Impact of Physical Activity on Challenging Obesity in Pakistan: A Knowledge, Attitude, and Practice (KAP) Study

Valuation of knowledge, attitude, practices of tuberculosis among the health care workers from Islamabad Pakistan

BACKGROUND

Tuberculosis (TB) as a foremost infectious disease adds massive burden to morbidity and mortality rate, despite of well-structured TB control programs around the globe. Inappropriate health care management system and poor implementation on standard in relevance to TB, remain some reasons causative to TB prevalence and its rising antimicrobial resistance. Health Care Workers (HCWs) laboring as a part of TB control system, are the vital warriors in achieving the goals of TB End Strategy by 2035. Their performance is influenced by their knowledge, attitude, and practices (KAP) toward this infectious disease. This study aimed to signify the role of KAP score of health care Workers in the better control and prevention of TB in the Islamabad Capital Territory (ICT), Pakistan.

METHODS

A cross-sectional study on Knowledge, Attitude and Practice study of Tuberculosis (TB) among health care Workers, was done in ICT, which is the capital of Pakistan. The KAP of TB was collected for the 306 Health Care Workers from all the Islamabad TB referring health facilities which refer the TB patients for testing to the National Reference Laboratory, Islamabad Pakistan. Eligible health care workers were requested to respond on KAP questionnaire after informed consent. KAP questionnaire comprised of knowledge, attitude, and practices section including demographic information. All the data was analyzed using IBM SPSS statistics 21. One Way Analysis of Variance (ANOVA) was applied to calculate KAP mean score against different variables. On the significant data sets of ANOVA output, Tukey's Multiple Comparison Test was applied for pairwise comparison. Pearson correlation coefficient was utilized to explore the association between two qualitative variables. The non-parametric tests were applied to evaluate difference of KAP score in relation to demographic covariates individually.

RESULTS

From June to July 2023, we conducted TB KAP study among Health Care Workers of ICT, Pakistan. The average age was 33 years (range 26-30 years). Majority of the recruited subjects were not being trained for dealing with TB infection. The results demonstrated that Health Care Workers working were lacking their knowledge about mode of TB transmission, best diagnostic technique, and contraction of TB infections. The mean knowledge, attitude and practices mean scores were 15.05 (SD = 3.96), 83.68 (SD = 15.74) and 6.31 (SD = 2.21), respectively. Mean knowledge score of Health Care Workers were significantly related to their educational level and occupation while no significant association was declared with working experience as TB staff. Pearson coefficient of attitude score with knowledge of Health Care Workers was of weak level (0.28). Practice mean score was correlated to knowledge mean score at a moderate level (r = 0.40). On the other hand, practice score was r = 0.29 with attitude mean score had shown weak level correlation. A number of demographic factors were strongly linked to each of the mean score of knowledge, attitude, and practices.

CONCLUSION

These findings highlighted the significant involvement of education, profession, and professional trainings in the better knowledge, attitude, and practices of the TB related health care Workers. For a better management system of infectious diseases like TB, a well-trained and professionally competent staff of Health Care Workers is important so as to achieve the goal of TB-End strategy by 2035 from Pakistan, which is the 5th highest burden country for TB.

Assessment of physical literacy in 8- to 12-year-old Pakistani school children: reliability and cross-validation of the Canadian assessment of physical literacy-2 (CAPL-2) in South Punjab, Pakistan

BACKGROUND

The increasing prevalence of physical inactivity, declining fitness, and rising childhood obesity highlight the importance of physical literacy (PL), as a foundational component for fostering lifelong health and active lifestyle. This recognition necessitates the development of effective tools for PL assessment that are applicable across diverse cultural landscapes.

AIM

This study aimed to translate the Canadian Assessment of Physical Literacy-2 (CAPL-2) into Urdu and adapt it for the Pakistani cultural context, to assess PL among children aged 8-12 years in Pakistan.

METHOD

The Urdu version of CAPL-2 was administered among 1,360 children aged 8-12 from 87 higher secondary schools across three divisions in South Punjab province, Pakistan. Statistical analysis includes test-retest reliability and construct validity, employing confirmatory factor analysis to evaluate the tool's performance both overall and within specific subdomains.

RESULTS

The Urdu version of CAPL-2 demonstrated strong content validity, with a Content Validity Ratio of 0.89. Confirmatory factor analysis supported the four-factor structure proposed by the original developers, evidenced by excellent model fit indices (GFI = 0.984, CFI = 0.979, TLI = 0.969, RMSEA = 0.041). High internal consistency was observed across all domains (α = 0.988 to 0.995), with significant correlations among most, excluding the Knowledge and Understanding domains. Notably, gender and age significantly influenced performance, with boys generally scoring higher than girls, with few exceptions.

