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Diet and physical activity for children's health: a qualitative study of Nepalese mothers' perceptions.

ABSTRACT: OBJECTIVES:Non-communicable diseases account for 50% of all deaths in Nepal and 25% result from cardiovascular diseases. Previous studies in Nepal indicate a high burden of behavioural cardiovascular risk factors, suggesting a low level of knowledge, attitude and practice/behaviour regarding cardiovascular health. The behavioural foundation for a healthy lifestyle begins in early childhood, when mothers play a key role in their children's lives. This qualitative study, conducted in a Nepalese peri-urban community, aimed to explore mothers' perception of their children's diet and physical activity. DESIGN:We notated, tape-recorded and transcribed all data collected from six focus group discussions, and used qualitative content analysis for evaluation and interpretation. SETTING:The study was conducted in the Jhaukhel-Duwakot Health Demographic Surveillance Site in the Bhaktapur district of Nepal. PARTICIPANTS:Local health workers helped recruit 61 women with children aged 5-10?years. We distributed participants among six different groups according to educational status. RESULTS:Although participants understood the importance of healthy food, they misunderstood its composition, perceiving it as unappetising and appropriate only for sick people. Furthermore, participants did not prioritise their children's physical activities. Moreover, mothers believed they had limited control over their children's dietary habits and physical activity. Finally, they opined that health educational programmes would help mothers and recommended various intervention strategies to increase knowledge regarding a healthy lifestyle. CONCLUSIONS:Our data reveal that mothers of young children in a peri-urban community of Nepal lack adequate and accurate understanding about the impact of a healthy diet and physical activity. Therefore, to prevent future cardiovascular disease and other non-communicable diseases among children, Nepal needs health education programmes to improve mothers' cardiovascular health knowledge, attitude and behaviour.

SUBMITTER: Oli N

PROVIDER: S-EPMC4563228 | biostudies-other | 2015 Sep

REPOSITORIES: biostudies-other

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Diet and physical activity for children's health: a qualitative study of Nepalese mothers' perceptions.

Oli Natalia N Vaidya Abhinav A Subedi Madhusudan M Eiben Gabriele G Krettek Alexandra A

BMJ open 20150908 9

<h4>Objectives</h4>Non-communicable diseases account for 50% of all deaths in Nepal and 25% result from cardiovascular diseases. Previous studies in Nepal indicate a high burden of behavioural cardiovascular risk factors, suggesting a low level of knowledge, attitude and practice/behaviour regarding cardiovascular health. The behavioural foundation for a healthy lifestyle begins in early childhood, when mothers play a key role in their children's lives. This qualitative study, conducted in a Nep ...[more]

PMID: 26351183

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Project description:BackgroundWith economic and social changes, participation in occupational and transport-related physical activity is declining among Nepalese adults, highlighting the growing importance of leisure-time physical activity. However, limited information is available to guide public health policies and interventions to promote leisure-time physical activity in Nepal. This study aimed to qualitatively explore the socioecological influences of participation in leisure-time physical activity among Nepalese adults aged 40 years and above.MethodsA total of 51 adults (30 females and 21 males) participated in one of the nine focus groups conducted in Kathmandu, Nepal. A semi-structured guide based on the social-ecological model of physical activity was used to facilitate these focus groups. Data were analysed using a reflexive thematic analysis approach in NVivo 12.ResultsParticipation in leisure-time physical activity was minimal and leisure time was mostly spent resting, socialising, or engaging in sedentary activities such as watching television. Walking was the most common form of leisure-time physical activity, and men reported being more active than women. Individual-level barriers included lack of knowledge, lack of skill, lack of motivation, considering oneself as sufficiently active and engagement in sedentary screen activities. Family and household responsibilities, lack of support and fear of being judged constituted the interpersonal barriers while environmental barriers included an absence of a supportive social norm, lack of open spaces, weather conditions and perceived lack of safety. Health benefits, prioritising physical activity, social support, provision of group-based activities and age-appropriate public exercise facilities were identified as major facilitators.ConclusionCritical issues that need to be addressed to increase leisure-time physical activity among Nepalese adults include traditional gender roles, family and social support, and social norms. Modifications of the built environment, such as public exercise facilities, offer further opportunities and will require coordination beyond the health sector.

