Browsing by Author "Boateng, G.O."
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Item Annual transition probabilities of overweight and obesity in older adults: Evidence from World Health Organization Study on global AGEing and adult health(Social Science & Medicine, 2020-01-28) Biritwum, R.B.; Lartey, S.T.; Si, L.; Otahal, P.; de Graaff, B.; Boateng, G.O.; Minicuci, N.; Kowal, P.; Magnussen, C.G.; Palmer, A.J.Overweight/obesity is becoming increasingly prevalent in sub-Saharan Africa including Ghana. However, transition probabilities, an essential component to develop cost-effective measures for weight management is lacking in this population. We estimated annual transition probabilities between three body mass index (BMI) categories: normal weight (BMI ≥18.5 and <25.0 kg/m2), overweight (BMI ≥25.0 and <30.0 kg/m2), and obesity (BMI ≥30.0 kg/m2), among older adults aged ≥50 years in Ghana. Data were used from a nationally representative, multistage sample of 1496 (44.3% females) older adults in both Waves 1 (2007/8) and 2 (2014/ 15) of the Ghana WHO SAGE. A multistage Markov model was used to estimate annual transition probabilities. We further examined the impact of specific socio-economic factors on the transition probabilities. At baseline, 22.8% were overweight and 11.1% were obese. The annual transition probability was 4.0% (95% CI: 3.4%, 4.8%) from normal weight to overweight, 11.1% (95% CI: 9.5%, 13.0%) from overweight to normal weight and 4.9% (95% CI: 3.8%, 6.2%) from overweight to obesity. For obese individuals, the probability of remaining obese, transitioning to overweight and completely reverting to normal weight was 90.2% (95% CI: 87.7%, 92.3%), 9.2% (95% CI: 7.2%, 11.6%) and 0.6% (95% CI: 0.4%, 0.8%) respectively. Being female, aged 50–65 years, urban residence, having high education and high wealth were associated with increased probability of transitioning into the overweight or obese categories. Our findings highlight the difficulty in transitioning away from obesity, especially among females. The estimated transition probabilities will be essential in health economic simulation models to determine sustainable weight management interventionsItem Coping strategies adapted by Ghanaians during the COVID-19 crisis and lockdown: A population-based study(PLOS, 2021) Iddi, S.; Obiri-Yeboah, D.; Aboh, I.K.; Quansah, R.; Owusu, S.A.; Enyan, N.I.E.; Kodom, R.V.; Nsabimana, E.; Jansen, S.; Ekumah, B.; Boamah, S.A.; Boateng, G.O.; Doku, D.T.; Armah, F.A.The COVID-19 pandemic and control measures adopted by countries globally can lead to stress and anxiety. Investigating the coping strategies to this unprecedented crisis is essential to guide mental health intervention and public health policy. This study examined how people are coping with the COVID-19 crisis in Ghana and identify factors influencing it. This study was part of a multinational online cross-sectional survey on Personal and Family Coping with COVID-19 in the Global South. The study population included adults, �18 years and residents in Ghana. Respondents were recruited through different platforms, including social media and phone calls. The questionnaire was composed of different psychometrically validated instruments with coping as the outcome variable measured on the ordinal scale with 3 levels, namely, Not well or worse, Neutral, and Well or better. An ordinal logistic regression model using proportional odds assumption was then applied. A total of 811 responses were included in the analysis with 45.2% describing their coping level as well/better, 42.4% as neither worse nor better and 12.4% as worse/not well. Manyrespondents (46.9%) were between 25–34 years, 50.1% were males while 79.2% lived in urban Ghana. Having pre-existing conditions increased the chances of not coping well (aOR = 1.86, 95%CI: 1.15–3.01). Not being concerned about supporting the family financially (aOR = 1.67, 95%CI: 1.06–2.68) or having the feeling that life is better during the pandemic (aOR = 2.37, 95%CI: 1.26–4.62) increased chances of coping well. Praying (aOR: 0.62, 95%CI: 0.43–0.90) or sleeping (aOR: 0.55, 95%CI: 0.34–0.89) more during the pandemic than before reduces coping. In Ghana, during the COVID-19 pandemic, financial security and optimism about the disease increase one’s chances of coping well while having pre-existing medical conditions, praying and sleeping more during the pandemic than before reduces one’s chances of coping well. These findings should be considered in planning