المؤلفون: Anthony Muchai Manyara, Elizabeth Mwaniki, Jason MR Gill, Cindy M Gray

المصدر: Public Health Nutrition, Vol 27 (2024)

مصطلحات موضوعية: Diabetes, Africa, Knowledge, Perceptions, Practices, Public aspects of medicine, RA1-1270, Nutritional diseases. Deficiency diseases, RC620-627

الوصف: Abstract Objective: To synthesise current evidence on knowledge, perceptions and practices towards type 2 diabetes risk in sub-Saharan Africa Design: Mixed-methods scoping review, which included 101 studies (seventy-three quantitative, twenty qualitative and eight mixed methods) from seven electronic databases. Setting: Sub-Saharan Africa, 2000–2023. Participants: Men and women without diabetes with mean ages ranging from 20 to 63 years. Results: The majority of participants in most studies knew the three main diabetes modifiable risk factors – excess weight, unhealthy diet and physical inactivity. However, most people with excess weight in almost all studies underestimated their weight. Further, the self-described ideal body weight was between midpoint of normal weight and the upper limits of overweight in most quantitative studies and was described as not too skinny but not too fat in qualitative studies. In the majority of studies, participants reported low engagement in weight control, high regular sugar intake, and low regular fruit and vegetable intake but moderate to high engagement in physical activity. Barriers to reducing diabetes risk were social (e.g. societal perceptions promoting weight gain) and environmental (e.g. limited affordability of healthy foods, high accessibility of Western diets and lack of physical activity facilities). Conclusion: There is a need for multicomponent type 2 diabetes prevention interventions that increase knowledge of identifying diabetes risk (e.g. what constitutes excess weight) and create social and physical environments that support healthy lifestyles (e.g. societal perceptions that promote healthy living, increased availability and affordability of healthy foods and physical activity facilities).

وصف الملف: electronic resource

العلاقة: https://www.cambridge.org/core/product/identifier/S1368980024000752/type/journal_articleTest; https://doaj.org/toc/1368-9800Test; https://doaj.org/toc/1475-2727Test

الوصول الحر: https://doaj.org/article/237eb60923ec43bfb3c32ec9f41a41acTest

المؤلفون: Irene Mashasi, Gershim Asiki, Shukri F Mohamed, Cindy M Gray, Frances S Mair, Sally M Mtenga, Peter Binyaruka, Caroline H Karugu

المصدر: BMJ Open, Vol 13, Iss 12 (2023)

مصطلحات موضوعية: Medicine

الوصف: Background People with type 2 diabetes (T2D) are at increased risk of poor outcomes from COVID-19. Vaccination can improve outcomes, but vaccine hesitancy remains a major challenge. We examined factors influencing COVID-19 vaccine uptake among people with T2D in two sub-Saharan Africa countries that adopted different national approaches to combat COVID-19, Kenya and Tanzania.Methods A mixed-methods study was conducted in February-March 2022, involving a survey of 1000 adults with T2D (500 Kenya; 500 Tanzania) and 51 in-depth interviews (21 Kenya; 30 Tanzania). Determinants of COVID-19 vaccine uptake were identified using a multivariate logistic regression model, while thematic content analysis explored barriers and facilitators.Results COVID-19 vaccine uptake was lower in Tanzania (26%) than in Kenya (75%), which may reflect an initial political hesitancy about vaccines in Tanzania. People with college/university education were four times more likely to be vaccinated than those with no education (Kenya AOR=4.25 (95% CI 1.00 to 18.03), Tanzania AOR=4.07 (1.03 to 16.12)); and people with health insurance were almost twice as likely to be vaccinated than those without health insurance (Kenya AOR=1.70 (1.07 to 2.70), Tanzania AOR=1.81 (1.04 to 3.13)). Vaccine uptake was higher in older people in Kenya, and among those with more comorbidities and higher socioeconomic status in Tanzania. Interviewees reported that wanting protection from severe illness promoted vaccine uptake, while conflicting information, misinformation and fear of side-effects limited uptake.Conclusion COVID-19 vaccine uptake among people with T2D was suboptimal, particularly in Tanzania, where initial political hesitancy had a negative impact. Policy-makers must develop strategies to reduce fear and misconceptions, especially among those who are less educated, uninsured and younger.

