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Veisy A, Mohammad-Alizadeh-Charandabi S, Abbas-Alizadeh S, Mirghafourvand M, Ghaderi F, Haghighi M. Monitored home-based with or without face-to-face exercise for maternal mental health during the COVID-19 pandemic. J Reprod Infant Psychol 2024; 42:110-125. [PMID: 35416742 DOI: 10.1080/02646838.2022.2063267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/31/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Despite the known beneficial effects of exercise, most pregnant women do not exercise regularly. Most studies on exercise have been conducted on supervised exercise and there is limited evidence regarding the adherence and effect of other exercise programs on pregnancy outcomes. Therefore, we aimed to investigate adherence to a face-to-face plus monitored home exercise program versus a monitored home-based exercise program on its own during pregnancy. In addition, effects of these two exercise programs on women's mental health during pregnancy and postpartum (primary outcomes) and on some other maternal and neonatal outcomes (secondary outcomes) will be assessed. METHODS In this superiority trial with three parallel arms, 150 women at 12-18 weeks of gestation will be randomised equally into three groups (face-to-face plus monitored home exercise, only monitored home-based exercise, and control). The exercise programs will be performed up to the 38th week of gestation during which participants will be assessed at specific intervals during the pregnancy, and post-partum and followed up until six months after childbirth. The exercise diary will be used to assess the adherence. The Edinburgh Depression Scale and the Positive and Negative Affect Schedule will be used to assess prenatal and postnatal depression and affect, respectively. DISCUSSION This study reflects the feasibility and acceptance of two exercise programs for pregnant women and their effects on important outcomes. If these programs are followed properly and effectively, pregnant women's health can be improved using these methods at a lower cost compared to the conventional supervised exercise program.
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Affiliation(s)
- Afsaneh Veisy
- Student Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Mohammad-Alizadeh-Charandabi
- Social Determinants of Health Research Center, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shamci Abbas-Alizadeh
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center (Sdhrc), Department of Family Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Fariba Ghaderi
- Department of Physiotherapy, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahmonir Haghighi
- Department of Psychiatry, Urmia University of Medical Sciences, Urmia, Iran
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Martiskainen T, Lamidi ML, Venojärvi M, Tikkanen H, Laatikainen T. Factors affecting the effectiveness of the physical activity counselling intervention implemented in primary health care in adults with type 2 diabetes. BMC Endocr Disord 2023; 23:166. [PMID: 37550678 PMCID: PMC10405502 DOI: 10.1186/s12902-023-01428-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 08/01/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) has become a major public health threat; physical inactivity and obesity are both independent risk factors. Increasing daily physical activity (PA) significantly benefits treatment. Individual PA counselling is helpful for people with T2D, especially those with previous inactivity or with diabetes complications. This study evaluated factors contributing to effectiveness of PA counselling in primary health care (PHC) patients with T2D in a real-world setting and using data elicited from electronic health records (EHRs). METHODS All patients with T2D were offered the opportunity to participate in a PA program organized as part of basic PHC services in the Siun sote region in North Karelia, Finland, from October 2016 to December 2018. The study population consists of patients aged 19 to 87 years (n = 546). During the intervention information on possible other factors in addition to age and sex influencing the intervention effect such as amount of counselling sessions, changes in PA and patients´ motivation was gathered. Changes in the participants' PA activity was generated by following the predefined rules from patient records and by assessing the descriptive documentation of activity patterns. The patients' motivation level was assessed using a Likert scale. RESULTS Over 60% of participants who attended PA counselling more than three times increased their PA compared with 1% of participants with one counselling session. Of the whole intervention group, the participants experiencing the largest weight loss were those with an increased level of PA (-1.36 kg vs. -0.63 kg among those with no change in PA). Age, sex, and baseline motivation did not affect the change the PA nor the main intervention outcomes. CONCLUSIONS Patients' compliance with the intervention was reflected in the number of PA counselling sessions attended which in turn was seen as increased levels of PA as well as better treatment outcomes. In the implementation of lifestyle counselling interventions attention should be paid on sufficient amount and frequency of counselling sessions. The individually tailored PA counselling provided in PHC has similar effects regardless of sex and age.
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Affiliation(s)
- Tuula Martiskainen
- Joint municipal authority for North Karelia social and health services (Siun sote), Tikkamäentie 16, Joensuu, 70210, Finland.
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, PO BOX 1627, Kuopio, 70211, Finland.
| | - Marja-Leena Lamidi
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, PO BOX 1627, Kuopio, 70211, Finland
| | - Mika Venojärvi
- Institute of Biomedicine/Sports and Exercise Medicine, University of Eastern Finland, PO BOX 1627, Kuopio, 70211, Finland
| | - Heikki Tikkanen
- Institute of Biomedicine/Sports and Exercise Medicine, University of Eastern Finland, PO BOX 1627, Kuopio, 70211, Finland
| | - Tiina Laatikainen
- Joint municipal authority for North Karelia social and health services (Siun sote), Tikkamäentie 16, Joensuu, 70210, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, PO BOX 1627, Kuopio, 70211, Finland
- Department of Public Health and Social Welfare, Finnish Institute for Health and Welfare, PO BOX 30, Helsinki, 00271, Finland
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Robinson J, Nitschke E, Tovar A, Mattar L, Gottesman K, Hamlett P, Rozga M. Nutrition and Physical Activity Interventions Provided by Nutrition and Exercise Practitioners for the General Population: An Evidence-Based Practice Guideline From the Academy of Nutrition and Dietetics and American Council on Exercise. J Acad Nutr Diet 2023; 123:1215-1237.e5. [PMID: 37061182 DOI: 10.1016/j.jand.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/10/2023] [Indexed: 04/17/2023]
Abstract
A nutritious diet and adequate physical activity vitally contribute to disease prevention, but most adults do not meet population-based dietary and physical activity recommendations. Qualified nutrition and exercise practitioners can address challenges to adopting healthy lifestyle behaviors by providing consistent, individualized, and evidence-based education and programming within their professional scopes of practice to improve client outcomes. The objective of this evidence-based practice guideline is to inform practice decisions for nutrition and exercise practitioners providing nutrition and physical activity interventions for adults who are healthy or have cardiometabolic risk factors, but no diagnosed disease. Evidence from a systematic review was translated to practice recommendations using an evidence-to-decision framework by an interdisciplinary team of nutrition and exercise practitioners and researchers. This evidence-based practice guideline does not provide specific dietary or physical activity recommendations but rather informs nutrition and exercise practitioners how they may utilize existing guidelines for the general population to individualize programming for a range of clients. This evidence-based practice guideline provides widely applicable recommendation statements and a detailed framework to help practitioners implement the recommendations into practice. Common barriers and facilitators encountered when delivering nutrition and physical activity interventions, such as adherence to professional scopes of practice; methods to support behavior change; and methods to support inclusion, diversity, equity, and access, are discussed. Nutrition and exercise practitioners can consistently provide individualized, practical, and evidence-based interventions by seeking to understand their clients' needs, circumstances, and values and by co-creating interventions with the client and their allied health team.
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Affiliation(s)
- Justin Robinson
- Kinesiology Department, Point Loma Nazarene University, San Diego, California
| | - Erin Nitschke
- Department of Exercise Science, Laramie County Community College, Cheyenne, Wyoming
| | | | - Lama Mattar
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Lebanon
| | - Kimberly Gottesman
- Department of Nutrition and Food Science, California State University Los Angeles, Los Angeles, California
| | - Peggy Hamlett
- Department of Kinesiology, Washington State University Pullman, Washington
| | - Mary Rozga
- Evidence Analysis Center, Academy of Nutrition and Dietetics, Chicago, Illinois.
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Ruart S, Sinnapah S, Hue O, Antoine-Jonville S. It's time to increase physical activity promotion among pregnant women in France. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:206. [PMID: 37545993 PMCID: PMC10402808 DOI: 10.4103/jehp.jehp_461_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 02/13/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND The lockdown linked to COVID-19 was shown to have negative effects on healthy behaviors in the general population, prompting the implementation of adapted public health measures. However, more vulnerable populations, such as pregnant women, were not specifically taken into account. At the time of writing this study, we know little about how the COVID-19 pandemic impacted the physical activity (PA) behavior of pregnant women in France. Given the many reports in the literature about women's low level of PA throughout pregnancy and the negative effects of the COVID-19 lockdown on behaviors in the general population; however, we might assume that their sedentary behaviors increased. The current study aimed to analyze the French recommendations and PA promotion among pregnant women. MATERIALS AND METHODS A literature search was done using PubMed for the key terms "physical activity/physical activity promotion," "pregnant women/pregnancy,", and "French population/France." All the relevant studies were included to support the argument for this narrative review. RESULTS Efforts to promote PA for pregnant women often seem ineffective and even unrealistic, and many women become overweight or obese during pregnancy. Health professionals need evidence-based guidelines and continuous training and skills development in order to convincingly encourage women to be more active during pregnancy and the postpartum period. CONCLUSION Health policies should strengthen PA promotion among pregnant women with detailed evidence-based guidelines on PA during postpartum.
