducted from April to May 2018 in Rupandehi district of Western Nepal. They were audio-recorded, transcribed, and analysed using a thematic approach. RESULTS Five main themes emerged that influenced diabetes self-management practices: individual factors, socio-cultural and economic factors, health system and policy factors, availability and accessibility of resources, and environmental factors. The important barriers were: lack of knowledge about diabetes self-management practices, cultural practices, insufficient counselling, lack of guidelines and protocols for counselling, and financial problems. The major facilitators were: motivation; support from family, peers, and doctors; and availability of resources in the community. CONCLUSION Based on our findings, a multilevel approach is needed to address these barriers and facilitators. These findings will help guide strategies to develop programs that impart knowledge and skills to improve the diabetes self-management practices of people with Type 2 diabetes.
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Affiliation(s)
| | | | - Tomris Cesuroglu
- Faculty of Science, Vrije University, Amsterdam, The Netherlands
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22
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Ikechukwu EC, Gloria MU, Ikenna UC, Chinonso UV, Mmanwanne UE, Chinedu OO, Chukwudi AC, Nene JJ, Chinwe O, Nkechi AC. Physical Activity Level and Factors Affecting Exercise Participation among Nigerian Adults with and Without Diabetes. EUROPEAN MEDICAL JOURNAL 2021. [DOI: 10.33590/emj/20-00214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Diabetes presents a multifaceted challenge to health systems in Nigeria and beyond. Physical activity is a cornerstone of diabetes management but is often underutilised. Despite the positive effects of physical activity on different dimensions of health to patients with diabetes, most fail to maintain long-term adherence to physical activity programmes.
Objectives: This study aimed to determine the physical activity level and factors affecting exercise participation among patients with and without diabetes.
Methods: This was a cross-sectional study involving 400 participants recruited by convenience sampling. International Physical Activity Questionnaire (IPAQ) and Exercise Benefit and Barrier Scale (EBBS) questionnaires were used to measure physical activity and perceived benefits and barriers to exercise, respectively. The data collected were analysed using descriptive statistics of percentages and frequency, mean and standard deviation, and independent t-test. The level of significance was set at p<0.05.
Results: The majority of the patients with diabetes (71%) had low physical activity levels while 52% of the nondiabetic group were moderately active. There was a significant difference between physical activity levels of patients with diabetes and the nondiabetic group (p<0.05). Physical exertion was reported by both patients with and without diabetes as the greatest barrier to exercise participation.
Conclusion: Patients with diabetes in Nigeria have a low level of physical activity and are also faced with certain barriers which limit their participation in exercise programmes. Exercise barrier identification and public awareness on the health benefits of exercise and physical activity in the prevention and management of diabetes should thus be encouraged.
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Affiliation(s)
| | | | | | - Ugwueze Vitalis Chinonso
- Department of Physiotherapy, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | | | - Okezue Obinna Chinedu
- Department of Medical Rehabilitation, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | | | - John Jeneviv Nene
- Department of Medical Rehabilitation, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Obiekwe Chinwe
- Department of Physiotherapy, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
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23
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Sadia L, Barua L, Banik PC, Faruque M. Physical activity levels, its barriers, and associated factors among the patients with type 2 diabetes residing in the capital city of Bangladesh. LIFESTYLE MEDICINE 2020. [DOI: 10.1002/lim2.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Laila Sadia
- Department of Noncommunicable Diseases Bangladesh University of Health Sciences (BUHS) Dhaka Bangladesh
| | - Lingkan Barua
- Department of Noncommunicable Diseases Bangladesh University of Health Sciences (BUHS) Dhaka Bangladesh
| | - Palash Chandra Banik
- Department of Noncommunicable Diseases Bangladesh University of Health Sciences (BUHS) Dhaka Bangladesh
| | - Mithila Faruque
- Department of Noncommunicable Diseases Bangladesh University of Health Sciences (BUHS) Dhaka Bangladesh
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24
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Mohamed BA, Mahfouz MS, Badr MF. Physical activity and its associated factors in females with type 2 diabetes in Riyadh, Saudi Arabia. PLoS One 2020; 15:e0239905. [PMID: 33002054 PMCID: PMC7529343 DOI: 10.1371/journal.pone.0239905] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 09/15/2020] [Indexed: 12/31/2022] Open
Abstract
Despite the benefits of physical activity (PA) for the management of type 2 diabetes Mellitus (T2DM), the topic of PA is poorly addressed in Saudi Arabia (SA), especially in females with T2DM. The present study examined PA and its associated factors in females with T2DM in Riyadh, Saudi Arabia. This observational cross-sectional study was performed in a random sample of 372 women with T2DM. A face-to-face interview that covered PA, health and environmental correlates of PA was performed. Discriminant analysis was used to determine which barriers had the greatest impact on PA in these women. The results showed that approximately 26.3% of the study participants met PA recommendations. Multivariate linear regression revealed lower levels of PA were associated with women who had more than three children (β = -0.17) compared to women with no children, older age (β = -0.18), women with a duration of diabetes ≥ 6 years (β = -0.16), women who were obese (β = -0.23), women with no family support (β = -0.20), no friend support (β = -0.13) and no healthcare provider support (β = -0.14). Discriminant analysis indicated that culture and tradition, lack of skills and knowledge, safety, fatigue, lack of time, weather conditions, and lack of facilities were the barriers that differentiated between the women who met and those who did not meet the PA recommendations. The present study suggests that the prevalence of PA is low and number of children, age, duration of diabetes, Obesity, family support, friend support and healthcare provider support are identified correlates of PA. These findings are valuable and should be used to design and implement future PA interventions, especially for women with T2DM. Healthcare providers may improve exercise levels and identify the specific barriers to reaching the recommended level of PA to improve health outcomes for each patient.