mental health and public health intervention/policy.Item Examining the correlates of gender equality and the empowerment of married women in Zambia(African Geographical Review, 2014) Boateng, G.O.; Mumba, D.; Asare-Bediako, Y.; Boateng, M.O.This paper is an analysis of the factors that predict the involvement of women in decision-making within households in Zambia. It is a study at the micro-level of some of the indicators used in calculating the Gender Status Index, which reflects women empowerment and gender equality. Using the 2007 Zambia Demographic Health Survey and complementary log-log models, the study investigates the determinants of women empowerment and gender equality. At the multivariate level, wealth, education, and employment significantly influence womens involvement in household decision-making. Older women were however, more likely to be involved in decision-making concerning daily household purchases. Interestingly, married women from the Northwestern and Western parts of the country were more likely to engage in a patriarchal bargain and negotiate spaces of power and decision-making than those from the Lusaka province - the capital. These findings will be beneficial for programme and policy formulation with regard to women empowerment and gender equality in Zambia. Womens involvement in decision-making with their partners and within the household will spill over into their integration and representation on civil-political platforms, with a potential to increase productivity and improve development outcomes in context. © 2013 The African Specialty Group of the Association of American Geographers.Item Examining the effects of household food insecurity on school absenteeism among Junior High School students: findings from the 2012 Ghana global school-based student health survey(AFRICAN GEOGRAPHICAL REVIEW, 2019-06-12) Dako-Gyeke, M.; Baiden, P.; Boateng, G.O.; Acolatse, C.K.; Peters, K.E.This study examined the effects of household food insecurity on school absenteeism among Junior High School students in Ghana. Data for this study were drawn fromthe 2012 Ghana Global School-based Health Survey. A sample of 1,121 students aged 11–18 years were analyzed using binary logistic regression with school absenteeism as the outcome variable. Of the 1,121 students examined, more than half (58.1%) were from food insecure households and 39.8% missed school without permission during the past 30 days. Adjustng for multiple predictors, students from food insecure households had 1.56 times higher odds of missing school without permission relative to those from food secure households. Other predictors of school absenteeism include being a victim of bullying, being involved in fighting in school, feeling lonely, history of suicidal ideation, alcohol use, and illicit substance use. Parental support had a protective effect on school absenteeism such that, for each additional increase in parental support score, the odds of school absenteeism were predicted to decrease by 4%. Addressing both distal and structural drivers of food insecurity is critical in reducing school absenteeism and improving student enrollment and school attendance.Item Health service utilization and direct healthcare costs associated with obesity in older adult population in Ghana(Health Policy and Planning, 2020-03) Aikins, M.; Lartey, S.T.; de Graaff, B.; Magnussen, C.G.; Boateng, G.O.; Minicuci, N.; Kowal, P.; Si, L.; Palmer, A.J.Obesity is a major risk factor for many chronic diseases and disabilities, with severe implications on morbidity and mortality among older adults. With an increasing prevalence of obesity among older adults in Ghana, it has become necessary to develop cost-effective strategies for its management and prevention. However, developing such strategies is challenging as body mass index (BMI)-specific utilization and costs required for cost-effectiveness analysis are not available in this population. Therefore, this study examines the associations between health services utilization as well as direct healthcare costs and overweight (BMI ≥25.00 and <30.00 kg/m2) and obesity (BMI ≥30.00 kg/m2) among older adults in Ghana. Data were used from a nationally representative, multistage sample of 3350 people aged 50+ years from the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE; 2014/15). Health service utilization was measured by the number of health facility visits over a 12-month period. Direct costs (2017 US dollars) included out-of-pocket payments and