CONCLUSION

This study marks a significant step in the cross-cultural adaptation of PL assessment tools, successfully validating the CAPL-2 Urdu version for the Pakistani context for the first time. The findings affirm the tool's suitability for assessing PL among Pakistani children, evidencing its validity and reliability across the Pakistani population.

Knowledge and attitudes towards and prevalence of overweight and obesity among undergraduate students at Universiti Kuala Lumpur Royal College of Medicine: A cross-sectional study

Introduction

Overweight and obesity pose significant health risks, affecting social and economic well-being and potentially hindering mental health and learning outcomes. This study investigated the knowledge, attitudes, and prevalence of overweight and obesity among undergraduate students at Universiti Kuala Lumpur Royal College of Medicine (UniKL RCMP), Malaysia.

Methods

A total of 351 UniKL RCMP undergraduate students participated in this study. Descriptive analysis was used to evaluate the sociodemographic and educational profiles of respondents. The chi-square test was conducted to identify the relationship between the sociodemographic and educational profiles and the level of knowledge and attitudes towards overweight and obesity.

Results

The prevalence of overweight and obesity was 25.4%. The majority of the respondents possessed a good level of knowledge regarding overweight and obesity (n=316, 90%). The respondents' programme was significantly associated with their level of knowledge (P=0.001).

Conclusion

This study provides important information to university authorities, students, lecturers, parents and other stakeholders in education and health sectors about the impacts of overweight and obesity on the physical, social and academic welfare of university students.

Saudi Adults' Understanding and Views of Weight Management Practices and Obesity

Background and Objective

The rising prevalence of overweight and obesity presents a significant global challenge. This study aimed to investigate the understanding and views of weight management practices and obesity among Saudi adults.

Methodology

A cross-sectional online survey was conducted from October 2022 to January 2023 among adults residing in Saudi Arabia. Participants completed a self-administered 41-item questionnaire designed to assess their understanding and views regarding weight management practices and obesity.

Results

A total of 1066 participants completed the survey. Gender distribution showed a majority of males (55.7%). Age-wise, the majority fell below 51 years, with 37.7% (young) between 18-24, 32.7% (young adult) between 25-33, and 21.3% (adult) between 34-51. Employment was reported by one-third (n = 315) of respondents, while 22.0% (n = 234) had a history of chronic diseases. Furthermore, 77.3% (n = 824) engaged in regular physical activity.The study results revealed that participants' mean score for understanding obesity was 3.28 ± 2.37 (range 0-6), while the average views score was 28.08 ± 8.79 (range 0-34). Furthermore, females displayed a higher level of understanding compared to males. Employment status also played a significant role, with employed individuals having a better understanding of obesity than those who were unemployed. Moreover, participants with higher qualifications demonstrated a more comprehensive understanding of obesity compared to those with lower qualifications. Additionally, individuals with higher monthly income levels displayed a greater understanding of obesity compared to those with lower incomes. Lastly, participants who engaged in regular physical activity exhibited a higher level of understanding compared to those who were physically inactive.

Conclusion

The study indicates that factors such as being older, being female, being employed, having higher education and income, and engaging in regular physical activity are associated with increased understanding and favorable views regarding weight management practices and obesity.

Establishment of health related physical fitness evaluation system for school adolescents aged 12-16 in Pakistan: a cross-sectional study

Background

The decline in adolescent physical fitness is a significant global public health concern, and Pakistan is no exception. The country's absence of a health-related physical fitness (HRPF) evaluation system has compounded this issue. To bridge this gap, this study aims to develop a scientifically-based HRPF evaluation system for the adolescent population that meets international standards. The evaluation system identifies at-risk children and improves adolescent health outcomes, including obesity, cardiovascular and musculoskeletal disorders, chronic diseases, and psychological illnesses, through crucial physical fitness evaluation. This study specifically aims to establish an HRPF evaluation system for school adolescents aged 12-16 in Pakistan.

Methods

A cross-sectional study was conducted among 2,970 school adolescents aged 12-16 years in the South Punjab, Pakistan. The study used a stratified sampling technique to select participants. The HRPF evaluation system included four components: cardiorespiratory endurance, core muscular endurance, muscular strength, and body composition. Data were collected through standardized tests and anthropometric measurements.

Results

The study's results indicated that the HRPF evaluation scoring system was feasible and valid for evaluating the HRPF of school adolescents in the South Punjab region of Pakistan. The results of the evaluation system categorized participants into five groups based on their performance: excellent (6.2%), good (24.9%), medium (50.7%), poor (17%), and very poor (1.2%).