وصف الملف: electronic resource

العلاقة: https://bmjopen.bmj.com/content/13/12/e073668.fullTest; https://doaj.org/toc/2044-6055Test

الوصول الحر: https://doaj.org/article/e5f029dbcdd0493280964f6de34981cdTest

المؤلفون: Jennifer K Quint, Jonathan Fuld, Angela Obasi, Sean Semple, Ruaraidh Dobson, Kevin Mortimer, Maia Lesosky, Jeremiah Chakaya, Cindy M Gray, Graham Devereux, Richard Kiplimo, Fred Orina, Helen Meme, Evans Amukoye, Cressida Bowyer, Amos Ndombi, Sarah E West, Lindsey Zurba

المصدر: BMJ Open Respiratory Research, Vol 10, Iss 1 (2023)

مصطلحات موضوعية: Medicine, Diseases of the respiratory system, RC705-779

الوصف: Background In sub-Saharan Africa, the origins of asthma and high prevalence of abnormal lung function remain unclear. In high-income countries (HICs), associations between birth measurements and childhood asthma and lung function highlight the importance of antenatal and early life factors in the aetiology of asthma and abnormal lung function in children. We present here the first study in sub-Saharan Africa to relate birth characteristics to both childhood respiratory symptoms and lung function.Methods Children attending schools in two socioeconomically contrasting but geographically close areas of Nairobi, Kenya, were recruited to a cross-sectional study of childhood asthma and lung function. Questionnaires quantified respiratory symptoms and preterm birth; lung function was measured by spirometry; and parents were invited to bring the child’s immunisation booklet containing records of birth weight and serial weights in the first year.Results 2373 children participated, 52% girls, median age (IQR), 10 years (8–13). Spirometry data were available for 1622. Child immunisation booklets were available for 500 and birth weight and infant weight gain data were available for 323 and 494 children, respectively. In multivariable analyses, preterm birth was associated with the childhood symptoms ‘wheeze in the last 12 months’; OR 1.64, (95% CI 1.03 to 2.62), p=0.038; and ‘trouble breathing’ 3.18 (95% CI 2.27 to 4.45), p

وصف الملف: electronic resource

العلاقة: https://bmjopenrespres.bmj.com/content/10/1/e001895.fullTest; https://doaj.org/toc/2052-4439Test

الوصول الحر: https://doaj.org/article/7ebab28263974cd6ab824f491d002241Test

المؤلفون: Jason M R Gill, Cindy M Gray, Christopher Bunn, Amelia C Crampin, Jethro Banda

المصدر: BMJ Open, Vol 13, Iss 1 (2023)

مصطلحات موضوعية: Medicine

الوصف: Objectives Given the decline in physical activity levels in Malawi, like other sub-Saharan African countries, and its implication for non-communicable disease (NCD) prevention, this study aimed to compare and contrast accounts of practices and attitudes towards physical activity among Malawian men and women (previously identified as having pre-diabetes) in urban and rural settings.Setting Two communities: one urban (Lilongwe) and one rural (Karonga).Participants 14 men (urban N=6, rural N=8) and 18 women (urban N=9, rural N=9) classified as prediabetic during their participation in an NCD survey 3-5 years previously.Design A qualitative focus group study (N=4) and thematic analysis, with the ecological model used as a framework to characterise the types of physical activity people engaged in and potential ways to support them to exercise more.Results Participants reported undertaking different types of physical activity across all ecological model domains (household, occupational, transport, recreational). Rural participants reported more vigorous physical activities than urban participants, and women reported more household activities than men. Many participants recognised a need to promote physical activity in Malawi, and the health benefits of doing so, including the importance of physical activity in helping them stay strong to maintain physical functioning. Barriers to physical activity included competing priorities (especially urban men), societal expectations around wealth, use of motorised transport, lack of accessible facilities for women, ageing and ill health.Conclusions Physical activity is declining in Malawi as working and transport practices change in response to economic development, making promotion of alternative forms of physical activity a public health priority. Multilevel interventions emphasising the personal benefits/value of physical activity for all ages, and routine and group-based exercising, as well as investment in accessible recreational facilities (including for women) and active travel infrastructure should be considered to improve physical activity levels in Malawi.

