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Vijayan B, Govil D, Sahoo H. Effect of Autonomy and Physical Activity on Self-Rated Health of Older Adults in India: Gendered Analysis Using Structural Equation Models. Exp Aging Res 2023:1-18. [PMID: 37953538 DOI: 10.1080/0361073x.2023.2278982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/28/2023] [Indexed: 11/14/2023]
Abstract
The gendered expectations and responsibilities placed upon women can impede their ability to participate in social activities and engage in physical leisure pursuits, ultimately having a negative impact on their health. Our study investigates the mechanisms through which gender influences individuals' engagement with physical activity during free time and how this relates to self-rated health outcomes among adults aged 45 years or older living in India. Using cross-sectional analysis and Structural Equation Modelling, we analyzed data stratified by gender and age from the Longitudinal Ageing Study of India to examine these conceptual pathways. We found that compared to men, women face greater limitations related to decision-making autonomy, experience more functional impairments, have weaker social networks that provide less support for engaging in leisure-time physical activity, leading them to report lower levels of overall wellbeing than men. Further analyses demonstrated distinct pathways through which each gender's level of social network connectivity shapes behavior - strong connections increase opportunities for women specifically to engage positively with both peers and physically active pursuits supporting overall wellness goals.
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Affiliation(s)
- Bevin Vijayan
- School of Development, Azim Premji University, Bhopal, India
| | - Dipti Govil
- Department of Family and Generations, International Institute for Population Sciences, Deonar, Mumbai, India
| | - Harihar Sahoo
- Department of Family and Generations, International Institute for Population Sciences, Deonar, Mumbai, India
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Hasan ABMN, Sharif AB, Jahan I. Perceived barriers to maintain physical activity and its association to mental health status of Bangladeshi adults: a quantile regression approach. Sci Rep 2023; 13:8993. [PMID: 37268704 DOI: 10.1038/s41598-023-36299-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 05/31/2023] [Indexed: 06/04/2023] Open
Abstract
Insufficient physical activity and unhealthy lifestyle preferences have been significant concerns for decades. This study aimed to determine the perceived barriers to maintaining physical activity among adults in three major cities of Bangladesh and their association with mental health status. This is a cross-sectional study where 400 participants were selected using a multistage sampling technique. Twenty municipal wards were randomly selected from three cities, followed by a convenient selection of the study participants from each ward. Questionnaires about perceived physical activity barriers were developed based on previously published literature. The DASS-21 scale assessed the mental health status of the study participants. Descriptive statistics were applied to narrate the baseline characteristics of the respondents. The Shapiro-Wilk test was used to check the normality of the perceived physical activity scores. Quantile regression analysis was applied to model the physical activity barrier scores depending on several covariates. Five quantiles were used: the 10th, 25th, 50th, 75th, and 90th. A p-value less than 0.05 was considered significant for hypothesis testing. Among the respondents, 68.50% were male, half of them were married, 68.0% belonged to nuclear families, 48.0% completed graduate level education, 34.25% were service holders, one-third of the respondent's working hours were 6-8 h, and 19.50% belongs to the overweight and obese groups. Poor traffic and construction work near the road (60.30%) was seen as the most significant barrier to physical activity. Over half of the respondents stated that lack of time, facilities, and expenses hinder physical activity. Mental health status reported mild to extremely severe levels of depression (32%), anxiety (47%), and stress (42.50%), respectively. Significant associations between the perceived physical activity scores and gender, family type, occupation, income, BMI, anxiety, and depression were obtained. Ensuring a safe environment, facilitating accessibility and availability of low-cost exercise facilities, improving road and traffic conditions, and providing appropriate mental health counseling may help to mitigate physical activity barriers.
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Affiliation(s)
- A B M Nahid Hasan
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Azaz Bin Sharif
- Department of Public Health, North South University, Dhaka, Bangladesh.
- Global Health Institute, North South University (NGHI), Dhaka, Bangladesh.
| | - Ishrat Jahan
- Department of Public Health, North South University, Dhaka, Bangladesh
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Goonatilaka WSM, De Silva WI. Impact of Leisure Activities on the Well-being of Elders: Evidence from Sri Lanka. J Cross Cult Gerontol 2023:10.1007/s10823-023-09474-6. [PMID: 36943613 DOI: 10.1007/s10823-023-09474-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 03/23/2023]
Abstract
Sri Lanka demonstrates the most rapid aging process among countries in South Asia. The high prevalence of non-communicable diseases (NCDs) in the meanwhile results in more than 70% of deaths in the population, a factor that would curtail leisure activities of elders significantly. The objective of this study was to investigate the engagement of elders in leisure activities in Sri Lanka, and to examine the relationship between leisure activities and their well-being. The study was conducted in 2018 in a rural district of Sri Lanka adopting a mixed methods approach. Simple random sampling technique was used to select the respondents aged between 55 and 74 years, and face-to-face interviews were conducted with 300 respondents. Qualitative data was also collected from ten key informants while a few observations were also made on selected activities of elders in the study area. The research found that a two-thirds of the surveyed respondents were suffering from NCDs, showing a clear impact on their leisure activities. The presence of leisure activities was much lower among NCD affected elders (48%) compared to NCD free elders (80%). The majority of respondents possess sufficient and accurate knowledge on how to prevent NCDs, but they rarely practiced it. Leisure activities were significantly higher among males (75%) compared to females (43%). Males participated in leisure activities such as, gardening/agriculture etc. (99%), while females were engaged in religious activities such as visiting such places and meditation (98%). Leisure engagement demonstrated a positive impact on their life satisfaction. Although a sizable proportion of elders was engaged in leisure activities, analysis of both qualitative and quantitative data supported the view that the intensity of activities may not be helpful to maintain good health. Life satisfaction and well-being of elders are crucial for rapidly aging Sri Lankan society. Motivating elders and others, including school children, via strengthening of related policies and programs would reduce the NCD burden and enable present and future elders to enjoy a more fulfilling life in old age.