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Affiliation(s)
- Shelly Ruart
- Université des Antilles, Laboratoire ACTES UPRES-EA3596, Pointe-à-Pitre, Guadeloupe, France
| | - Stéphane Sinnapah
- Université des Antilles, Laboratoire ACTES UPRES-EA3596, Pointe-à-Pitre, Guadeloupe, France
| | - Olivier Hue
- Université des Antilles, Laboratoire ACTES UPRES-EA3596, Pointe-à-Pitre, Guadeloupe, France
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Barriers and facilitators to physical activity for young adult women: a systematic review and thematic synthesis of qualitative literature. Int J Behav Nutr Phys Act 2023; 20:23. [PMID: 36849995 PMCID: PMC9972741 DOI: 10.1186/s12966-023-01411-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/22/2022] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Physical activity (PA) has many benefits in preventing diseases and maintaining physical and mental health. Women, in particular, can benefit from regular PA. However, women's PA did not increase over the past decade globally, and the situations faced by women are often gender-specific. Healthy young adult women's PA does not receive as much attention as older women and adolescent girls, yet, they face the same situation of low level of PA. This review aims to explore and synthesise the self-identified barriers and facilitators to young adult women's participation in PA from qualitative research studies and offer suggestions for future studies and programs designed for this population. METHODS A systematic search was conducted in Pubmed, Web of Science, Scopus, Medline, and SPORTDiscus for studies published between January 2000 to February 2022 to identify qualitative studies on the barriers and facilitators of young adult women's PA between ages 18 to 40. The search yielded 694 studies initially, of which 23 were included. The research quality of included studies was appraised using the Critical Appraisal Skills Programme (CASP) tool. Data were extracted and thematically analysed based on the tenets of the social-ecological model (SEM). RESULTS Identified barriers and facilitators were grouped into different levels of the SEM, with the most frequently cited factors being time, body image and societal beauty standards, family duty and social support, religious and cultural norms, organisation and community facilities and environment, safety issues and physical environment. Descriptive data were thematically analysed and synthesised in line with the five levels: body image, health and beauty; multiple roles, support, and PA; religious identity, cultural identity, and PA; safety issues and women's fears. CONCLUSIONS This qualitative synthesis revealed in-depth information on barriers and facilitators influencing young adult women's PA. It highlighted that the factors young adult women face are diverse at different levels yet holistic and intertwined. Future studies on young adult women's PA should address the social-cultural influence and would benefit from applying multilevel strategies employing the SEM model. It is critical to create an open and inclusive environment and offer more opportunities for women. TRIAL REGISTRATION PROSPERO CRD42021290519.
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Ho-A-Tham N, Struyf N, Ting-A-Kee B, de Almeida Mello J, Vanlandewijck Y, Dankaerts W. Physical activity, fear avoidance beliefs and level of disability in a multi-ethnic female population with chronic low back pain in Suriname: A population-based study. PLoS One 2022; 17:e0276974. [PMID: 36315484 PMCID: PMC9621425 DOI: 10.1371/journal.pone.0276974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 10/18/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Chronic low back pain (CLBP) is an important cause for reduced daily physical activity (PA) and loss of quality of life, especially in women. In Suriname, a middle-income country in South America, the relationship between PA and CLBP is still unknown. AIMS To assess the level of PA in women with CLBP of different ethnicity, and to identify whether fear avoidance beliefs (FAB), disability, co-occurring musculoskeletal pain sites and various sociodemographic and lifestyle factors were associated with self-reported PA. METHODS A cross-sectional community-based house-to-house survey was conducted between April 2016 and July 2017. The survey followed the Community Oriented Program for Control of Rheumatic Diseases methodology. Selection criteria were being female of Asian-Surinamese, African-Surinamese or of Mixed ethnicity and aged 18 or older, living in an urban area, and reporting CLBP. Data was collected on PA, FAB, disability, co-occurring musculoskeletal pain sites, CLBP intensity and sociodemographic and lifestyle factors. RESULTS Urban adult women with current CLBP (N = 210) were selected. Nearly 57% of the population met the WHO recommendation on PA, with work-related PA as the largest contributor to total self-reported PA. Most women showed low FAB scores (FABQ-Work ≤34 (96.2%) and FABQ-PA ≤14 (57.6%)) and low disability levels (Oswestry Disability Index ≤20 (62.4%)). An inverse association between total PA and FABQ-Work (OR = 0.132, CI: 0.023; 0.750) was found. In contrast, total PA had a significant, positive association with disability (OR = 2.154, CI: 1.044; 4.447) and workload (OR = 2.224, CI: 1.561; 3.167). All other variables showed no association with total PA. CONCLUSION This was the first study in Suriname reporting that 43.3% of urban adult women with CLBP were physically inactive. Total self-reported PA is influenced by FABQ-Work, average to heavy workload and moderate to severe disability. In this study, PA-Work was the major contributor to total PA. Therefore, future longitudinal studies should evaluate different types and aspects of PA in relation to CLBP management.
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Affiliation(s)
- Nancy Ho-A-Tham
- Department of Physiotherapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
- Department of Rehabilitation Sciences, Research Group for Musculoskeletal Rehabilitation, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- * E-mail: ,
| | - Niels Struyf
- Department of Physiotherapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
- Department of Rehabilitation Sciences, Research Group for Musculoskeletal Rehabilitation, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Beverly Ting-A-Kee
- Department of Pathology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | | | - Yves Vanlandewijck
- Department of Rehabilitation Sciences, Research Group of Adapted Physical Activity and Psychomotor Rehabilitation, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Department of Physiology, Nutrition and Biomechanics, Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Wim Dankaerts
- Department of Rehabilitation Sciences, Research Group for Musculoskeletal Rehabilitation, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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Brannon GE, Ray M, Cho P, Baum M, Beg MS, Bevers T, Schembre SM, Basen-Engquist K, Liao Y. A qualitative study to explore the acceptability and usefulness of personalized biofeedback to motivate physical activity in cancer survivors. Digit Health 2022; 8:20552076221129096. [PMID: 36238756 PMCID: PMC9551329 DOI: 10.1177/20552076221129096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/11/2022] [Indexed: 11/07/2022] Open
Abstract
Objective Many cancer survivors do not meet recommended levels of exercise, despite the
benefits physical activity offers. This study aimed to understand
experiences of insufficiently active overweight/obese breast or colorectal
cancer survivors, in efforts to (1) examine regular physical activity
barriers, and (2) determine perceptions and acceptability of a remotely
delivered physical activity intervention utilizing wearable sensors and
personalized feedback messages. Methods In-person and virtual small group interviews were conducted engaging
overweight/obese cancer survivors (n = 16, 94% female, 94%
breast cancer survivors) in discussions resulting in 314 pages of
transcribed data analyzed by multiple coders. Results All participants expressed needing to increase physical activity, identifying
lack of motivation centering on survivorship experiences and symptom
management as the most salient barrier. They indicated familiarity with
activity trackers (i.e., Fitbit) and expressed interest in biosensors (i.e.,
continuous glucose monitors [CGMs]) as CGMs show biological metrics in
real-time. Participants reported (1) personalized feedback messages can
improve motivation and accountability; (2) CGM acceptability is high given
survivors’ medical history; and (3) glucose data is a relevant health
indicator and they appreciated integrated messages (between Fitbit and CGM)
in demonstrating how behaviors immediately affect one's body. Conclusions This study supports the use of wearable biosensors and m-health interventions
to promote physical activity in cancer survivors. Glucose-based biofeedback
provides relevant and motivating information for cancer survivors regarding
their daily activity levels by demonstrating the immediate effects of
physical activity. Integrating biofeedback into physical activity
interventions could be an effective behavioral change strategy to promote a
healthy lifestyle in cancer survivors.
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Affiliation(s)
- Grace E. Brannon
- Department of Communication, University of Texas at
Arlington, Arlington, TX, USA
| | - Madison Ray
- Department of Communication, University of Texas at
Arlington, Arlington, TX, USA
| | - Patrick Cho
- Department of Behavioral Science, The University of Texas MD Anderson Cancer
Center, Houston, TX, USA
| | - Miranda Baum
- Department of Behavioral Science, The University of Texas MD Anderson Cancer
Center, Houston, TX, USA
| | - Muhammad Shaalan Beg
- Division of Hematology/Medical Oncology,
University of
Texas Southwestern Medical Center, Dallas,
TX, USA
| | - Therese Bevers
- Department of Clinical Cancer Prevention,
The University
of Texas MD Anderson Cancer Center,
Houston, TX, USA
| | - Susan M. Schembre
- Department of Family and Community Medicine, College of Medicine,
University of Arizona, Tucson, Arizona, USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer
Center, Houston, TX, USA
| | - Yue Liao
- Department of Behavioral Science, The University of Texas MD Anderson Cancer
Center, Houston, TX, USA,Department of Kinesiology, University of Texas at
Arlington, Arlington, TX, USA,Yue Liao, Department of Kinesiology,
University of Texas at Arlington, 500 West Nedderman Drive, MAC 147, Arlington,
TX 76019, USA. E-mail:
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Rick P, Sánchez-Martín M, Singh A, Navas-León S, Borda-Mas M, Bianchi-Berthouze N, Tajadura-Jiménez A. Investigating psychological variables for technologies promoting physical activity. Digit Health 2022; 8:20552076221116559. [PMID: 35923757 PMCID: PMC9340353 DOI: 10.1177/20552076221116559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 07/08/2022] [Indexed: 11/06/2022] Open
Abstract
Background Many technological interventions designed to promote physical activity (PA) have limited efficacy and appear to lack important factors that could increase engagement. This may be due to a discrepancy between research conducted in this space, and software designers' and developers' use of this research to inform new digital applications. Objectives This study aimed to identify (1) what are the variables that act as barriers and facilitators to PA and (2) which PA variables are currently considered in the design of technologies promoting PA including psychological, physical, and personal/contextual ones which are critical in promoting PA. We emphasize psychological variables in this work because of their sparse and often simplistic integration in digital applications for PA. Methods We conducted two systematized reviews on PA variables, using PsycInfo and Association for Computing Machinery Digital Libraries for objectives 1 and 2. Results We identified 38 PA variables (mostly psychological ones) including barriers/facilitators in the literature. 17 of those variables were considered when developing digital applications for PA. Only few studies evaluate PA levels in relation to these variables. The same barriers are reported for all weight groups, though some barriers are stronger in people with obesity. Conclusions We identify PA variables and illustrate the lack of consideration of these in the design of PA technologies. Digital applications to promote PA may have limited efficacy if they do not address variables acting as facilitators or barriers to participation in PA, and that are important to people representing a range of body weight characteristics.