وصف الملف: electronic resource

العلاقة: https://bmjopen.bmj.com/content/13/1/e058261.fullTest; https://doaj.org/toc/2044-6055Test

الوصول الحر: https://doaj.org/article/26ddd8abae8f47cc8412a52d78b46f6fTest

المؤلفون: Maria Bissett, Cindy M Gray, Sharifa Abdulla, Christopher Bunn, Amelia C Crampin, Angel Dillip, Jason M R Gill, Heri C Kaare, Sharon Kalima, Elson Kambalu, John Lwanda, Herbert F Makoye, Otiyela Mtema, Mia Perry, Zoë Strachan, Helen Todd, Sally M Mtenga

المصدر: PLOS Global Public Health, Vol 2, Iss 12, p e0000927 (2022)

مصطلحات موضوعية: Public aspects of medicine, RA1-1270

الوصف: The burden of noncommunicable diseases (NCDs) including hypertension, diabetes, and cancer, is rising in Sub-Saharan African countries like Tanzania and Malawi. This increase reflects complex interactions between diverse social, environmental, biological, and political factors. To intervene successfully, new approaches are therefore needed to understand how local knowledges and attitudes towards common NCDs influence health behaviours. This study compares the utility of using a novel arts-based participatory method and more traditional focus groups to generate new understandings of local knowledges, attitudes, and behaviours towards NCDs and their risk factors. Single-gender arts-based participatory workshops and focus group discussions were conducted with local communities in Tanzania and Malawi. Thematic analysis compared workshop and focus group transcripts for depth of content and researcher-participant hierarchies. In addition, semiotic analysis examined the contribution of photographs of workshop activities to understanding participants' experiences and beliefs about NCD risk factors. The arts-based participatory workshops produced in-depth, vivid, emotive narratives of participants' beliefs about NCDs and their impact (e.g., "… it spreads all over your body and kills you-snake's poison is similar to diabetes poison"), while the focus groups provided more basic accounts (e.g., "diabetes is a fast killer"). The workshops also empowered participants to navigate activities with autonomy, revealing their almost overwhelmingly negative beliefs about NCDs. However, enabling participants to direct the focus of workshop activities led to challenges, including the perpetuation of stigma (e.g., comparing smells associated with diabetes symptoms with sewage). Semiotic analysis of workshop photographs provided little additional insight beyond that gained from the transcripts. Arts-based participatory workshops are promising as a novel method to inform development of culturally relevant approaches to NCD prevention in Tanzania and Malawi. Future research should incorporate more structured opportunities for participant reflection during the workshops to minimise harm from any emerging stigma.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2767-3375Test

الوصول الحر: https://doaj.org/article/cc441787550742a3981119d0cefee74bTest

المؤلفون: Evangelia Demou, Alice MacLean, Lismy J Cheripelli, Kate Hunt, Cindy M Gray

المصدر: Scandinavian Journal of Work, Environment & Health, Vol 44, Iss 6, Pp 568-584 (2018)

مصطلحات موضوعية: workplace intervention, weight, sedentary behavior, healthy lifestyle, group-based, healthy eating, review, shift work, physical activity, shift worker, intervention, systematic review, Public aspects of medicine, RA1-1270