the National Health Insurance Scheme (NHIS) claims. Associations between utilization and BMI were examined using multivariable zero-inflated negative binomial regressions; and between costs and BMI using multivariable two-part regressions. Twenty-three percent were overweight and 13% were obese. Compared with normal-weight participants, overweight and obesity were associated with 75% and 159% more inpatient admissions, respectively. Obesity was also associated with 53% additional outpatient visits. One in five of the overweight and obese population had at least one chronic disease, and having chronic disease was associated with increased outpatient utilization. The average per person total costs for overweight was $78 and obesity was $132 compared with $35 for normal weight. The NHIS bore approximately 60% of the average total costs per person expended in 2014/15. Overweight and obese groups had significantly higher total direct healthcare costs burden of $121 million compared with $64 million for normal weight in the entire older adult Ghanaian population. Compared with normal weight, the total costs per person associated with overweight increased by 73% and more than doubled for obesity. Even though the total prevalence of overweight and obesity was about half of that of normal weight, the sum of their cost burden was almost doubled. Implementing weight reduction measures could reduce health service utilization and costs in this population.Item Parenting practices and family relationships during the COVID-19 lockdown in Ghana(Journal of Public Health in Africa, 2022) Owusu, S.A.; Ekumah, B.; Kodom, R.V.; Enyan, N.I.E.; Aboh, I.K.; Quansah, R.; Boamah, S.A.; Boateng, G.O.; Obiri-Yeboah, D.; Doku, D.T.; Nsabimana, E.; Jansen, S.; Ato Arma, F.The effects of the COVID-19 pandemic have been far reaching across almost every sphere of life. Families, which are the basic units of society, have not been spared the ravages of the pandemic. Changes in family daily routines as a result of COVID-19 can affect spousal relationships, parenting and childcare practices. However, the extent to which the pandemic has affected parenting practices and family relationships in Ghana is not known. The goal of this study was to assess how parenting practices and family relationships have been influenced during the COVID-19 pandemic in Ghana. Data for this paper was drawn from an online questionnaire response from 463 participants in Ghana as a subset analysis from a multi-country study on personal and family coping system with COVID-19 pandemic in the global south. The mean score for pre-COVID-19 relationship with partner (36.86) was higher (p<0.0001) than the mean score for during COVID-19 relationship with partner (35.32) indicating that COVID-19 has had negative influence on relationships. The mean score for pre-COVID-19 parenting (32.78) was higher (p<0.0001) compared to the mean score for during COVID-19 parenting (31.40) indicating negative influence on parenting. We have predicted that participants whose coping levels were “Well” on the average, are likely to be doing well in relationship with partners and parenting practices during the COVID-19 period. The challenging public health containment measures of the COVID-19 pandemic have negatively influenced the relationship between partners and parenting practices in Ghana.Item Prevalence and changes in boredom, anxiety and well-being among Ghanaians during the COVID-19 pandemic: a population-based study(2021) Boateng, G.O.; Doku, D.T.; Enyan, N.I.E.; Owusu, S.A.; Aboh, I.K.; Kodom, R.V.; Ekumah, B.; Quansah, R.; Boamah, S.A.; Obiri-Yeboah, D.; Nsabimana, E.; Jansen, S.; Armah, F.A.Background: The outbreak of the COVID-19 pandemic has been associated with several adverse health outcomes. However, few studies in sub-Saharan Africa have examined its deleterious consequences on mental health. Therefore, we investigated the prevalence and changes in boredom, anxiety and psychological well-being before and during the COVID-19 pandemic in Ghana. Methods: Data for this study were drawn from an online survey of 811 participants that collected retrospective information on mental health measures including symptoms of generalized anxiety disorder, boredom, and wellbeing. Additional data were collected on COVID-19 related measures, biosocial (e.g. age and sex) and sociocultural factors (e.g., education, occupation, marital status). Following descriptive and psychometric evaluation of measures used, multiple linear regression