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Affiliation(s)
- Patricia Rick
- Department of Psychology, Universidad Loyola
Andalucía, Spain
| | | | - Aneesha Singh
- UCL Interaction Centre, University College London, UK
| | | | - Mercedes Borda-Mas
- Department of Personality, Assessment, and Psychological Treatment, Universidad de Sevilla, Spain
| | | | - Ana Tajadura-Jiménez
- UCL Interaction Centre, University College London, UK,DEI Interactive Systems group, Department of Computer Science and
Engineering, Universidad Carlos III de
Madrid, Spain,Ana Tajadura-Jiménez, Universidad Carlos
III de Madrid, Av. de la Universidad, 30, 28911 Leganés, Madrid, Spain.
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Recreational Physical Activity in Urban India: Perceptions and a Pilot Intervention. BEHAVIOUR CHANGE 2022. [DOI: 10.1017/bec.2022.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
The inactive lifestyle of urban Indians has increased their risk of non-communicable diseases (NCDs). A qualitative study was designed to explore barriers and facilitators related to exercise participation among urban Indians. Underpinned by the developmental life course theory, nine focus group discussions (FGDs) were conducted with 29 women and 26 men residing in Mumbai, India. Focus groups were gender and age stratified. Both thematic analysis and content analysis techniques were used to analyse the data. While the lack of time was mentioned as a barrier by all groups, an unstructured schedule was mentioned specifically by women and awareness of physical health benefits emerged as the most popular facilitator for recreational physical activity. Based on the results of the FGDs, a pilot exercise intervention for sedentary women (N = 6) was conducted which consisted of a morning walk six days a week for 10 weeks. Post-intervention, an FGD was conducted to explore participants’ perspectives on their experience in the intervention. The participants reported that the intervention enhanced exercise self-efficacy and well-being. Exercise as relaxation, spousal support, and need for peers to exercise with emerged as primary themes during the follow-up FGD. These findings can inform the development of age and gender-specific as well as culturally appropriate interventions to facilitate active living.
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10
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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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Noguchi M, Kinuta M, Sairenchi T, Yamakawa M, Koide K, Katsura S, Matsuo K, Omote S, Imano H, Nishizawa H, Shimomura I, Iso H. Relationship between Health Counselor Characteristics and Counseling Impact on Individuals at High-Risk for Lifestyle-Related Disease: Sub-Analysis of the J-HARP Cluster-Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116375. [PMID: 35681960 PMCID: PMC9179978 DOI: 10.3390/ijerph19116375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/14/2022] [Accepted: 05/18/2022] [Indexed: 12/16/2022]
Abstract
Early diagnosis and treatment are necessary to prevent lifestyle-related diseases among high-risk individuals. This study aimed to examine the impact of counselor characteristics on clinic visits among individuals at high risk for lifestyle-related diseases. A total of 8975 patients aged 40 to 74 years with lifestyle-related comorbidities, who underwent an annual health checkup and received health counseling, were included in this study. Data intervention timing, mode of counseling, number of counseling sessions, and explanation methods were collected. We assessed the impact of counselor characteristics, including profession (public health nurse, clinical nurse, and nutritionist), age, and years of counseling experience, on counseling outcomes. The probability ratios (95% confidence intervals) of clinic visits were 1.22 (1.11-1.35) for public health nurses and 1.04 (0.90-1.20) for nurses compared with nutritionists. After adjustment for participant and counselor characteristics and initial timing, mode, and number of counseling sessions, the corresponding probability ratios (95% confidence intervals) were 1.16 (1.05-1.29) and 1.12 (0.95-1.31), respectively. Counselor age and years of experience did not influence clinic visits of the target population. Public health nurses were more effective in increasing clinic visits among the target population owing to their profession-specific knowledge, skills, and experience.
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Affiliation(s)
- Midori Noguchi
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita-shi 565-0871, Japan; (M.K.); (H.I.); (H.I.)
- Correspondence: ; Tel.: +81-(0)6-6879-3911
| | - Minako Kinuta
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita-shi 565-0871, Japan; (M.K.); (H.I.); (H.I.)
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama-shi 700-8558, Japan
| | - Toshimi Sairenchi
- Center for Research Collaboration and Support, Comprehensive Research Facilities for Advanced Medical Science, Dokkyo Medical University, Mibu-machi 321-0293, Japan;
| | - Miyae Yamakawa
- Geriatric Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita-shi 565-0871, Japan;
| | - Keiko Koide
- Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita-shi 565-0871, Japan;
| | - Shoko Katsura
- Graduate School of Nursing, Miyagi University, Taiwa-cho 981-3298, Japan;
| | - Kazue Matsuo
- Department of Public Health Nursing, Fukuoka Jo Gakuin Nursing University, Fukuoka-shi 811-1313, Japan;
| | - Shizuko Omote
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa-shi 920-8640, Japan;
| | - Hironori Imano
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita-shi 565-0871, Japan; (M.K.); (H.I.); (H.I.)
| | - Hitoshi Nishizawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita-shi 565-0871, Japan; (H.N.); (I.S.)
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita-shi 565-0871, Japan; (H.N.); (I.S.)
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita-shi 565-0871, Japan; (M.K.); (H.I.); (H.I.)
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
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Huang Y, Ng OL, Ha ASC. A Qualitative Exploration of Facilitators and Barriers to Physical Activity Participation among Chinese Retired Adults in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063495. [PMID: 35329182 PMCID: PMC8955847 DOI: 10.3390/ijerph19063495] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to identify facilitators and barriers associated with physical activity participation among retired Chinese adults in Hong Kong. This study adopts an interview research design in order to generate an in-depth understanding and insights into the participants' thoughts, motivators and experiences of physical activity participation. Independent, semi-structured interviews with 10 retired participants (aged 54-74) were conducted based on an interview protocol with open-ended questions prompting the participants to describe their experiences. Transcribed texts were analysed using thematic analysis, combining both deductive and inductive analysis techniques. Common physical activities reported were walking, stretching exercise and jogging/running. Participants responded that their physical activity level increased since their retirement. We report the interview results according to the themes which emerged from the analysis: (1) physical and mental health, (2) socio-emotional factors, (3) environmental context, (4) family responsibilities. We found that the themes (1), (2) and (3) act either as a facilitator or a barrier for the participants interviewed, while theme (4) family responsibilities act as a barrier. The findings suggested that future physical activity interventions for retired Chinese adults should include more physical activity knowledge, such as the benefits to physical and mental health brought by physical activity and social elements, considering the specific challenges that participants are confronted with (from the family side).
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Affiliation(s)
- Ying Huang
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong 999077, China;
| | - Oi-Lam Ng
- Department of Curriculum and Instruction, Faculty of Education, The Chinese University of Hong Kong, Hong Kong 999077, China;
| | - Amy S. C. Ha
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong 999077, China;
- Correspondence:
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Collins KA, Huffman KM, Wolever RQ, Smith PJ, Siegler IC, Ross LM, Hauser ER, Jiang R, Jakicic JM, Costa PT, Kraus WE. Determinants of Dropout from and Variation in Adherence to an Exercise Intervention: The STRRIDE Randomized Trials. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022; 7:e000190. [PMID: 35669034 PMCID: PMC9165469 DOI: 10.1249/tjx.0000000000000190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Purpose This study aimed to characterize the timing and self-reported determinants of exercise dropout among sedentary adults with overweight or obesity. We also sought to explore variations in adherence among individuals who completed a 6- to 8-month structured exercise intervention. Methods A total of 947 adults with dyslipidemia [STRRIDE I, STRRIDE AT/RT] or prediabetes [STRRIDE-PD] were enrolled to either control or to one of 10 exercise interventions, ranging from doses of 8-23 kcal/kg/week; intensities of 50%-75% V̇O2 peak; and durations of 6-8 months. Two groups included resistance training and one included dietary intervention (7% weight loss goal). Dropout was defined as an individual who withdrew from the study due a variety of determinants. Timing of intervention dropout was defined as the last session attended and categorized into phases. Exercise training adherence was calculated by dividing weekly minutes or total sets of exercise completed by weekly minutes or total sets of exercise prescribed. General linear models were used to characterize the associations between timing of dropout and determinant category. Results Compared to exercise intervention completers (n=652), participants who dropped out (n=295) were on average non-white (98% vs. 80%, p<0.01), had higher body mass index (31.0 kg/m2 vs. 30.2 kg/m2; p<0.01), and were less fit at baseline (25.0 mg/kg/min vs. 26.7 ml/kg/min, p<0.01). Of those who dropped out, 67% did so prior to the start of or while ramping up to the prescribed exercise volume and intensity. The most commonly reported reason for dropout was lack of time (40%). Notably, among individuals who completed the ramp training period, subsequent exercise intervention adherence did not waiver over the ensuing 6-8 months of training. Conclusion These findings are some of the first to delineate associations between the timing of dropout and dropout determinants, providing guidance to future exercise interventions to better support individuals at-risk for dropout.