الوصف: OBJECTIVE: Shift work is a risk factor for many chronic diseases and has been associated with unhealthy lifestyle behaviors. Workplaces have great potential for promoting and supporting behavior change. We conducted a systematic review of group-based lifestyle workplace interventions for shift workers to (i) identify adaptations and intervention components that accommodate shift working and (ii) assess their impact on weight, physical activity, sedentary behavior and healthy eating. METHODS: A systematic search was conducted in Scopus, Web of Knowledge, EBSCO and Ovid databases. Using pre-established criteria, independent pairs of researchers conducted the study selection, quality appraisal and data extraction. RESULTS: In total, 22 studies on group-based workplace interventions for shift workers were included. Many demonstrated organizational level adaptations, such as flexible delivery times and paying employees’ time for their involvement. Delivery locations near the workplace and management support were other key features. Common intervention components included competitive group activities, individualized goal setting, self-monitoring and feedback, staff involvement in intervention delivery, and incentives. There was moderate evidence for effectiveness on weight and physical activity outcomes, but insufficient evidence for healthy eating outcomes. No interventions focusing on sedentary behavior among shift workers were found. CONCLUSION: Current evidence demonstrates that group-based workplace interventions can be effective for supporting shift workers to lose weight and increase physical activity, while further research is needed to change healthy eating and sedentary behaviors. Our findings offer decision support on organizational-level adaptations and intervention components that are important to make interventions that promote healthy lifestyles more accessible to shift workers.

وصف الملف: electronic resource

العلاقة: https://www.sjweh.fi/show_abstract.php?abstract_id=3763Test; https://doaj.org/toc/0355-3140Test; https://doaj.org/toc/1795-990XTest

الوصول الحر: https://doaj.org/article/71fefd22183b4fbe97748890e7e9dbc2Test

المؤلفون: Øystein B Røynesdal, Femke van Nassau, Nai Rui Chng, Hugo Pereira, Eivind Andersen, Christopher Bunn, Judith G M Jelsma, Maria W G Nijhuis-van der Sanden, Glyn C Roberts, Marit Sørensen, Irene van de Glind, Theo van Actherberg, Cindy M Gray

المصدر: PLoS ONE, Vol 16, Iss 11, p e0259458 (2021)

مصطلحات موضوعية: Medicine, Science

الوصف: This study mapped existing health-promotion provisions targeting adults in professional football clubs across England, the Netherlands, Norway, and Portugal, and explored motives behind the clubs' adoption of the European Fans in Training (EuroFIT) programme. We surveyed top-tier football clubs in the four countries and interviewed representatives from football clubs and the clubs' charitable foundation who delivered EuroFIT. The findings showed large between-country differences, with football clubs in England reporting far greater healthy lifestyle provision than other countries. Relatively few health-promotion programmes targeted adults, particularly in the Netherlands, Portugal, and Norway. Club representatives reported that the motives for adopting the EuroFIT programme often involved adhering to both the social objectives of the football club or club's foundation and business-related objectives. They viewed the scientific evidence and evaluation underpinning EuroFIT as helpful in demonstrating the value and potential future impact of both the programme and the clubs' wider corporate social responsibility provision.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1932-6203Test

الوصول الحر: https://doaj.org/article/1c3437174c5944e1ac4f2838464f21e3Test

المؤلفون: Stephan U Dombrowski, Matthew McDonald, Marjon van der Pol, Mark Grindle, Alison Avenell, Paula Carroll, Eileen Calveley, Andrew Elders, Nicola Glennie, Cindy M Gray, Fiona M Harris, Adrian Hapca, Claire Jones, Frank Kee, Michelle C McKinley, Rebecca Skinner, Martin Tod, Pat Hoddinott

المصدر: Public Health Research, Vol 8, Iss 11 (2020)

مصطلحات موضوعية: obesity, men, feasibility, trial, short message service, narrative sms, weight loss, behaviour change, financial incentives, Public aspects of medicine, RA1-1270