Project description:Background: Nepal, like many low- and middle-income countries, exhibits rising burden of cardiovascular diseases. Misconceptions, poor behavior, and a high prevalence of risk factors contribute to this development. Health promotion efforts along with primary prevention strategies, including risk factor reduction in both adults and children, are therefore critical. Objectives: This study assessed the effectiveness of a health promotion intervention on mothers' knowledge, attitude and practice (KAP) and their children's behavior regarding diet and physical activity. Methods: The Heart-health Associated Research, Dissemination and Intervention in the Community (HARDIC), a community-based trial, used peer education to target mothers with 1-9-year-old children in the peri-urban Jhaukhel-Duwakot Health Demographic Surveillance Site, Nepal, during August-November 2016. In the intervention area, 47 peer mothers were trained to conduct four education classes for about 10 fellow mothers (N = 391). After 3 months, all eligible mothers in the intervention and control areas were interviewed and the results were compared with the KAP of all eligible mothers at baseline. Results: Post-intervention, mothers' KAP median scores had improved regarding heart-healthy diet and physical activity. More mothers had 'good' KAP (>75% of maximum possible scores), and mothers with 'good' knowledge increased from 50% to 81%. Corresponding control values increased only from 58% to 63%. Mothers' attitude and practice improved. Additionally, mothers in the intervention area reported improvement in their children's diet and physical activity behavior. Moreover, Difference in Differences analysis showed that the HARDIC intervention significantly increased mothers' KAP scores and children's behavior scores in the intervention area compared to the control area. Conclusions: Our intervention improves KAP scores regarding diet and physical activity and shows potential for expansion via community health workers, volunteers, and/or local women. Moreover, HARDIC can contribute to Nepal's Package of Essential Noncommunicable Diseases Initiative, which currently lacks a specific package for health promotion.

Project description:Activity trackers are widely used by adults and several models are now marketed for children.The aims of this study were to (1) perform a content analysis of behavioral change techniques (BCTs) used by three commercially available youth-oriented activity trackers and (2) obtain feedback describing children's perception of these devices and the associated websites.A content analysis recorded the presence of 36 possible BCTs for the MovBand (MB), Sqord (SQ), and Zamzee (ZZ) activity trackers. In addition, 16 participants (mean age 8.6 years [SD 1.6]; 50% female [8/16]) received all three trackers and were oriented to the devices and websites. Participants were instructed to wear the trackers on 4 consecutive days and spend ≥10 min/day on each website. A cognitive interview and survey were administered when the participant returned the devices. Qualitative data analysis was used to analyze the content of the cognitive interviews. Chi-square analyses were used to determine differences in behavioral monitoring and social interaction features between websites.The MB, SQ, and ZZ devices or websites included 8, 15, and 14 of the possible 36 BCTs, respectively. All of the websites had a behavioral monitoring feature (charts for tracking activity), but the percentage of participants indicating that they "liked" those features varied by website (MB: 8/16, 50%; SQ: 6/16, 38%; ZZ: 11/16, 69%). Two websites (SQ and ZZ) included an "avatar" that the user could create to represent themselves on the website. Participants reported that they "liked" creating and changing their avatar (SQ: 12/16, 75%, ZZ: 15/16, 94%), which was supported by the qualitative analyses of the cognitive interviews. Most participants (75%) indicated that they would want to wear the devices more if their friends were wearing a tracker. No significant differences were observed between SQ and ZZ devices in regards to liking or use of social support interaction features (P=.21 to .37).The websites contained several BCTs consistent with previously identified strategies. Children "liked" the social aspects of the websites more than the activity tracking features. Developers of commercial activity trackers for youth may benefit from considering a theoretical perspective during the website design process.

Project description:BackgroundCOVID-19 has drastically changed the everyday lives of children, including limiting interactions with peers, loss of regularly organized activities, and closure of schools and recreational facilities. While COVID-19 protocols are in place to reduce viral transmission, they have affected children's access to physical activity opportunities. The purpose of this study was to understand how COVID-19 has affected children's engagement in physical activity and to identify strategies that can support children's return to physical activity programming in public places.MethodsParents of past participants in the Grade 5 ACT-i-Pass Program in London, Ontario, Canada were invited to participate in a semi-structured interview online (in November and December 2020) via Microsoft Teams. The script was comprised of questions about their child's physical activity levels (before, current, and anticipated following COVID-19), lifestyle changes due to COVID-19, and what service providers can do to assist children's return to public programming. Interviews were transcribed in Microsoft Teams, reviewed by a member of the research team, and analyzed in NVivo 12 using thematic analysis.ResultsTwenty-seven parents participated in an interview. Four themes and two subthemes were identified during analysis: (1) modifications to everyday life (a. activity options available and b. altered social environment), (2) safety in public spaces, (3) accessibility of activities, and (4) utilizing outdoor spaces.ConclusionsCOVID-19 protocols have decreased children's physical activity levels due to the loss of their regular activities, recreational spaces, and peer support. Implementing facility and activity-specific health protocols, providing outdoor activity options, and offering a variety of activity types, times, and locations are three strategies recommended by parents to help facilitate their children's return to public recreational places. Due to the negative consequences of physical inactivity on children's health and well-being, service providers need to implement programming and safety protocols that support children's engagement in physical activity throughout the remainder of, and the years following, the COVID-19 pandemic.