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Affiliation(s)
- Katherine A. Collins
- Duke University Medical Center, Duke Molecular Physiology Institute, Durham, NC, United States
| | - Kim M. Huffman
- Duke University Medical Center, Duke Molecular Physiology Institute, Durham, NC, United States
- Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, NC, United States
| | - Ruth Q. Wolever
- Department of Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Patrick J. Smith
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Ilene C. Siegler
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Leanna M. Ross
- Duke University Medical Center, Duke Molecular Physiology Institute, Durham, NC, United States
| | - Elizabeth R. Hauser
- Duke University Medical Center, Duke Molecular Physiology Institute, Durham, NC, United States
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, United States
- Cooperative Studies Program Epidemiology Center-Durham, Durham VA Health Care System, Durham, NC, United States
| | - Rong Jiang
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - John M. Jakicic
- Translational Research Institute, Advent Health, Orlando, FL, United States
| | - Paul T. Costa
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - William E. Kraus
- Duke University Medical Center, Duke Molecular Physiology Institute, Durham, NC, United States
- Division of Cardiology, Duke University School of Medicine, Durham, NC, United States
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James A, Lawrence B, O’Connor M. Healthy Eating as a New Way of Life: A Qualitative Study of Successful Long-Term Diet Change. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221090397. [PMID: 35418258 PMCID: PMC9016560 DOI: 10.1177/00469580221090397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Improving diet quality has been shown to be an effective way to improve
health and well-being. Yet information on how to assist those wanting to
transition to and maintain a healthier diet is still limited. The aim of
this study was to explore what motivated people to initiate and maintain a
healthy diet. Methods Semi-structured interviews were conducted with 20 participants (all
Australian residents) who had made significant improvements to their diets
and had maintained these changes for a minimum of two years
(nfemale = 15, nmale = 5, Mage = 37.7, SD = 12.4). The transcripts were analysed
using thematic analysis which identified five overarching themes: A desire
to feel better, investigation and learning, helpful habits, benefits, and
values. Results Participants reported a strong wish to feel better and investigated the role
of diet as a possible way to improve well-being. Through daily habits and
continuous engagement with the topic, healthy eating became a way of life
for many participants. Experiencing the benefits of a healthier diet and
having developed strong values regarding diet and health supported long-term
maintenance. Conclusions Findings from the present study contribute to the literature in highlighting
the importance of internal motivation and autonomy for health behaviours.
Findings may inform the development of healthy eating interventions.
Encouraging autonomy, fostering values aligned with a healthier diet, and
helping individuals establish daily habits is likely to support change.
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Affiliation(s)
- Anna James
- WA Cancer Prevention Research Unit, Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Blake Lawrence
- WA Cancer Prevention Research Unit, Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Moira O’Connor
- WA Cancer Prevention Research Unit, Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
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Lansburgh F, Jacques-Aviñó C, Pons-Vigués M, Morgan R, Berenguera A. Time for themselves: Perceptions of physical activity among first and second-generation Pakistani women living in the Raval, Barcelona. WOMEN'S HEALTH 2022; 18:17455057221078738. [PMID: 35168422 PMCID: PMC8855417 DOI: 10.1177/17455057221078738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: Pakistani women experience higher-than-average rates of certain chronic diseases, including diseases related to sedentary lifestyles. The aim of this study is to explore how first and second-generation Pakistani women living in the Raval, Barcelona, conceive of physical activity, and their barriers and facilitators around participating in physical activity, with the goal of increasing physical activity in this group. Methods: Qualitative research with an intersectional approach. Nine informal interviews with key community informants were conducted from November 2018 to January 2019 to gain background on the topic, using snowball sampling. Eleven individual interviews were conducted from February to June 2019. Seven were with Pakistani women having lived, or currently living, in the neighborhood of the Raval, Barcelona. Four additional interviews were conducted with non-Pakistani women key community informants who have worked extensively with this community. Thematic content analysis was carried out using ATLAS.ti. Results: First-generation Pakistani women generally did not have physical activity present in their daily lives, but by most accounts wished to. Areas that shed light on this included the following: limited economic opportunities and associated living conditions, barriers to social integration, health concepts and access to information, and cultural norms and related gender roles. For the first-generation, gender-related divisions of labor as well as the absence of the concept of self-care were particularly relevant barriers to their participation in physical activity. The experience of immigration-related grief emerged as a transversal theme which overlapped with multiple areas. While both generations expressed a need for the separation of genders during physical activity—as per their cultural interpretation of Islam—the lack of such spaces was highlighted as a principal barrier in physical activity among the second generation. Conclusion: These findings shed light on distinct elements that exert influence in Pakistani women immigrants’ participation in physical activity—among them: social and living conditions, access to public space, and gender-related work distribution and cultural norms—which are in turn influenced by first or second-generation immigration status. Considering the specific needs of both groups when proposing politics and health programs to encourage physical activity is paramount in order to successfully partner with these populations.
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Affiliation(s)
- Flora Lansburgh
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mariona Pons-Vigués
- Servei Català de la Salut (CatSalut), Barcelona, Spain
- Universitat de Girona, Girona, Spain
| | - Rosemary Morgan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anna Berenguera
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
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Brannon GE, Mitchell S, Ray MA, Bhai S, Beg MS, Basen-Engquist KM, Liao Y. A Qualitative Examination of COVID-19's Impacts on Physical Activity and Perceptions of Remote Delivery Interventions. Am J Health Promot 2021; 36:472-476. [PMID: 34786991 PMCID: PMC8851044 DOI: 10.1177/08901171211053845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose The COVID-19 pandemic is correlated with decreased physical activity (PA). Transitioning to remote work may impact people’s acceptability and preferences for remotely delivered behavioral interventions, including PA. The objective was to examine perceptions of COVID-19 impacts on PA engagement and motivation, and perspectives related to remotely delivered PA interventions. Design Cross-sectional small-group interview. Setting Harris County, Texas. Participants: Insufficiently active, overweight/obese adults (16 healthy adults [aged 25–52 years], and 7 cancer survivors [aged 50–74 years]). Method Group discussion was guided by semi-structured questions. Audio-transcribed data (278 pages) was analyzed using Braun and Clarke’s process centering identification, analysis, organization, description, and reports. Results Overall, participants expressed a decreased level of PA due to the pandemic. Difficulties (e.g., care-taking activities, working from home, and safety concerns) negatively affected motivation. Participants indicated high acceptability of remotely delivered PA interventions, with advantages of virtual technology features (e.g., did not have to maintain a gym membership) and even accountability in maintaining a PA routine (e.g., using virtual groups to engage in community support). Conclusion Participants described COVID-19 negatively affects access to PA opportunities yet also expressed willingness to engage in remotely delivered PA interventions instead of in-person programs because of their COVID-19 experiences. Remote interventions can greatly increase accessibility and offer opportunities to provide personalized motivation and accountability that people need to be more physically active.
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Affiliation(s)
- Grace Ellen Brannon
- Department of Communication, University of Texas at Arlington, Arlington, TX, USA
| | - Sophia Mitchell
- Department of Communication, University of Texas at Arlington, Arlington, TX, USA
| | - Madison A Ray
- Department of Communication, University of Texas at Arlington, Arlington, TX, USA
| | - Salman Bhai
- Department of Neurology, University of Texas Southwestern Medical Center, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Muhammad Shaalan Beg
- Division of Hematology and Medical Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Karen M Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yue Liao
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
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Khadan J, Spencer N, Strobl E, Bose-Duker T. Factors Associated With Being Overweight or Obese in Suriname. Int J Public Health 2021; 66:1604101. [PMID: 34744598 PMCID: PMC8565296 DOI: 10.3389/ijph.2021.1604101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/26/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To identify the socio-demographic risk factors that are associated with adult Body Mass Index. Methods: We apply probit and ordinal probit models to a sample of 3,803 adults aged 20 and above from the 2016/17 round of the Suriname Survey of Living Conditions. Results: Women, the elderly, and couples who are either married and/or living together are more likely to be obese or overweight. This is also true for individuals who have chronic illnesses. We also find that individuals who engage in a sport or in other forms of exercise, even if modest, have lower odds of being overweight or obese. Interestingly, our findings indicate that individuals who benefit from government social safety net programs are less likely to be associated with being overweight or obese. Conclusion: Obesity could become a serious public health issue if not addressed appropriately. Policymakers should promptly develop a national strategy to help health care systems cope with the outcomes of obesity and to tackle the risk factors that have the greatest impacts on individual Body Mass Index.
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Affiliation(s)
| | - Nekeisha Spencer
- Department of Economics, University of the West Indies, Kingston, Jamaica
| | - Eric Strobl
- Department of Economics, University of Bern, Bern, Switzerland
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18
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Okafor UB, Goon DT. Development and Validation of Prenatal Physical Activity Intervention Strategy for Women in Buffalo City Municipality, South Africa. Healthcare (Basel) 2021; 9:healthcare9111445. [PMID: 34828491 PMCID: PMC8622375 DOI: 10.3390/healthcare9111445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/12/2021] [Accepted: 10/23/2021] [Indexed: 11/24/2022] Open
Abstract
Women rarely participate in physical activity during pregnancy, despite scientific evidence emphasising its importance. This study sought to develop an intervention strategy to promote prenatal physical activity in Buffalo City Municipality, Eastern Cape Province, South Africa. A multi-stage approach was utilised. The Strength, Weakness, Opportunity and Threat (SWOT) approach was applied to the interfaced empirical findings on prenatal physical activity in the setting. Subsequently, the Build, Overcome, Explore and Minimise model was then used to develop strategies based on the SWOT findings. A checklist was administered to key stakeholders to validate the developed strategies. Key strategies to promote prenatal physical activity include the application of the Mom-Connect (a technological device already in use in South Africa to promote maternal health-related information for pregnant women) in collaboration with cellphone and network companies; the South African government to integrate prenatal physical activity and exercise training in the medical and health curricula to empower the healthcare providers with relevant knowledge and skills to support pregnant women in prenatal physical activity counselling; provision of increased workforce and the infrastructure necessary in antenatal sessions and antenatal physical exercise classes and counselling; the government, in partnership with various stakeholders, to provide periodical prenatal physical activity campaigns based in local, community town halls and clinics to address the lack of awareness, misrepresentations and concerns regarding the safety and benefits of physical activity during pregnancy. The effective implementation of this developed prenatal physical activity by policymakers and health professionals may help in the promotion of physical activity practices in the context of women in the setting.