Conclusion

The study establishes an HRPF evaluation system for Pakistani school adolescents. This system lays the foundation for implementing effective strategies to improve their physical health. The findings offer valuable insights to policymakers, health professionals, and educators, enabling them to promote fitness and devise impactful interventions for enhancing HRPF in this population.

Addressing Non-Communicable Diseases in Primary Healthcare in Kyrgyzstan: A Study on Population' Knowledge and Behavioral Changes

Objective: Non-communicable diseases (NCDs) in Kyrgyzstan are responsible for 83% of all deaths. This study aimed to assess the effectiveness of WHO "Package of Essential Interventions on NCDs" (PEN) on health education and counselling at primary healthcare in Kyrgyzstan. Methods: Interventions consisted of information diffusion in primary care facilities and in communities by trained volunteers. The study aimed to assess the evolution of population's knowledge and behaviour through a questionnaire applying a quasi-experimental approach. The sample size was 2,000 at baseline and after 4 years in intervention and control oblasts. Results: Population's knowledge and behaviour improved in intervention areas compared to control areas. Knowledge on NCD-related risks increased from 61% to 87%. Behaviour improved with physical activity increasing from 23% to 32%; smokers reduced from 22% to 20%; alcohol consumption reduced from 23% to 16%; daily walking (minimum 30') improved from 40% to 71%. Conclusion: This study suggests that the PEN-protocol is effective in improving healthy behaviour, thus potentially contributing to prevent NCDs. This example from Kyrgyzstan provides a practical example for promoting PEN-protocol adaptation in other countries.

Epidemiological trend and age-period-cohort effects on cardiovascular disease mortality and disability-adjusted life years attributable to dietary risks and high body mass index at the regional and country level across China and Pakistan

Background

Modifiable risk factors are major drivers of cardiovascular disease (CVD). We aimed to determine the epidemiological trend and age-period-cohort effects on CVD burden attributable to dietary risks and high body mass index (BMI) across China and Pakistan from 1990 to 2019.

Methods

Data on the all-ages and age-specific CVD burden, age-standardized CVD mortality and disability-adjusted life years (DALYs) rates were obtained from the Global Burden of Disease Study 2019. Joinpoint regression analysis was conducted to find temporal trends and age-period-cohort (APC) modeling was used to estimate age, period, and cohort effects on CVD burden.

Results

Between 1990 and 2019, the all-ages CVD burden attributable to dietary risks and high BMI increased by ~2-3-fold in China and by 3-5-fold in Pakistan. The diet-related CVD age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALYs) rate significantly decreased in China but increased in Pakistan. Both countries showed a marked increasing trend of CVD ASMR and the age-standardized DALYs rate attributable to high BMI. Taiwan in China showed a remarkable reduction in CVD burden. However, in Pakistan, all regions observed a significantly increasing trend of CVD burden attributable to modifiable risk factors. A higher risk ratio of premature CVD mortality (<70 years) was observed among Chinese attributable to high BMI and among Pakistani attributable to dietary risks. In China, early birth cohorts showed a higher risk ratio and recent birth cohorts experienced a lower risk ratio of CVD burden compared with Pakistan.

Conclusion

In conclusion, dietary risks and high BMI caused a huge CVD burden across China and Pakistan.

Impact of Coronavirus Disease of 2019 Vaccine on Health and Physical Activities Among Physical Education Students in China

Purpose

This research focused primarily on the impact of the SARS-CoV-2 Vaccine (VeroCell) on Chinese physical education (PE) students' health and physical activity (PA) performance.

Methods

This study used quantitative methods and phenomenological procedures to collect and analyze data. Survey techniques were the main method used for collecting data from Chinese university students, using a self-designed questionnaire with a Cronbach's alpha α value of 0.76. To ensure the quality of the study, confirmatory factor analyses (CFA) were conducted, and the internal consistency reliability of the instrument was measured (alpha coefficient = 0.82). The determined sample size was 490 and around 90% as the minimum sample size was determined with the help of a sample size calculator. The author using factor loadings with h2 and an independent-sample t-test analyzed the responses of the remaining valid participants (n = 443 with a response rate of 90.40).

Results

Most participants (around 94%) did not experience any adverse reactions that impacted their daily life activities, health, or performance during physical activity. However, about 30–40% of students felt lethargy, weakness, muscle pain, or swelling. Regarding the impact of the vaccine on daily life, there was no difference in the responses between participants who had only received one shot of the coronavirus disease 2019 (COVID-19) vaccine and those who had received two shots (p &gt; 0.05 in most cases).

Conclusion

The study concluded that the COVID-19 vaccine had no significant effect on PE students' daily activities, health, and PA performance. The results of this study could be used by policymakers to encourage people to get vaccinated and eradicate the isolation caused by COVID-19, which leads many people to develop various non-communicable diseases (NCDs).

