Abstract

Obesity and other lifestyle-related chronic diseases impact urban West African women at high rates. Physical activity (PA) can improve these health outcomes but there is little published data on the associated psychosocial predictors in this population. We aimed to explore preliminary associations between perceptions of PA, PA behaviours, and health in a group of Ghanaian women. Non-experimental, cross-sectional case study using a mixed-methods approach. Focus groups and in-depth interviews with a convenience sample of Ghanaian women, fitness trainers and clergy comprised the qualitative phase. A self-administered survey (n=218) comprised the quantitative phase. Constant comparative method, logistic regression, component and factor analyses were used for analysis. Women viewed activities of daily living like housework as PA; rarely utilized organized fitness facilities; understood "rigorous" PA as professional male athleticism; and took interest in socialized PA. Mean age was 49.4 years. Mean body mass index was 30.3 kg/m2. The majority (75.9 %) reported exercising sometimes or often. Half (48.4%) reported a lifestyle-related chronic disease. "Weight loss," "health concerns" and "increased energy," were top motivators for PA. "Can't find the time," "work/family obligations," and "don't have a facility" were top barriers. Presence of hypertension, hypercholesterolemia and prior weight loss correlated with the slimming motivator (adjusted odds ratio 2.59, p=0.008; AOR 3.56, p=0.012; AOR 3.36, p=<0.001). Among those surveyed, PA motivators and barriers were associated with demographics, PA exposure, and health status. Further research on unique PA perceptions, behaviours and health could catalyze health promotion through culturally relevant fitness programming.

Highlights

  • Regular physical activity (PA) and proper nutrition are the two major determinants of a healthy lifestyle

  • Specific aims The specific aims of this study were to: 1) collect and summarize demographic and obesity-related health data on a cohort of women aged forty and above in Accra, Ghana, 2) conduct qualitative and quantitative analyses of social, cultural and individual psychosocial determinants of PA among the cohort, and 3) use these data to demonstrate the need for large-scale formative research which may be used to design a cohort-specific fitness intervention

  • Once the top three motivators and barriers to PA were identified, they were separately regressed on four covariates: age, educational status, marital status and body mass index (BMI)

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Summary

Introduction

Regular physical activity (PA) and proper nutrition are the two major determinants of a healthy lifestyle. They can help reduce obesity-related risk of chronic disease, and improve indicators related to chronic disease (e.g., blood lipid and glucose levels).[1] The socio-cultural climate of urban West Africa, increasingly defined by technological advances in transportation and food, enables a sedentary lifestyle and related diseases.[2,3,4,5]. The regional prevalence of obesity is approximately 10% and rising: trend analyses demonstrate obesity prevalence has more than doubled in the past decade and a half.[6] Women (versus men) and urban dwellers (versus rural) have the highest rates of obesity.[6] The regional prevalence of physical inactivity is 13%. Women (versus men), older adults (> age 50) and urban dwellers (versus rural) have the highest rates of inactivity.[6] In Ghana, the prevalence of obesity is between 10.7% and 14.1%.

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