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Affiliation(s)
- Uchenna Benedine Okafor
- Department of Nursing Science, University of Fort Hare, East London 5201, South Africa
- Correspondence:
| | - Daniel Ter Goon
- Department of Public Health, University of Fort Hare, East London 5201, South Africa;
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Pirotta S, Joham AE, Moran LJ, Skouteris H, Lim SS. Informing a PCOS Lifestyle Program: Mapping Behavior Change Techniques to Barriers and Enablers to Behavior Change Using the Theoretical Domains Framework. Semin Reprod Med 2021; 39:143-152. [PMID: 34433214 DOI: 10.1055/s-0041-1735456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This article aimed to identify the behavior change techniques (BCTs) based on facilitators and barriers to lifestyle management in women with polycystic ovary syndrome (PCOS) according to the behavior change wheel (BCW). This qualitative study design using inductive thematic analysis following semistructured interviews (n = 20) identified barriers and enablers to lifestyle management. These were then mapped to Capability, Opportunity, Motivation-Behavioral Model (COM-B) constructs and the corresponding Theoretical Domains Framework (TDF) domains. This study included women with PCOS residing in Australia. Main outcome measures include intervention functions, policy categories, and BCTs described in the BCW. Twenty-three BCTs were recognized to influence behavior change in women with PCOS. Factors were categorized into the subcomponents of the COM-B: psychological capability (e.g., lack of credible information), physical capability (e.g., managing multiple health conditions), physical opportunity (e.g., limited access to resources), social opportunity (e.g., adequate social support), reflective motivation (e.g., positive health expectancies following behavior change), and automatic motivation (e.g., emotional eating). Future research should use this work to guide PCOS lifestyle intervention development and then test intervention effectiveness through an experimental phase to provide empirical evidence for wider use and implementation of tailored, theory-informed PCOS lifestyle programs as part of evidence-based PCOS management.
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Affiliation(s)
- Stephanie Pirotta
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - A E Joham
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Diabetes, Monash Health, Clayton, Victoria, Australia
| | - L J Moran
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - H Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Warwick Business School, Warwick University, Coventry, United Kingdom
| | - S S Lim
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042023. [PMID: 33669679 PMCID: PMC7922504 DOI: 10.3390/ijerph18042023] [Citation(s) in RCA: 158] [Impact Index Per Article: 52.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 12/18/2022]
Abstract
Physical inactivity is a major concern and poor adherence to exercise programs is often reported. The aim of this paper was to systematically review published reviews on the study of adherence to physical exercise in chronic patients and older adults and to identify those adherence-related key factors more frequently suggested by reviews for that population. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Results were classified considering the target population and participants’ characteristics to identify the most repeated factors obtained for each condition. Fifty-five articles were finally included. Fourteen key factors were identified as relevant to increase adherence to physical exercise by at least ten reviews: (a) characteristics of the exercise program, (b) involvement of professionals from different disciplines, (c) supervision, (d) technology, (e) initial exploration of participant’s characteristics, barriers, and facilitators, (f) participants education, adequate expectations and knowledge about risks and benefits, (g) enjoyment and absence of unpleasant experiences, (h) integration in daily living, (i) social support and relatedness, (j) communication and feedback, (k) available progress information and monitoring, (l) self-efficacy and competence, (m) participant’s active role and (n) goal setting. Therefore, adherence to physical exercise is affected by several variables that can be controlled and modified by researchers and professionals.
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21
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Hasan M, Singh H, Haffizulla F. Culturally Sensitive Health Education in the Caribbean Diaspora: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041476. [PMID: 33557252 PMCID: PMC7913987 DOI: 10.3390/ijerph18041476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 11/17/2022]
Abstract
Context: The Caribbean diaspora in the United States is a diverse community that is afflicted with high morbidity and mortality due to preventable chronic diseases. Objective: Our goal is to determine which culturally sensitive health and nutrition educational modalities have the highest efficacy for improving general health in the Caribbean diaspora. Methods: A scoping literature review was performed on the MEDLINE, CINAHL, and Web of Science databases using terms related to health and nutrition in the Caribbean population. Original, peer-reviewed research published from 2010 to 2020, which took place in the U.S. and Caribbean countries, were included in our review. Results: We identified a total of nine articles that met our inclusion criteria. Rate differences for individual education program features were calculated to assess the likelihood of a positive impact on diet, physical activity, and diabetes. Conclusion: Our review helps to identify key educational modalities targeting diabetes, diet, and physical activity levels that can be used to meet the health and nutritional needs of the Caribbean diaspora population.
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Affiliation(s)
- Mashtura Hasan
- Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA;
- Correspondence: (M.H.); (F.H.)
| | - Harmandip Singh
- Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA;
| | - Farzanna Haffizulla
- Department of Internal Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Correspondence: (M.H.); (F.H.)
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22
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Chen MH, Yu CL, Chang SH. Constant Daily Exercise to Keep the Doctor Away: A Study of Adherence to Physical Exercise Using a Gym in Individuals Older Than 55 Years. Int J Qual Stud Health Well-being 2020; 16:1859174. [PMID: 33345759 PMCID: PMC7751382 DOI: 10.1080/17482631.2020.1859174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The purpose of this study was to examine the role of using a gym as a mechanism for adherence to regular physical exercise among individuals with aged 55 and over. This was a grounded theory research design. Data were collected from face-to-face interviews and observations among 15 people who attended the gym regularly and then analysed via content analysis. Three categories emerged from the present study regarding the adherence to regular physical exercise: (1) meaningful starting points, (2) reinforcement by motivators, and (3) adherence through positive changes. Results of this study can help health policymakers, managers of gyms/fitness centres, and gym instructors to design and implement programs.
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Affiliation(s)
- Ming-Hsin Chen
- Department of Senior Citizen Services, National Tainan Junior College of Nursing , Tainan, Taiwan ROC
| | - Ching-Len Yu
- Department of Environmental Engineering, Kun Shan University , Tainan, Taiwan ROC
| | - Su-Hsien Chang
- Department of Senior Citizen Services, National Tainan Junior College of Nursing , Tainan, Taiwan ROC
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Mishra A, Chawathey SA, Mehra P, Nagarathna R, Anand A, Rajesh SK, Singh A, Patil S, Sai Sivapuram M, Nagendra HR. Perceptions of benefits and barriers to Yoga practice across rural and urban India: Implications for workplace Yoga. Work 2020; 65:721-732. [PMID: 32310204 DOI: 10.3233/wor-203126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Even though Yoga is useful for prevention of obesity, diabetes and hypertension it is not universally practiced. The purpose of the study was to determine the benefits and barriers confronted by the community members while incorporating Yoga into routine practice and at workplace. OBJECTIVE This study explored the motivators and barriers to Yoga practice by estimating how these elements can be useful for development and incorporation of Yoga as a workplace activity and as a profession. METHODS A nationwide multi-centered prospective study was conducted recruiting individuals of different age groups and geographical zones in India. Participants of Yoga intervention group were administered a questionnaire with 19 items on benefits (YBS) and 18 items on barriers for Yoga practice (BFYS). Data was analyzed using SPSS v21 software. RESULTS Majority of the participants perceived Yoga improves "physical fitness", "relaxes mind and body", improves "stamina", across age groups. "Lifestyle", "Family commitments", "Physical over-exertion", "No Encouragement from family", "Occupational commitments" and "Few places to do Yoga" were perceived barriers across various geographical zones. Despite knowing the benefits of Yoga, these barriers prevented individuals from integrating it into their daily routine. CONCLUSIONS The present study may be considered as a starting point for development of Yoga as a workplace activity and a profession based on the perceptions of its various benefits and barriers faced by a large study population spanning an entire nation.
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Affiliation(s)
| | | | - Priya Mehra
- Neurosciences Research Lab, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Akshay Anand
- Neurosciences Research Lab, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | - Madhava Sai Sivapuram
- Department of General Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna-Avutapalli, India
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Okafor UB, Goon DT. Applying the Ecological Model to understand pregnant women's perspectives on the modifiable constraints to physical activity during pregnancy: A qualitative research study. Medicine (Baltimore) 2020; 99:e23431. [PMID: 33285736 PMCID: PMC7717830 DOI: 10.1097/md.0000000000023431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/19/2020] [Accepted: 10/26/2020] [Indexed: 11/26/2022] Open
Abstract
The benefits of physical activity (PA) during pregnancy are widely reported; however, PA practice is seemingly not a valued habit among pregnant women attending public antenatal health centres in the Eastern Cape of South Africa. Guided by the ecological model, we sought to explore modifiable barriers to PA among pregnant women.Semi-structured interviews involved a purposive sample of 15 pregnant women. Interview questions were guided by the ecological model constructs at intrapersonal, interpersonal, and environmental level. Thematic analysis was applied to summarise the modifiable barriers to PA during pregnancy.Three main themes emerged, based on the modifiable barriers to PA during pregnancy that belong to the varying Ecological Model constructs. On the intrapersonal level, 5 themes emerged, namely, time-constraint beliefs, feeling of tiredness, low energy, lack of motivation, and a lack of knowledge on benefits and types of PA. Two themes emerged for the interpersonal level, lack of PA advice and lack of information on PA recommendations and guidelines. Another theme defined the environmental level lacking resources. Most themes related to individual factors, which prevent PA-promoting behaviour.Overall, intrapersonal factors relating to tiredness and exhaustion, lack of time beliefs, work and household commitments, and lack of motivation were key modifiable barriers to PA by the women. The findings provide insights into possible interventional strategies to optimise PA during pregnancy among women in this setting. Appropriate knowledge, education and advice on the benefits, types, and intensity of PA in pregnancy are needed.