الوصف: Background: In 2016, 26% of UK men were estimated to be obese. Systematic reviews suggest that few men engage in formal weight loss interventions that support weight reduction and improve health. Objective: To co-produce, with patient and public involvement, an acceptable and feasible randomised controlled trial design to test a men-only weight management intervention. Design: This was a two-phase feasibility study. Phase 1 was the development of intervention components, study procedures and materials including a discrete choice experiment with survey questions. Phase 2 was an individually randomised three-arm feasibility trial over 12 months. Qualitative interviews were conducted at 3 and 12 months. Setting: The setting was two sites in Scotland that had disadvantaged urban and rural areas and differed in employment levels and ethnic groups. Participants: In phase 1, 1045 men with obesity were recruited by Ipsos MORI (London, UK; www.ipsos.com/ipsos-mori/en-uk) to represent the UK population. In phase 2, 105 men with obesity were recruited in the community or through general practice obesity registers. Qualitative interviews were conducted with 50 men at 3 months and with 33 men at 12 months. Interventions: The trial arms were narrative short message service (SMS) for 12 months (SMS only), financial endowment incentive informed by loss aversion and linked to achievement of weight loss targets plus narrative SMS for 12 months (SMS + I), and waiting list control group for 12 months followed by 3 months of an alternative SMS style developed based on feedback from men who had received the narrative SMS (control). Main outcome measures: The main outcome measures were acceptability and feasibility of recruitment, retention, engagement, intervention components and trial procedures. Outcomes were assessed by examining procedural, quantitative and qualitative data at 3, 6 and 12 months. Results: The most acceptable incentive strategy, based on the discrete choice experiment results, was to verify weight loss of 5% at 3 months, verify weight loss of 10% at 6 months and maintain weight loss of 10% at 12 months. Overall, 105 men with obesity from across the socioeconomic spectrum were successfully recruited to target, 59% of whom lived in more disadvantaged areas. Retention at 12 months was acceptable (74%) and was higher among individuals from disadvantaged areas. Narrative SMS were acceptable to many men, with a minority reporting negative reactions. Incentives were acceptable but were not the primary motivation for behaviour change. Twelve men in the incentive arm (33%) secured at least some money and three (8%) secured the full amount. Both intervention arms lost some weight, with greater weight loss in the arm that received SMS and incentives. The alternative SMS based on men’s feedback received no strong negative reactions. Limitations: Fewer participants from the SMS + I arm (64%) completed the study at 12 months than did those in the SMS-only (79%) and control (83%) arms. The reasons for this difference were complex. Conclusions: The men-only weight management intervention consisting of narrative SMS and financial incentives was acceptable and feasible, meeting the progression criteria for a full trial. Tailoring of SMS may improve acceptability and retention. Future work: Minor refinements to the intervention components based on the study findings will be made prior to testing in a multisite definitive randomised controlled trial. Trial registration: ClinicalTrials.gov NCT03040518. Funding: This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 11. See the NIHR Journals Library website for further project information.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2050-4381Test; https://doaj.org/toc/2050-439XTest

الوصول الحر: https://doaj.org/article/d68ffef3197b485ebfe4b8aa4c8af7b7Test

المؤلفون: Dominika Kwasnicka, Nikos Ntoumanis, Kate Hunt, Cindy M Gray, Robert U Newton, Daniel F Gucciardi, Cecilie Thøgersen-Ntoumani, Jenny L Olson, Joanne McVeigh, Deborah A Kerr, Sally Wyke, Philip J Morgan, Suzanne Robinson, Marshall Makate, Eleanor Quested

المصدر: PLoS Medicine, Vol 17, Iss 8, p e1003136 (2020)