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Martín-Moya R, Ruiz-Montero PJ, García ER. Personal barriers to physical practice by older adults in different socio-economic locations: a qualitative study. JOURNAL OF GERONTOLOGY AND GERIATRICS 2022. [DOI: 10.36150/2499-6564-n520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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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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Gamage AU, Seneviratne RDA. Physical inactivity, and its association with hypertension among employees in the district of Colombo. BMC Public Health 2021; 21:2186. [PMID: 34844564 PMCID: PMC8628394 DOI: 10.1186/s12889-021-12013-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: 05/25/2021] [Accepted: 10/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical inactivity is a leading cause of morbidity and mortality and is a major public health problem. Insufficient activity is responsible for a large proportion of non-communicable diseases such as hypertension. OBJECTIVES The purpose of this study was to assess socioeconomic variations in physical activity and to measure the association between physical inactivity and hypertension among government officials in Sri Lanka. METHODS A cross-sectional study was carried out among 275 senior-officers(SOs) and 760 managerial-assistants(MAs) aged 30-60 years and attached to Public Administration institutions in Colombo District in Sri Lanka. Physical-activity(PA) was gathered using the International Physical Activity Questionnaire(IPAQ) adopted and validated to the Sri Lankan context. Blood pressure(measured and classified using JNC-7 guidelines) and anthropometric indices were recorded. Energy utilization of all vigorous and moderated PA and walking was expressed as metabolic-equivalent-of-task(MET) min per week. A total-MET-score was calculated and categorized based on IPAQ guidelines. RESULTS Socioeconomic variations in PA levels were observed as 58.1%(n = 158) SOs and 30.6%(n = 226) MAs were involved in inadequate PA. Among the SOs diagnosed with hypertension, more half(59.1%; n = 52) were physically inactive, while among MAs, 65.9%(n = 143) with hypertension were physically inactive. After adjusting for potential confounding factors being physically inactive was associated with a higher risk of hypertension among SOs[OR 2.08 [95% CI 1.07, 4.6] and MAs[OR 2.8 [95% CI 1.8, 4.6]. The main modality of commuting to work for SOs(59%) was private transport, and MAs(64%) public transport Commuting distance was positively correlated(p < 0.05) with total transport MET among SOs and MAs. After adjusting for confounders, commuting distance of > 20 km was found to lower the odds of hypertension among SOs and MAs(OR = 0.713; 95% CI 0.4 to1.3; and OR = 0.63; 95% CI 0.46 to 0.87). CONCLUSION Despite the current knowledge that being physically active promotes health, the practice was different. Physical inactivity was associated with hypertension and prevalent among both SOs and MAs. Higher commuting distance is positively correlated with total transport MET and associated with lower odds of hypertension among SOs and MAs. Longitudinal studies are required to provide a causative association between physical inactivity and hypertension among these employees.
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Affiliation(s)
- A U Gamage
- Senior Lecturer in Community Medicine, Paraclinical Department, Faculty of Medicine, General Sir John Kotelawala Defence University, Ratmalana, 10390, Sri Lanka.
| | - R de A Seneviratne
- Senior Professor in Community Medicine, Paraclinical Department, Faculty of Medicine, General Sir John Kotelawala Defence University, Ratmalana, 10390, Sri Lanka
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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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Sisira Kumara A, Sachitra V. Modeling the participation in physical exercises by university academic community in Sri Lanka. HEALTH EDUCATION 2021. [DOI: 10.1108/he-02-2021-0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe World Health Organization issued its global action plan on physical activities 2018–2030, emphasizing the importance of context-specific evidence on the subject. Accordingly, this study aims to provide unique and important policy insights on trends and drivers of participation in physical exercises by academic community in Sri Lankan universities.Design/methodology/approachFor this purpose, we collected cross-sectional data (n = 456) in 2020 using a survey, and first, estimated a double-hurdle model to uncover covariates influencing likelihood and intensity of physical exercises overall. Second, count-data models are estimated to capture regularity of key exercises.FindingsThe results reveal that about 50% of members do not participate in any general physical exercise. Older members (marginal effect (ME) = 3.764, p < 0.01), non-Buddhists (ME = 54.889, p < 0.01) and alcohol consumers (ME = 32.178, p < 0.05) exhibit a higher intensity of participating in exercises overall. The intensity is lower for rural members (ME = −63.807, p < 0.01) and those with health insurance covers (ME = −31.447, p < 0.05). Individuals diagnosed for chronic illnesses show a higher likelihood of exercising but, their time devotion is limited. The number of children the academic staff members have as parents reduces the likelihood, but for those who choose to exercise have higher time devotion with increased number of children. The covariates play a similar role in determining regularity of key exercises: walking, jogging and exercising on workout machines.Research limitations/implicationsThe results imply a need to promote exercising in general and particularly among younger, healthy, insured and female individuals living in rural sector.Originality/valueThe study covers an under-researched professional sub-group in an under-researched developing context, examining both the likelihood and regularity of exercising as both dimensions are equally important for individuals to maintain healthy lives.