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Affiliation(s)
| | - Daniel Ter Goon
- Department of Public Health, University of Fort Hare, East London, South Africa
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Determinants of dietary and physical activity behaviours among women of reproductive age in urban Uganda, a qualitative study. Public Health Nutr 2020; 24:3624-3636. [PMID: 33000718 DOI: 10.1017/s1368980020003432] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To explore determinants of dietary and physical activity behaviours among women of reproductive age. DESIGN Data were collected through focus group discussions (FGD). The FGD guide was based on a modified theoretical framework; theory of planned behaviour was incorporated with constructs of health belief model, precaution adoption process model, social cognitive and social support theory. Discussions were audio recorded, transcribed verbatim and analysed thematically. SETTING Kampala, Uganda. PARTICIPANTS Women were categorised into young adults; 18-34 years and adults; 35-45 years. RESULTS Separate FGD with independent participants were conducted for dietary and physical activity behaviours until data saturation was achieved. Six FGD were conducted per behaviour. Determinants of dietary behaviours at intra-individual level included gaps in food skills, knowledge and self-efficacy, food safety concerns, convenience, finances and physiological satisfaction. The social-cultural norms were relationship between vegetable consumption and low social status, consideration of fruits as a snack for children and not food and habitual orientation towards carbohydrate foods. At environment level, social networks and increased availability of energy-dense, nutrient poor, street and processed foods influence dietary behaviour. For physical activity, intra-individual determinants were knowledge gaps and self-efficacy, while socio-cultural norms included gender stereotypes. Home (limited space and sedentary entertainment like social media and TV) and physical environment (cheap motorised transportation) influence physical activity. CONCLUSION The existing cultural beliefs promote dietary and physical activity behaviours which are divergent from healthy recommendations. Therefore, a comprehensive intervention is needed to address socio-cultural misconceptions, financial and time limitations in urban Uganda.
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Okafor UB, Goon DT. Developing a Physical Activity Intervention Strategy for Pregnant Women in Buffalo City Municipality, South Africa: A Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6694. [PMID: 32937983 PMCID: PMC7557735 DOI: 10.3390/ijerph17186694] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/02/2020] [Accepted: 09/05/2020] [Indexed: 02/06/2023]
Abstract
Despite global awareness about the importance and health benefits of physical activity (PA) during pregnancy, several studies have reported a low prevalence of PA participation among pregnant women in both developed and developing countries. This means that most pregnant women do not meet the current PA recommended guideline of 150 min of moderate intensity PA per week. The global call to prioritise PA participation levels in the general population necessitates evaluating the factors affecting PA practice. Seemingly, pregnant women mostly from low-to-middle income countries like South Africa are often predisposed to adverse pregnancy outcomes, possibly because of limited access to, and knowledge of, improved pregnancy and health outcomes as a result of PA participation. Physical activity has been sparsely studied among pregnant South African women, and specifically, there is no known study that assesses the PA levels, patterns, beliefs, sources of information, perceived benefits, barriers, attitudes of pregnant women concerning PA and exercise participation; nor one that explores the perspectives of healthcare providers regarding prenatal PA in the Eastern Cape Province. In addition, no PA intervention strategy exists to promote PA participation in the region. This study, in attempting to fill these gaps in knowledge, adopts two phases. In Phase I, a concurrent mixed-method (quantitative and qualitative) approach assesses the following factors related to PA participation in pregnant women: participation levels, beliefs, attitudes, perceived benefits, barriers to uptake and sources of information. It further ascertains if healthcare professionals are sufficiently informed about PA and if they are advising pregnant women about the need for PA participation during pregnancy. Data will be collected through a structured questionnaire, interviews and focus group discussions. Information on socio-demographic and maternal characteristics will be obtained, and the Pregnancy Physical Activity Questionnaire (PPAQ) will assess PA during pregnancy. A sample size of 384 pregnant women is the required minimum sample for an infinite population at a confidence level of 95%, a precision level of ± 5% and at a prevalence of PA or exercise during pregnancy of 50% (p < 0.05); however, a sample size larger than the minimum number necessary will be recruited to account for possible attrition and to protect against possible data loss. Data will be analysed using a multiple logistic regression to determine the factors that predict sedentary or moderate PA levels and chi-squared analysis to determine the associations between the PA levels of the participants and socio-demographic and clinical variables. The study will assess the data collected on the above-mentioned variables and draw conclusions based on patterns and themes that emerge during analysis. Phase II of the study focuses on strategy development and validation to facilitate the promotion of PA during pregnancy. The developed strategy will be validated through the application of the Delphi technique and the administration of a checklist to selected key stakeholders through organised workshops. Understanding the level and correlates of PA participation among this special population is fundamental to designing intervention strategies to enhance their understanding of, and participation in, PA and exercise. Furthermore, this study's findings will inform facility-based healthcare providers about the need to integrate health education on PA and pregnancy into antenatal and postnatal care visits in the setting.
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Affiliation(s)
- Uchenna Benedine Okafor
- Department of Nursing Sciences, University of Fort Hare, 50 Church Street, East London 5201, South Africa
| | - Daniel Ter Goon
- Department of Public Health, University of Fort Hare, 5 Oxford Street, East London 5201, South Africa;
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Kim Y, Kang S. Effects of a weight control intervention based on the transtheoretical model on physical activity and psychological variables in middle-aged obese women. J Women Aging 2020; 33:556-568. [PMID: 32174245 DOI: 10.1080/08952841.2020.1728183] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The study examined the effect of a weight control intervention on BMI, physical activity levels, and psychological variables toward physical activity. Thirty-three middle-aged obese women participated in the 16-week weight control intervention. Results indicated that the participants' BMI significantly decreased and physical activity levels significantly increased over the intervention. Moreover, exercise self-efficacy and perceived benefits toward physical activity significantly increased, but perceived barriers of physical activity gradually decreased over the intervention. The study suggests that it is important to consider not only physical activity itself, but also the various psychological variables when planning and implementing the weight control program.
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Affiliation(s)
- Youngho Kim
- Department of Sport Science, Seoul National University of Science and Technology, Nowon-gu, Korea
| | - Soojin Kang
- Department of Sport Science, Seoul National University of Science and Technology, Nowon-gu, Korea
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Lim S, Smith CA, Costello MF, MacMillan F, Moran L, Ee C. Barriers and facilitators to weight management in overweight and obese women living in Australia with PCOS: a qualitative study. BMC Endocr Disord 2019; 19:106. [PMID: 31647000 PMCID: PMC6813064 DOI: 10.1186/s12902-019-0434-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/23/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Lifestyle modification targeting weight management is the first-line treatment for women with Polycystic Ovary Syndrome (PCOS) regardless of presenting symptoms. Women with PCOS are more likely to gain more weight compared with women without PCOS, which may be related to barriers in engaging in lifestyle modification. The aim of this study is to explore the experience of women with PCOS in weight management and to determine the facilitators and barriers to lifestyle modifications in women with PCOS. METHODS Ten women with PCOS participated in focus groups and semi-structured telephone interviews on lifestyle and weight management in PCOS. Discussions were audio-recorded and transcribed verbatim. Thematic analysis of the transcripts was conducted. Thematic analysis of the transcripts were conducted using the method of constant comparison. RESULTS Women in the current study attempted a wide range of weight loss interventions, but had difficulties losing weight and preventing weight regain. Women felt that having PCOS affected their ability to lose weight and to keep it off. Facilitators to lifestyle modification for weight management were reported as structured approaches such as having balanced meals and support by health professionals, peers, friends or family. Barriers to lifestyle changes in women with PCOS included logistical barriers such as time and cost, motivational barriers including tiredness or feeling unrewarded, environmental barriers such as not having access to safe places to exercise, emotional barriers such as having depressive and defeating thoughts, and relational barriers such as having unsupportive partner or prioritising children's meal preferences. CONCLUSIONS Women with PCOS face a number of personal, environmental and social facilitators and barriers to lifestyle modification for weight loss. While many of these are also experienced by women without PCOS, women with PCOS face additional barriers in having low sense of self-confidence and high prevalence of negative thoughts which may impair their ability to maintain efforts in lifestyle modification over the long term. Future research should further explore the impact of the emotional and mental burden of PCOS on the management of weight and other aspects of PCOS. Future lifestyle intervention should also address the psychosocial aspect of PCOS.
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Affiliation(s)
- Siew Lim
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Vic Australia
| | - Caroline A. Smith
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Michael F. Costello
- School of Women’s and Children’s Health UNSW, Royal Hospital for Women, Barker St, Randwick, NSW 2013 Australia
| | - Freya MacMillan
- School of Science and Health and the Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Lisa Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Vic Australia
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
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On the limitations of barriers: Social visibility and weight management in Cuba and Samoa. Soc Sci Med 2019; 239:112501. [DOI: 10.1016/j.socscimed.2019.112501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 08/18/2019] [Accepted: 08/19/2019] [Indexed: 12/11/2022]
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Serrano Fuentes N, Rogers A, Portillo MC. Social network influences and the adoption of obesity-related behaviours in adults: a critical interpretative synthesis review. BMC Public Health 2019; 19:1178. [PMID: 31455318 PMCID: PMC6712627 DOI: 10.1186/s12889-019-7467-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 08/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obesity is a key risk factor for developing a long-term condition and a leading cause of mortality globally. The limited evidence associated with interventions that currently target obesity-related behaviours demand new approaches to tackle this problem. Given the evidence that social ties are implicated in the gaining and reduction of weight, the use of social networks in interventions is potentially a novel and useful means of tackling this health issue. There is a specific gap in the literature regarding what and how social network properties and processes together with environmental and individual factors influence the adoption of positive and negative obesity-related behaviours in adults. METHODS To address this gap in developing an integrated and holistic conceptual approach, a critical interpretative synthesis was undertaken following a line of argument synthesis as an analytical strategy. RESULTS Twenty-four studies were included. The data-driven themes meso-micro network processes, contextual and individual factors, and types of ties and properties were identified individually as components and causes of different health scenarios. Nevertheless, these drivers do not act on their own. As a consequence, developing multi-agent coalitions considering cross-level influences between the data-driven themes are two mechanisms that are created to understand more in-depth how social networks and the environment influence the adoption of obesity-related behaviours. These two new constructs point to a dynamic multilevel set of influences between multiple constructs, developing scenarios where positive and negative health results are identified. CONCLUSIONS This critical interpretative synthesis offers a new means of exploring the application of social network properties and mechanisms in the 'obesity' field. The synthesizing argument created during the analysis process might be considered by health policy-makers, who might need to contemplate the wider open system of socially connected individuals and harness these forces to design new interventions where social networks and other contextual and individual factors operate together in a complex multilevel environment influencing obesity-related behaviours and practices.