مصطلحات موضوعية: Medicine

الوصف: BackgroundRecent evidence shows that sport settings can act as a powerful draw to engage men in weight loss. The primary objective of this pilot study was to test the feasibility of delivering and to evaluate preliminary efficacy of Aussie-FIT, a weight-loss program for men with overweight/obesity delivered in Australian Football League (AFL) settings, in preparation for a future definitive trial.Methods and findingsThis 6-month pilot trial took place in Perth, Australia. Participants were overweight/obese (Body Mass Index [BMI] ≥ 28 kg/m2), middle-aged (35-65 years old) men. Participants were recruited in May 2018, and the intervention took place between June and December 2018. The intervention involved 12 weekly 90-min face-to-face sessions, incorporating physical activity, nutrition, and behaviour change information and practical activities delivered by coaches at 2 clubs. Data were collected at baseline and immediately postintervention. For trial feasibility purposes, 6-month follow-ups were completed. Outcomes were differences in weight loss (primary outcome) and recruitment and retention rates, self-reported measures (for example, psychological well-being), device-measured physical activity, waist size, and blood pressure at 3 months. Within 3 days of advertising at each club, 426 men registered interest; 306 (72%) were eligible. Men were selected on a first-come first-served basis (n = 130; M age = 45.8, SD = 8; M BMI = 34.48 kg/m2, SD = 4.87) and randomised by a blinded researcher. Trial retention was 86% and 63% at 3- and 6-month follow-ups (respectively). No adverse events were reported. At 3 months, mean difference in weight between groups, adjusted for baseline weight and group, was 3.3 kg (95% CI 1.9, 4.8) in favour of the intervention group (p < 0.001). The intervention group's moderate-to-vigorous physical activity (MVPA) was higher than the control group by 8.54 min/day (95% CI 1.37, 15.71, p = 0.02). MVPA among men attracted to Aussie-FIT was high at baseline (intervention arm 35.61 min/day, control arm 38.38 min/day), which may have limited the scope for improvement.ConclusionsAussie-FIT was feasible to deliver; participants increased physical activity, decreased weight, and reported improvements in other outcomes. Issues with retention were a limitation of this trial. In a future, fully powered randomised controlled trial (RCT), retention could be improved by conducting assessments outside of holiday seasons.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12617000515392.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1549-1277Test; https://doaj.org/toc/1549-1676Test

الوصول الحر: https://doaj.org/article/84797a71bd154e8f80fef451d4834795Test

المؤلفون: Stuart Gray, Amelia Crampin, Cindy M Gray, Christopher Bunn, Chisomo Kalinga, Otiyela Mtema, Sharifa Abdulla, Angel Dillip, John Lwanda, Sally M Mtenga, Jo Sharp, Zoë Strachan, Jason Gill, Hazel Namadingo, Mia Perry, Helen Todd

المصدر: BMJ Global Health, Vol 5, Iss 5 (2020)

مصطلحات موضوعية: Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216

الوصف: Introduction Arts-based approaches to health promotion have been used widely across sub-Saharan Africa (SSA), particularly in public health responses to HIV/AIDS. Such approaches draw on deep-rooted historical traditions of indigenous groups in combination with imported traditions which emerged from colonial engagement. To date, no review has sought to map the locations, health issues, art forms and methods documented by researchers using arts-based approaches in SSA.Methods Using scoping review methodology, 11 databases spanning biomedicine, arts and humanities and social sciences were searched. Researchers screened search results for papers using predefined criteria. Papers included in the review were read and summarised using a standardised proforma. Descriptive statistics were produced to characterise the location of the studies, art forms used or discussed, and the health issues addressed, and to determine how best to summarise the literature identified.Results Searches identified a total of 59 794 records, which reduced to 119 after screening. We identified literature representing 30 (62.5%) of the 48 countries in the SSA region. The papers covered 16 health issues. The majority (84.9%) focused on HIV/AIDS-related work, with Ebola (5.0%) and malaria (3.3%) also receiving attention. Most studies used a single art form (79.0%), but a significant number deployed multiple forms (21.0%). Theatre-based approaches were most common (43.7%), followed by music and song (22.6%), visual arts (other) (9.2%), storytelling (7.6%) and film (5.0%).Conclusions Arts-based approaches have been widely deployed in health promotion in SSA, particularly in response to HIV/AIDS. Historically and as evidenced by this review, arts-based approaches have provided a platform to facilitate enquiry, achieved significant reach and in some instances supported demonstrable health-related change. Challenges relating to content, power relations and evaluation have been reported. Future research should focus on broadening application to other conditions, such as non-communicable diseases, and on addressing challenges raised in research to date.

وصف الملف: electronic resource

العلاقة: https://gh.bmj.com/content/5/5/e001987.fullTest; https://doaj.org/toc/2059-7908Test

الوصول الحر: https://doaj.org/article/a9e97784cc8743d392fa4c26c1a0811eTest