was used to assess the relationships between predictor variables and boredom, anxiety and psychological well-being scores during the pandemic. Second, we assessed the effect of anxiety on psychological well-being. Next, we assessed predictors of the changes in boredom, anxiety, and well-being. Results: Before the COVID-19 pandemic, 63.5% reported better well-being, 11.6% symptoms of anxiety, and 29.6% symptoms of boredom. Comparing experiences before and during the pandemic, there was an increase in boredom and anxiety symptomatology, and a decrease in well-being mean scores. The adjusted model shows participants with existing medical conditions had higher scores on boredom (ß = 1.76, p < .001) and anxiety (ß = 1.83, p < .01). In a separate model, anxiety scores before the pandemic (ß = -0.25, p < .01) and having prior medical conditions (ß = -1.53, p < .001) were associated with decreased psychological well-being scores during the pandemic. In the change model, having a prior medical condition was associated with an increasing change in boredom, anxiety, and well-being. Older age was associated with decreasing changes in boredom and well-being scores. Conclusions: This study is the first in Ghana to provide evidence of the changes in boredom, anxiety and psychological well-being during the COVID-19 pandemic. The findings underscore the need for the inclusion of mental health interventions as part of the current pandemic control protocol and public health preparedness towards infectious disease outbreaks.Item Prevalence and changes in boredom, anxiety and well-being among Ghanaians during the COVID-19 pandemic: a population-based study(BMC Public Health, 2021) Boateng, G.O.; Doku, D.T.; Enyan, N.I.E.; Owusu, S. A.; Aboh, I.K.; Kodom, R.V.; Ekumah, B.; Quansah, R.; Boamah, S.A.; Obiri-Yeboah, D.; Nsabimana, E.; Jansen, S.; Armah, F.A.Background: The outbreak of the COVID-19 pandemic has been associated with several adverse health outcomes. However, few studies in sub-Saharan Africa have examined its deleterious consequences on mental health. Therefore, we investigated the prevalence and changes in boredom, anxiety and psychological well-being before and during the COVID-19 pandemic in Ghana. Methods: Data for this study were drawn from an online survey of 811 participants that collected retrospective information on mental health measures including symptoms of generalized anxiety disorder, boredom, and well being. Additional data were collected on COVID-19 related measures, biosocial (e.g. age and sex) and sociocultural factors (e.g., education, occupation, marital status). Following descriptive and psychometric evaluation of measures used, multiple linear regression was used to assess the relationships between predictor variables and boredom, anxiety and psychological well-being scores during the pandemic. Second, we assessed the effect of anxiety on psychological well-being. Next, we assessed predictors of the changes in boredom, anxiety, and well-being. Results: Before the COVID-19 pandemic, 63.5% reported better well-being, 11.6% symptoms of anxiety, and 29.6% symptoms of boredom. Comparing experiences before and during the pandemic, there was an increase in boredom and anxiety symptomatology, and a decrease in well-being mean scores. The adjusted model shows participants with existing medical conditions had higher scores on boredom (ß = 1.76, p < .001) and anxiety (ß = 1.83, p < .01). In a separate model, anxiety scores before the pandemic (ß = -0.25, p < .01) and having prior medical conditions (ß = -1.53, p < .001) were associated with decreased psychological well-being scores during the pandemic. In the change model, having a prior medical condition was associated with an increasing change in boredom, anxiety, and well-being. Older age was associated with decreasing changes in boredom and well-being scores. Conclusions: This study is the first in Ghana to provide evidence of the changes in boredom, anxiety and psychological well-being during the COVID-19 pandemic. The findings underscore the need for the inclusion of mental health interventions as part of the current pandemic control protocol and public health preparedness towards infectious disease outbreaks.Item Rapidly increasing prevalence of overweight and obesity in older Ghanaian adults from 2007-2015: Evidence from WHO-SAGE Waves 1 & 2(Plos One, 2019-08-19) Biritwum, R.B.; Lartey, S.T.; Magnussen, C.G.; Si, L.; Boateng, G.O.; de Graaff, B.; Minicuci, N.; Kowal, P.; Blizzard, L.; Palmer, A.J.Background