Project description:BackgroundPeople living with HIV (PLWH) have low levels of physical activity. Using the social ecological model to understand perceptions, facilitators and barriers of physical activity in this population is of importance for developing contextualised interventions to improve physical activity in PLWH.MethodThis was a qualitative sub-study conducted between august and November 2019 as part of a cohort study on diabetes and associated complications in HIV infected in Mwanza, Tanzania. Sixteen in-depth interviews and three focus groups with nine participants in each were conducted. The interviews and focus groups were audio recorded, transcribed and translated into English. The social ecological model was considered during the coding and interpretation of the results. Transcripts were discussed, coded and analyzed using deductive content analysis.ResultsForty-three PLWH aged 23-61 years participated in this study. The findings showed that most PLWH perceived physical activity as beneficial to their health. However, their perceptions of physical activity were rooted within existing gender stereotypes and roles in the community. Running and playing football were perceived as activities for men while household chores activities were for women. Further, men were perceived to do more physical activity than women. For women, household chores and income-generating activities were perceived as sufficient physical activity. Social support and engagement of family members and friends in physical activity were reported as facilitators of physical activity. Reported barriers of physical activity were lack of time, money, availability of physical activity facilities and social support groups, and poor information on physical activity from health care providers in HIV clinics. Human-immunodeficiency virus (HIV) HIV infection was not perceived by PLWH as a barrier for doing physical activity but most family members did not support them to do physical activity, fearing that it might worsen their condition.ConclusionThe findings demonstrated differing perceptions, facilitators and barriers of physical activity among PLWH. Interventions addressing awareness, gender stereotypes and roles related to physical activity from individual to community level are needed. Supportive environment and infrastructures are needed to improve physical activity levels in PLWH in Tanzania.

Project description:BackgroundWomen with a history of gestational diabetes mellitus (GDM) are at high risk of developing type 2 diabetes mellitus (T2DM). They are therefore recommended to follow a healthy diet and be physically active in order to reduce that risk. However, achieving and maintaining these behaviours in the postpartum period is challenging. This study sought to explore women's views on suggested practical approaches to achieve and maintain a healthy diet and physical activity to reduce T2DM risk.MethodsSemi-structured interviews with 20 participants in Cambridgeshire, UK were conducted at three to 48 months after GDM. The participants' current diet and physical activity, intentions for any changes, and views on potential interventions to help manage T2DM risk through these behaviours were discussed. Framework analysis was used to analyse the transcripts. The interview schedule, suggested interventions, and thematic framework were based on a recent systematic review.ResultsMost of the participants wanted to eat more healthily and be more active. A third of the participants considered that postpartum support for these behaviours would be transformative, a third thought it would be beneficial, and a third did not want additional support. The majority agreed that more information about the impact of diet and physical activity on diabetes risk, support to exercise with others, and advice about eating healthily, exercising with a busy schedule, monitoring progress and sustaining changes would facilitate a healthy diet and physical activity. Four other suggested interventions received mixed responses. It would be acceptable for this support to be delivered throughout pregnancy and postpartum through a range of formats. Clinicians were seen to have important roles in giving or signposting to support.ConclusionsMany women would appreciate more support to reduce their T2DM risk after GDM and believe that a variety of interventions to integrate changes into their daily lives would help them to sustain healthier lifestyles.

Project description:BackgroundCancer survivors are at an elevated risk for several negative health outcomes, but physical activity (PA) can decrease those risks. Unfortunately, adherence to PA recommendations among survivors is low. Fitness mobile apps have been shown to facilitate the adoption of PA in the general population, but there are limited apps specifically designed for cancer survivors. This population has unique needs and barriers to PA, and most existing PA apps do not address these issues. Moreover, incorporating user preferences has been identified as an important priority for technology-based PA interventions, but at present there is limited literature that serves to establish these preferences in cancer survivors. This is especially problematic given the high cost of app development and because the majority of downloaded apps fail to engage users over the long term.ObjectiveThe aim of this study was to take a qualitative approach to provide practical insight regarding this population's preferences for the features and messages of an app to increase PA.MethodsA total of 35 cancer survivors each attended 2 focus groups; a moderator presented slide shows on potential app features and messages and asked open-ended questions to elicit participant preferences. All sessions were audio recorded and transcribed verbatim. Three reviewers independently conducted thematic content analysis on all transcripts, then organized and consolidated findings to identify salient themes.ResultsParticipants (mean age 63.7, SD 10.8, years) were mostly female (24/35, 69%) and mostly white (25/35, 71%). Participants generally had access to technology and were receptive to engaging with an app to increase PA. Themes identified included preferences for (1) a casual, concise, and positive tone, (2) tools for personal goal attainment, (3) a prescription for PA, and (4) an experience that is tailored to the user. Participants reported wanting extensive background data collection with low data entry burden and to have a trustworthy source translate their personal data into individualized PA recommendations. They expressed a desire for app functions that could facilitate goal achievement and articulated a preference for a more private social experience. Finally, results indicated that PA goals might be best established in the context of personally held priorities and values.ConclusionsMany of the desired features identified are compatible with both empirically supported methods of behavior change and the relative strengths of an app as a delivery vehicle for behavioral intervention. Participating cancer survivors' preferences contrasted with many current standard practices for mobile app development, including value-based rather than numeric goals, private socialization in small groups rather than sharing with broader social networks, and interpretation of PA data rather than merely providing numerical data. Taken together, these insights may help increase the acceptability of theory-based mHealth PA interventions in cancer survivors.

Dataset Information

Diet and physical activity for children's health: a qualitative study of Nepalese mothers' perceptions.

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Diet and physical activity for children's health: a qualitative study of Nepalese mothers' perceptions.

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