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Affiliation(s)
- Badreldin Abdelrhman Mohamed
- Department of Community Health Sciences, College of Applied Medical
Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed Salih Mahfouz
- Department of Family and Community Medicine, Faculty of Medicine, Jazan
University, Jazan, Saudi Arabia
| | - Mohamed Farouk Badr
- Department of Community Health Sciences, College of Applied Medical
Sciences, King Saud University, Riyadh, Saudi Arabia
- Nutrition and Food Science Department, Faculty of Home Economics, Helwan
University, Cairo, Egypt
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25
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Liu Z, Yang C. The impact of sleep medications on physical activity among diabetic older adults. Geriatr Nurs 2020; 41:400-405. [DOI: 10.1016/j.gerinurse.2019.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/13/2019] [Accepted: 12/14/2019] [Indexed: 01/01/2023]
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26
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Prevalence of Total and Domain-Specific Physical Activity and Associated Factors Among Nepalese Adults: A Quantile Regression Analysis. J Phys Act Health 2020; 17:501-511. [PMID: 32217789 DOI: 10.1123/jpah.2019-0441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/18/2019] [Accepted: 02/05/2020] [Indexed: 11/18/2022]
Abstract
AIM To analyze the data from the World Health Organization Nepal STEPS survey 2013 to determine the prevalence of total and domain-specific physical activity (PA) and associated factors among Nepalese adults. METHODS A multistage cluster sampling technique was used to proportionately select participants from the 3 ecological zones (Mountain, Hill, and Terai) in Nepal. The Global PA Questionnaire was used to assess PA. The data were analyzed using quantile and ordinary least square regression. RESULTS Only 4% of the adults did not meet the World Health Organization PA guidelines. Age had a negative monotonic association with total PA and occupational PA, with the highest difference at the upper tails of the PA distribution. Lower total PA and occupational PA were associated with secondary or higher education, being retired or in unpaid employment, living in Terai or urban areas, and nonsmoking. Age, higher education, unpaid employment, and Terai or urban residence were negatively associated, while being currently married was positively associated with transport-related PA. CONCLUSION Increasing age, higher education, unpaid employment, unemployment or retirement, and urban residence were associated with lower PA, with the stronger association at the upper tails of the distribution. The correlates had dissimilar associations across the quantiles of PA distribution.
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Nwose EU, Ekotogbo B, Ogbolu CN, Mogbusiaghan M, Agofure O, Igumbor EO. Evaluation of ADL and BMI in the management of diabetes mellitus at secondary and tertiary health facilities. Diabetes Metab Syndr 2019; 13:2266-2271. [PMID: 31235167 DOI: 10.1016/j.dsx.2019.05.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 05/24/2019] [Indexed: 12/18/2022]
Abstract
AIMS Physical activities of daily living (ADL) constitutes one of diabetes management options. This study aimed to assess the extent that ADL and BMI are evaluated among diabetes patients in hospital practice. METHOD This was a clinical observational baseline study in two hospitals. Audit of medical files was performed to assess if BMI and occupations were recorded (N = 112). Afterwards, 'N = 38' who consented to participate in prospective study were conveniently sampled to assess ADL in relation to accessible metabolic syndrome tests. A validated questionnaire was used to collect data, which were analysed using SPSS version 20. RESULTS Audit shows 55/112 of clients' occupation were taken, of which 31% has BMI record. Those with lipid profile results are without blood pressure and vice versa. In the cross-sectional assessment, 74% are in physically demanding ADL occupations, but affirmed inactivity is 98% on leisure exercise. Further, 47% have BMI >25 kg/m2 and were consistently less active on all leisure ADL relative to those with BMI <25 kg/m2 (p < 0.02). CONCLUSION This report highlights oversight in clinical practice, whereby accessible metabolic syndrome parameters and occupation of clients living with diabetes are being assessed inconsistently. This implies an unmet need in the integration BMI and occupational information to improve diabetes self-management.
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Affiliation(s)
- Ezekiel U Nwose
- Department of Public & Community Health, Novena University, Ogume, Nigeria; School of Community Health, Charles Sturt University, Orange, Australia.
| | - Benjamin Ekotogbo
- Department of Public & Community Health, Novena University, Ogume, Nigeria
| | | | | | - Otovwe Agofure
- Department of Public & Community Health, Novena University, Ogume, Nigeria
| | - Eunice O Igumbor
- Department of Public & Community Health, Novena University, Ogume, Nigeria
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