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Affiliation(s)
- Nestor Serrano Fuentes
- NIHR CLAHRC Wessex. School of Health Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK.
| | - Anne Rogers
- NIHR CLAHRC Wessex. School of Health Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK
| | - Mari Carmen Portillo
- NIHR CLAHRC Wessex. School of Health Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK
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Blackshaw LCD, Chhour I, Stepto NK, Lim SS. Barriers and Facilitators to the Implementation of Evidence-Based Lifestyle Management in Polycystic Ovary Syndrome: A Narrative Review. Med Sci (Basel) 2019; 7:medsci7070076. [PMID: 31252682 PMCID: PMC6681274 DOI: 10.3390/medsci7070076] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 01/22/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a complex condition that involves metabolic, psychological and reproductive complications. Insulin resistance underlies much of the pathophysiology and symptomatology of the condition and contributes to long term complications including cardiovascular disease and diabetes. Women with PCOS are at increased risk of obesity which further compounds metabolic, reproductive and psychological risks. Lifestyle interventions including diet, exercise and behavioural management have been shown to improve PCOS presentations across the reproductive, metabolic and psychological spectrum and are recommended as first line treatment for any presentation of PCOS in women with excess weight by the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome 2018. However, there is a paucity of research on the implementation lifestyle management in women with PCOS by healthcare providers. Limited existing evidence indicates lifestyle management is not consistently provided and not meeting the needs of the patients. In this review, barriers and facilitators to the implementation of evidence-based lifestyle management in reference to PCOS are discussed in the context of a federally-funded health system. This review highlights the need for targeted research on the knowledge and practice of PCOS healthcare providers to best inform implementation strategies for the translation of the PCOS guidelines on lifestyle management in PCOS.
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Affiliation(s)
- Lucinda C D Blackshaw
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 3168, Australia.
| | - Irene Chhour
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 3168, Australia.
| | - Nigel K Stepto
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 3168, Australia.
- Institute for Health and Sport, Victoria University, Melbourne, Victoria 8001, Australia.
- Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, St. Albans, Victoria 3021, Australia.
- Medicine- Western Health, Faculty of Medicine, Dentistry and Health Science, Melbourne University, Melbourne, Victoria 3000, Australia.
| | - Siew S Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 3168, Australia.
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Thai CL, Taber JM, Oh A, Segar M, Blake K, Patrick H. "Keep it Realistic": Reactions to and Recommendations for Physical Activity Promotion Messages From Focus Groups of Women. Am J Health Promot 2019; 33:903-911. [PMID: 30704265 DOI: 10.1177/0890117119826870] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Less than half of US adults meet the recommended guidelines of 150 minutes of exercise each week. Health promotion messages are frequently used to promote physical activity (PA); however, this messaging may be ineffective if it does not resonate with the target audience. The purpose of this exploratory study is to understand how women respond to examples of PA promotion messages. APPROACH/DESIGN A qualitative study. SETTING Washington DC Metro Area. PARTICIPANTS Forty women, stratified by race/ethnicity (white, black, Latina) and level of self-reported PA (active, inactive). METHOD Eight focus groups were conducted in which participants were shown 3 PA promotion messages representative of typical messaging strategies. Three researchers conducted a thematic analysis to code the data for emergent themes. RESULTS Current PA promotion messaging strategies do not resonate with women. Women want to see individuals with "realistic" bodies who look similar to them (eg, body shape, age, race/ethnicity), and for PA messaging to include daily activities as a way to be active. CONCLUSIONS Public health practitioners who promote PA to women should consider developing messages that better resonate with women's dynamic roles and lifestyles. Successful strategies may include depicting busy lifestyles that PA may be physically and logistically difficult to fit into and using models with diverse body shapes.
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Affiliation(s)
- Chan L Thai
- 1 Department of Communication, Santa Clara University, Santa Clara, CA, USA
| | - Jennifer M Taber
- 2 Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - April Oh
- 3 Health Communication and Informatics Research Branch, National Cancer Institute, USA
| | - Michelle Segar
- 4 Sport, Health, and Activity Research and Policy (SHARP) Center, University of Michigan, Ann Arbor, MI, USA
| | - Kelly Blake
- 3 Health Communication and Informatics Research Branch, National Cancer Institute, USA
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Guariguata L, Brown C, Sobers N, Hambleton I, Samuels TA, Unwin N. An updated systematic review and meta-analysis on the social determinants of diabetes and related risk factors in the Caribbean. Rev Panam Salud Publica 2018; 42:e171. [PMID: 31093199 PMCID: PMC6385809 DOI: 10.26633/rpsp.2018.171] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/15/2018] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To conduct an analysis of the most recent data on diabetes and its risk factors by gender and other social determinants of health to understand why its prevalence is higher among women than men in the Caribbean; to inform policy agenda-setting for diabetes prevention and control in the Caribbean; and to identify gaps in the evidence that require further research. METHODS A previous systematic review of the literature describing studies conducted in the Caribbean that presented the distribution of diabetes, its outcomes, and risk factors, by one or more social determinants, was updated to include sources from 1 January 2007 - 31 December 2016. Surveys by the World Health Organization (WHO) were also included. Where data were sufficient, meta-analyses were undertaken. RESULTS A total of 8 326 manuscripts were identified. Of those, 282 were selected for full text review, and 114, for abstraction. In all, 36 papers, including WHO-related surveys, had sufficient information for meta-analysis. More women compared to men were obese (OR: 2.1; 95%CI = 1.65 - 2.69), physically inactive (OR: 2.18; 95%CI = 1.75 - 2.72), and had diabetes (OR: 1.48; 95%CI = 1.25 - 1.76). More men smoked (OR: 4.27; 95%CI = 3.18 - 5.74) and had inadequate fruit and vegetable intake (OR: 1.37; 95%CI = 1.21 - 1.57). CONCLUSION Thirty-six papers were added to the previously conducted systematic review; of those, 13 were added to the meta-analysis. Diabetes and its risk factors (primarily obesity and physical inactivity) continue to disproportionately affect women in the Caribbean. Smoking interventions should be targeted at men in this geographic area.
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Affiliation(s)
- Leonor Guariguata
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados.
| | - Catherine Brown
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados.
| | - Natasha Sobers
- Faculty of Medical Sciences, The University of the West Indies, Bridgetown, Barbados.
| | - Ian Hambleton
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados.
| | - T. Alafia Samuels
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados.
| | - Nigel Unwin
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
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Incubation of feeding behavior is regulated by neuromedin U receptor 2 in the paraventricular nucleus of the hypothalamus. Behav Brain Res 2018; 359:763-770. [PMID: 30227148 DOI: 10.1016/j.bbr.2018.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/14/2018] [Accepted: 08/15/2018] [Indexed: 01/09/2023]
Abstract
A diet of energy-dense food, characterized mainly as a high-fat diet, leads to a persistent excessive consumption defined as overeating. According to the National Institute of Health, more than 2 in 3 adults in the United States are overweight or obese, straining our healthcare system with epidemic proportions. Diets that include abstaining from high-fat foods, ironically, result in an increase in motivation and craving for said high-fat foods, defined as an incubation effect because the behavior aids in developing overeating. Previously, we have shown that modulation of neuromedin U receptor 2 (NMUR2) in the paraventricular nucleus of the hypothalamus (PVN) results in increased food intake and motivation for energy-dense foods. Here, we continue our focus on NMUR2 in the PVN, but in relation to the incubation effect on craving for high-fat food. We employed a model for incubation of craving by having rats abstain from high-fat foods for 30 days before undergoing intake of fatty food on fixed ratio and progressive ratio schedules of reinforcement, and then assess their response to reactivity to cues. Using this model, we compared the feeding behaviors of rats that underwent an mRNA knockdown of the NMUR2 in the PVN to controls after both underwent a 30-day abstinence from high-fat foods. Our results show knockdown of NMUR2 in the PVN blocks the incubation of feeding behavior for food-related cues and high-fat foods.
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Sundar TKB, Løndal K, Lagerløv P, Glavin K, Helseth S. Overweight adolescents' views on physical activity - experiences of participants in an internet-based intervention: a qualitative study. BMC Public Health 2018; 18:448. [PMID: 29618327 PMCID: PMC5885359 DOI: 10.1186/s12889-018-5324-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 03/15/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Overweight and obese adolescents are reported to be less physically active than their peers. Research-based knowledge about their views may contribute to a better understanding of key factors that may foster or undermine motivation for physical activity, and provide knowledge for the future development of interventions. This paper explores experiences of physical activity among overweight adolescents, age 13-14 years, participants in Young & Active, a web-based controlled trial intervention to increase physical activity (ClinicalTrials.gov NCT01700309). The theoretical perspective is based on Self-Determination Theory. METHODS Two qualitative post-intervention research interviews, with a nine-month interval, were conducted with 21 adolescents, 15 girls and 6 boys to study short-term and long-term changes. The informants were recruited from a total of 84 participants from the Young & Active intervention group. Data were analyzed using qualitative content analysis. RESULTS The participants associated physical activity with organized sports and physical education classes at school, and as a means of promoting good health and attractive bodies. A majority of the adolescents said that they experienced their health as poorer than other youths, and expressed worries about their fitness and future health. Mastering a physical activity, being together with friends and having fun promoted motivation to perform sports. Not mastering an activity, or not knowing the others made them less motivated. None of the adolescents highlighted the importance of informal active living when asked about their understanding and experiences of physical activity. Consistency was found between the first and second interviews. CONCLUSION This study adds to limited research on overweight and obese adolescents' experiences of physical activity. The participants' views reflect opinions in society about physical activity, and its importance for health. Viewing physical activity as conducted within organized sports makes it necessary to look into how these are organized, structured and led, and what can be done to support self-esteem, autonomous motivation and participation. The ability to choose among available, affordable and desirable physical activities, together with friends, may promote participation and maintenance.