Studies on changes in the prevalence and determinants of obesity in older adults living in sub-Saharan Africa are scarce. We examined recent changes in obesity prevalence and associated factors for older adults in Ghana between 2007/08 and 2014/15. Methods Data on adults aged 50 years and older in Ghana were drawn from the WHO SAGE 2007/ 08 (Wave 1; n = 4158) and 2014/15 (Wave 2; n = 1663). The weighted prevalence of obesity, overweight, normal weight and underweight, and of high central adiposity were compared in 2007/08 and 2014/15. Multinomial and binomial logistic regressions were used to examine whether the determinants of weight status based on objectively measured body mass index and waist circumference changed between the two time periods. Results The prevalence of overweight (2007/08 = 19.6%, 95% CI: 18.0–21.4%; 2014/15 = 24.5%, 95% CI: 21.7–27.5%) and obesity (2007/08 = 10.2%, 95% CI: 8.9–11.7%; 2014/15 = 15.0%, 95% CI: 12.6–17.7%) was higher in 2014/15 than 2007/08 and more than half of the population had high central adiposity (2007/08 = 57.7%, 95% CI: 55.4–60.1%; 2014/15 = 66.9%, 95% CI: 63.7–70.0%) in both study periods. While the prevalence of overweight increased in both sexes, obesity prevalence was 16% lower in males and 55% higher in females comparing 2007/08 to 2014/15. Female sex, urban residence, and high household wealth were associated with higher odds of overweight/obesity and high central adiposity. Those aged 70+ years had lower odds of obesity in both study waves. In 2014/15, females who did not meet the recommended physical activity were more likely to be obese. Conclusion Over the 7-year period between the surveys, the prevalence of underweight decreased and overweight increased in both sexes, while obesity decreased in males but increased in females. The difference in obesity prevalence may point to differential impacts of past initiatives to reduce overweight and obesity, potential high-risk groups in Ghana, and the need to increase surveillanceItem The role of intergenerational educational mobility and household wealth in adult obesity: Evidence from Wave 2 of the World Health Organization’s Study on global AGEing and adult health(PLoS ONE, 2019-01) Lartey, S.T.; Magnussen, C.G.; De Graaff, B.; Biritwum, R.B.; Mensah, G.; Yawson, A.; Minicuci, N.; Kowal, P.; Boateng, G.O.; Palmer, A.J.BACKGROUND: Obesity has emerged as a major risk factor for non-communicable diseases in low and middle-income countries but may not follow typical socioeconomic status (SES)-related gradients seen in higher income countries. This study examines the associations between current and lifetime markers of SES and BMI categories (underweight, normal weight, overweight, obese) and central adiposity in Ghanaian adults. METHODS: Data from 4,464 adults (2,610 women) who participated in the World Health Organization's Study on global AGEing and adult health (SAGE) Wave 2 were examined. Multilevel multinomial and binomial logistic regression models were used to examine associations. SES markers included parental education, individual education, intergenerational educational mobility and household wealth. Intergenerational educational mobility was classified: stable-low (low parental and low individual education), stable-high (high parental and high individual education), upwardly (low parental and high individual education), or downwardly mobile (high parental and low individual education). RESULTS: The prevalence of obesity (12.9%) exceeded the prevalence of underweight (7.2%) in the population. High parental and individual education were significantly associated with higher odds of obesity and central adiposity in women. Compared to the stable low pattern, stable high (obesity: OR = 3.15; 95% CI: 1.96, 5.05; central adiposity: OR = 1.75; 95% CI: 1.03, 2.98) and upwardly (obesity: OR = 1.71; 95% CI: 11.13, 2.60; central adiposity: OR = 1.60; 95% CI: 1.08, 2.37) mobile education patterns were associated with higher odds of obesity and central adiposity in women, while stable high pattern was associated with higher odds of overweight (OR = 1.88; 95% CI: 1.11, 3.19) in men. Additionally, high compared to the lowest household wealth was associated with high odds of obesity and central adiposity in both sexes. CONCLUSION: Stable high and upwardly mobile education patterns are associated with higher odds of obesity and central adiposity in women while the stable high pattern was associated with higher odds of overweight in men.