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Wickramarachchi BI, Siop SJ, Perera B. Personal Determinants for Physical Activity Behavior of Urban-Dwelling Older Adults in Sri Lanka. Gerontol Geriatr Med 2021; 7:23337214211023684. [PMID: 34179299 PMCID: PMC8202329 DOI: 10.1177/23337214211023684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 12/24/2022] Open
Abstract
Physical inactivity is a vital risk factor for the development and maintenance of chronic ill-health conditions among older adults. This study examined personal factors associated with physical activity (PA) behavior of urban-dwelling older adults in Sri Lanka, a middle-income country in South Asia. A total of 880 older adults (aged ≥60 years) participated in this cross-sectional study. They responded to anthropometrical, health, and socio-demographic data pertaining to their current physical and behavioral status. The mean age of the participants was 70.1 years (SD ±6.0), and the majority (75%) were women. Increasing age, male gender, middle income, having cardiovascular diseases or arthritis, deficiencies in muscle strength and balance, pain, and lower self-rated health were associated with insufficient PA behavior among the participants. Old-age physical activity promotion programs should target older adults in advanced ages and men in particularly, as they are highly vulnerable to sedentary lifestyles. Muscle strength and balance, a neglected area in PA promotion in older adults, seem to play an important role in older adults' participation in physical activities. Incorporation of pain management, and muscle strength and balance techniques into older adults' PA promotion programs would probably increase adherence rates of the participants in such programs.
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Affiliation(s)
- Bimba I Wickramarachchi
- University of Ruhuna, Galle, Sri Lanka.,Department of Nursing, Faculty of Medical and Health Sciences, Universiti Malaysia Sarawak, Malaysia
| | - Sidiah J Siop
- Department of Nursing, Faculty of Medical and Health Sciences, Universiti Malaysia Sarawak, Malaysia
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Pace NP, Vassallo J, Calleja-Agius J. Gestational diabetes, environmental temperature and climate factors - From epidemiological evidence to physiological mechanisms. Early Hum Dev 2021; 155:105219. [PMID: 33046275 DOI: 10.1016/j.earlhumdev.2020.105219] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Gestational diabetes (GDM) is a common metabolic complication of pregnancy that is generally asymptomatic in its clinical course, although it is potentially associated with a wide range of both maternal and foetal complications. The population prevalence of GDM varies widely, depending on the clinical diagnostic criteria, ethnicity, demographics and background prevalence of type 2 diabetes. Climate variability and environmental temperature have recently come to the forefront as potential direct or indirect determinants of human health. The association between GDM and environmental temperature is complex, and studies have often reported conflicting findings. Epidemiologic studies have shown a direct relation between rising environmental temperature and the risk of both GDM and impaired beta cell function. Seasonal trends in the prevalence of GDM have been reported in several populations, with a higher prevalence in summer months. Multiple mechanisms have been proposed to explain the GDM-temperature correlation. A growing body of evidence supports a link between temperature, energy expenditure and adipose tissue metabolism. Brown adipose tissue thermogenesis, induced by cold temperatures, improves insulin sensitivity. Further biological explanations for the GDM-temperature correlation lie in potential association with low vitamin D levels, which varies according to sunshine exposure. Observational studies are also complicated by lifestyle factors, such as diet and physical activity, that could exhibit seasonal variation. In this review article, we provide a systematic overview of available epidemiological evidence linking environmental temperature and gestational diabetes. Furthermore, the physiological mechanisms that give biological plausibility to association between GDM and temperature are explored. As future climate patterns could drive global changes in GDM prevalence, this knowledge has important implications for both clinicians and researchers.
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Affiliation(s)
- Nikolai Paul Pace
- Department of Anatomy, Faculty of Medicine and Surgery, Biomedical Sciences Building, University of Malta, Msida MSD 2080, Malta.
| | - Josanne Vassallo
- Department of Medicine, Faculty of Medicine and Surgery, Biomedical Sciences Building, University of Malta, Msida MSD 2080, Malta
| | - Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, Biomedical Sciences Building, University of Malta, Msida MSD 2080, Malta
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