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Affiliation(s)
- Turid Kristin Bigum Sundar
- Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Knut Løndal
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Department of Primary and Secondary Teacher Education, Faculty of Education and International Studies, OsloMet -Oslo Metropolitan University, Oslo, Norway
| | - Per Lagerløv
- Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Department of Primary and Secondary Teacher Education, Faculty of Education and International Studies, OsloMet -Oslo Metropolitan University, Oslo, Norway
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Kalani Z, Pourmovahed Z, Farajkhoda T, Bagheri I. A Qualitative Approach to Women's Perspectives on Exercise in Iran. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2018; 6:156-166. [PMID: 29607344 PMCID: PMC5845119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND It is believed that women of all ages do less physical activities compared to men. The development of interventional projects for increasing the women's participation in physical activity needs the recognition of resources and exploration of women's perspectives on exercise in their lives in the Iranian culture and context. METHODS This qualitative study was conducted in an urban area of Iran on 46 women attending healthcare centers, volunteer health care providers, university students, sportswomen and one of the officials of the provincial women's sports. This study was done from April 2015 to June 2016. Four focus group discussions and one in depth semi-structured interview was conducted. A qualitative conventional content analysis approach was used for data analysis. RESULTS Four categories were developed as follows: 'preferences', 'planning', 'motivators' and 'inhibitors'. Preferences had three distinct subcategories: preferences to do exercise in specific settings, specific exercise and group exercise. The family role, exercise as one part of daily routines, and exercise as a habit were subcategories of planning. Motivators were physical, emotional and social benefits; physician advice and encouragement; being alarmed; and championship. The inhibitors of doing exercise were various: gender issues, economical and costs issues, geographical access, making excuses, cultural infrastructures, shortage of sports experts, fears, concerns and misconceptions, inappropriate facilities and inadequate administrative cooperation and official barriers. CONCLUSION The findings showed that the women were sensitive to and interested in doing exercise. However, barriers to exercise were multiple and complex. Nursing interventions are required to increase the individuals' awareness of misconceptions and also develop strategic programs for improving exercise among women.
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Affiliation(s)
- Zohreh Kalani
- Department of Nursing, School of Nursing and Midwifery, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran;
| | - Zahra Pourmovahed
- Department of Health Education and Promotion, School of Health, Social Determinants of Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran;
| | - Tahmineh Farajkhoda
- Department of Midwifery, School of Nursing and Midwifery, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran;
| | - Imane Bagheri
- Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Doshi RS, Bleich SN, Gudzune KA. Health Professionals' perceptions of insurance coverage for weight loss services. Obes Sci Pract 2017; 3:384-389. [PMID: 29259796 PMCID: PMC5729498 DOI: 10.1002/osp4.137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 09/20/2017] [Accepted: 09/26/2017] [Indexed: 11/08/2022] Open
Abstract
Objective To examine health professionals' (HPs) perceptions of top challenges and solutions in obesity care, and whether these perceptions differ by patient-panel income level. Methods A 2014 national cross-sectional survey of HPs in nutrition, nursing, behavioural or mental health, exercise and pharmacy was analysed. The dependent variables were identification of insurance coverage for their services as a top (1) challenge or (2) solution for obesity care. The independent variable was self-reported income distribution of HPs' patient panels, which was dichotomized as 'lower-income' if 'mostly low income' or 'higher-income' if 'mostly not low income/evenly split between low-income and not low-income'. Multivariate logistic regression with survey weights was used. Results Among 450 HPs, mean age was 44.9 years; 86% were women; 44% had lower-income panels. Overall, 25% of HPs endorsed insurance coverage as a current challenge, and 58% viewed improved coverage as a solution. HPs with lower and higher-income patient panels were similarly likely to identify coverage as a challenge (28% vs. 20%, p = 0.33) and benefits expansion as a solution (47% vs. 64%, p = 0.08). Conclusions Most HPs perceive insurance coverage for their services to benefit patient weight loss. While the Affordable Care Act expands obesity counselling coverage to many lower-income patients, legislation increasing access to benefits for all patients regardless of insurance type may be beneficial.
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Affiliation(s)
- R S Doshi
- Johns Hopkins Bloomberg School of Public Health Baltimore USA.,Johns Hopkins University School of Medicine Baltimore USA
| | - S N Bleich
- Johns Hopkins Bloomberg School of Public Health Baltimore USA
| | - K A Gudzune
- Johns Hopkins University School of Medicine Baltimore USA.,Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins University Baltimore USA
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Burgess E, Hassmén P, Pumpa KL. Determinants of adherence to lifestyle intervention in adults with obesity: a systematic review. Clin Obes 2017; 7:123-135. [PMID: 28296261 DOI: 10.1111/cob.12183] [Citation(s) in RCA: 233] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 01/10/2017] [Accepted: 01/11/2017] [Indexed: 12/01/2022]
Abstract
Lifestyle intervention programmes are efficacious in the management of obesity but often report poor attendance and adherence rates that hinder treatment effectiveness and health outcomes. The aim of this systematic review is to identify (i) barriers to behaviour change and (ii) predictors of adherence to lifestyle intervention programmes in adults with obesity. Studies were identified by systematically reviewing the literature within Medline, PsycINFO, CINAHL, SPORTDiscus and Web of Science from inception to August 2016. Barriers to behaviour change include poor motivation; environmental, societal and social pressures; lack of time; health and physical limitations; negative thoughts/moods; socioeconomic constraints; gaps in knowledge/awareness; and lack of enjoyment of exercise. The most prominent predictors of adherence include early weight loss success, lower baseline body mass index (BMI), better baseline mood, being male and older age. The findings within this review provide novel insight to clinicians working in obesity and have important implications for lifestyle intervention programme design. Barriers to behaviour change need to be addressed early in treatment, with lifestyle intervention individualized accordingly. Predictors of adherence should also be taken into careful consideration, with negative moods and unrealistic weight loss expectations discussed at the outset. If adherence is improved, treatment effectiveness, health outcomes and the ultimate burden of chronic diseases could also be improved.
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Affiliation(s)
- E Burgess
- University of Canberra Research Institute for Sport and Exercise, Canberra, Australia
| | - P Hassmén
- University of Canberra Research Institute for Sport and Exercise, Canberra, Australia
- School of Health and Human Sciences, Southern Cross University, Lismore, Australia
| | - K L Pumpa
- University of Canberra Research Institute for Sport and Exercise, Canberra, Australia
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, Australia
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Howitt C, Brage S, Hambleton IR, Westgate K, Samuels TA, Rose AM, Unwin N. A cross-sectional study of physical activity and sedentary behaviours in a Caribbean population: combining objective and questionnaire data to guide future interventions. BMC Public Health 2016; 16:1036. [PMID: 27716210 PMCID: PMC5045650 DOI: 10.1186/s12889-016-3689-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 09/20/2016] [Indexed: 11/20/2022] Open
Abstract
Background Current understanding of population physical activity (PA) levels and sedentary behaviour in developing countries is limited, and based primarily on self-report. We described PA levels using objective and self-report methods in a developing country population. Methods PA was assessed in a cross-sectional, representative sample of the population of Barbados (25–54 years), using a validated questionnaire (RPAQ) and individually calibrated combined heart rate and movement sensing monitors. The RPAQ collects information on recalled activity in 4 domains: home, work, transport, and leisure. Physical inactivity was defined according to World Health Organization (WHO) guidelines; sedentary lifestyle was defined as being sedentary for 8 h or more daily; PA overestimation was defined as perceiving activity to be sufficient, when classified as ‘inactive’ by objective measurement. Results According to objective estimates, 90.5 % (95 % CI: 83.3,94.7) of women and 58.9 % (48.4,68.7) of men did not accumulate sufficient activity to meet WHO minimum recommendations. Overall, 50.7 % (43.3,58.1) of the population was sedentary for 8 h or more each day, and 60.1 % (52.8,66.9) overestimated their activity levels. The prevalence of inactivity was underestimated by self-report in both genders by 28 percentage points (95 % CI: 18,38), but the accuracy of reporting differed by age group, education level, occupational grade, and overweight/obesity status. Low PA was greater in more socially privileged groups: higher educational level and higher occupational grade were both associated with less objectively measured PA and more sedentary time. Variation in domain-specific self-reported physical activity energy expenditure (PAEE) by educational attainment was observed: higher education level was associated with more leisure activity and less occupational activity. Occupational PA was the main driver of PAEE for women and men according to self-report, contributing 57 % (95 % CI: 52,61). The most popular leisure activities for both genders were walking and gardening. Conclusions The use of both objective and self-report methods to assess PA and sedentary behaviour provides important complementary information to guide public health programmes. Our results emphasize the urgent need to increase PA and reduce sedentary time in this developing country population. Women and those with higher social economic position are particularly at risk from low levels of physical activity. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3689-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Christina Howitt
- Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Jemmott's Lane, Bridgetown, West Indies, Barbados.
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Ian R Hambleton
- Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Jemmott's Lane, Bridgetown, West Indies, Barbados
| | - Kate Westgate
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - T Alafia Samuels
- Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Jemmott's Lane, Bridgetown, West Indies, Barbados
| | - Angela Mc Rose
- Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Jemmott's Lane, Bridgetown, West Indies, Barbados
| | - Nigel Unwin
- Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Jemmott's Lane, Bridgetown, West Indies, Barbados.,MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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