Assessing the Association Between Pakistani Women's Religious Beliefs and Sports Participation

Women’s participation in physical activities has been discouraged for a variety of reasons, especially in Muslim countries. This study aims to highlight Pakistani women’s religious beliefs about sports. It focuses on whether their religion contradicts their participation in sporting activities, and it does so by using an adapted version of the Santa Clara Strength of Religious Faith Questionnaire (SCSRFQ) in the theoretical context of feminism in sports. The snowball sampling method was used to select women (n = 357) from the Sindh province of Pakistan, who completed a questionnaire incorporating the SCSRFQ that was specially designed for the current study. The results were unexpected, revealing that religious beliefs have no negative impact on Pakistani women’s participation in sports. Few participants (14 out of 357, 3.9%) believe that religion is an obstacle to their participation in sports. The results of the study challenge the traditional view by most of the previous studies that Islam is against women’s sports. It also challenges cultural limitations, such as some unwritten rules in Pakistani culture according to which women cannot participate in sports. These efforts should lead to enhanced female sports participation in the Pakistani context.

Influencing Factors Related to Female Sports Participation Under the Implementation of Chinese Government Interventions: An Analysis Based on the China Family Panel Studies

Objectives

Regular sports participation is a gendered phenomenon in China. Women have reported much higher constraints than men on time, partner, psychology, knowledge, and interest. This study explores personal, family, lifestyle, and health factors associated with sports participation.

Study Design

This study is a cross-sectional study.

Methods

Data were collected from the national reprehensive China Family Panel Studies (CFPS) database (2018) to analyze personal information, family background, lifestyle, and health in relation to women's sports participation. Multiple classification logistic regression was used to quantify the association between independent variables and sports time.

Results

Women with high personal income and education, who were unmarried, in faster economic development areas have more awareness and more time for sports participation. Women who were overweight and self-rated as unattractive spent less time on sports participation. Women with a small family population and no children have more time for sports participation. Less time on the internet and moderate sleep contribute to active sports participation. Women with chronic diseases and high medical costs are less likely to participate in sports.

Conclusions

Negative body aesthetic perception, the burden of family environment, modernization of lifestyle, and the normalization of sub-health are essential factors affecting women's sports participation. The government should understand the inner and outer barriers to women's participation in sports, develop policies and regulations to protect and support women's sports participation, and guide and monitor the effective implementation of women's sports activities.

Young Women as Change Agents in Sports and Physical Activities in the Punjab (Southern) Province of Pakistan

Women's empowerment is a concept describing the promotion of women doing things independently and in their own interests, being more conducive to their future and physical and mental development; this includes participation in different outdoor activities, including sports. This qualitative study presents data collected from 18 young female students at sports and physical education universities in Southern Punjab (SP) in Pakistan, selected using a snowball sampling technique. The current study explores their gendered and lived experiences of playing sports and engaging in physical activities in patriarchal systems by emphasizing the concept of women's empowerment in the context of feminism in sports theory. The findings suggest that the participants faced typical gender stereotypes in their families and communities, which position sports and physical activities as being not feminine. The chances for women to participate in sports and physical activities decrease as they grow up. However, the participants used a range of strategies to advance their interests and academic careers in sports and physical activities by resisting and incorporating dominant discourses of women's participation in sports and physical activities, which also has implications in the internal and external policy domains at the local and national levels. The participants displayed great resilience and optimism, empowering them to enter the male-dominated domains, and thus we labeled them as change agents.

Performance, Health, and Psychological Challenges Faced by Students of Physical Education in Online Learning during COVID-19 Epidemic: A Qualitative Study in China

The spread of COVID-19 has led students to take classes online (rather than face-to-face) worldwide, including in China. For this study, we conducted qualitative focus group discussions to identify the experience of and difficulties faced by online physical education students in higher education taking online classes, including the impact on their physical activity performance, as well as some health problems they face while taking online classes during the quarantine period, such as weight gain, depression, and anxiety. Finally, utilizing Mayer's learning model as a conceptual framework, we propose a method that addresses how to effectively manage an optimal future learning system for physical education students, both during and after the COVID-19 outbreak situation. During the isolation period of COVID-19, the required equipment for the participants was rarely available at home while attending the online classes, which inevitably reduced the number of physical education units that could be conveyed. This resulted in a transfer of attention from competition to underperformance, weight gain, and adverse psychological conditions. We conclude that it is important to review and systematize the methods of online physical education learning, particularly highlighting the cultural and educational characteristics of different countries, and to investigate the effectiveness of online physical education as a whole.