Assessment Of Physical Activity Knowledge, Stages Of Behaviour Change, Practices And Non-Communicable Diseases Among Adult Out-Patient Attendants Of Lekma Hospital.

Abstract

Background: Physical inactivity is the fourth leading cause of global mortality and a significant cause of non-communicable diseases (NCDs). There is a reported increase in physical inactivity levels among adults due to urbanization and technological advancements. Conversely, physical activity reduces the risk of developing NCDs and their associated burdens. Engaging in physical activity is influenced by the understanding of prescribed physical activity recommendations, which initiates behavioural change to engage in and maintain the levels of physical activity. Objectives: To assess physical activity knowledge, stages of behaviour change, activity level, and their association with NCDs among adult attendants of the out-patient department of Ledzokuku Municipal Assembly (LEKMA) Hospital. Method: The study adopted a mixed method design. A descriptive cross-sectional study was used to obtain quantitative data, while focus group discussion (FGD) was used to obtain qualitative data for this study. A stratified and quota sampling technique was used to recruit the eligible participants into the quantitative study. A self-designed questionnaire, Physical Activity Stages of Change Questionnaire and the Global Physical Activity Questionnaire were used to collect data on sociodemographic characteristics, stages of physical activity behaviour and physical activity level respectively. Two separate FGDs was organised for 9 purposively sampled participants from the quantitative study and 10 community health nurses at LEKMA hospital. Descriptive analysis was done for socio-demographic data whiles Chi-square and logistic regression were used for inferential analysis at a significance level of p<0.05 and 95% confidence interval. Recorded discussions were transcribed verbatim and analysed by content thematic analysis. Descriptive analysis of frequencies, percentages, mean and standard deviation were carried out for all the sections (sections A-C) of the questionnaire. Chi-square and multiple logistic regression were used for inferential analysis at a significance level of p<0.05 and 95% confidence interval. Results: Out of the 480 respondents, 203 (42.3%) were males and 277 (57.7%) were females. Majority, 287 (59.9), had a normal BMI while 185 (38.8) were either overweight or obese. One hundred and eighty-five (38.5%) were married and a greater portion, 281 (58.5%), had at least one child. Regarding stage of behaviour change for physical activity, using the Transtheoretical Model, the majority 273 (58.9%) of the participants were in the pre-action stage, and 197 (41.1%) were in the action stage. Eighty-two (17.1%) knew and stated correctly the recommended physical activity level for adults to stay healthy. The prevalence of selected NCDs among the respondents was 26.7%. Results of the Chi Square test indicated that there was a significant association between participation in physical activity and gender (X2 =37.64, p< 0.001), age range (X2 = 35.93, p<0.001), marital status (X2 = 14.76, p=0.005) , having a child (X2 = 9.93, p=0.002), education (X2 =24.68, p< 0.001), occupation (X2 = 17.32, p=0.004), sedentary behaviour (X2 =101.43, p<0.001), behaviour change (X2 =178.97, p<0.001) and impact of COVID-19 pandemic (X2 =4.72, p=0.030). The test also showed that there was significant association between the prevalence of NCDs and gender (X2 =10.00, p=0.002), age (X2 =89.48, p<0.001), BMI (X2 =33.60, p<0.001), marital status (X2 =67.30, p<0.001), having a child (X2 =39.68, p<0.001), educational status (X2 =31.24, p<0.001), occupation (X2 =36.03, p<0.001), alcohol (X2 =18.33, p<0.001), family history (X2 =30.39, p<0.001), sedentary behaviour (X2 =4.13, p=0.042) and participation in physical activity (X2 =12.68, p<0.001) Conclusion: Knowledge of physical activity recommendation was very low among the adults and majority were in the pre-action stage based on the Transtheoretical Model. More than half of the adults were physically inactive according to the WHO requirement. The most prevalent NCDs among the adults was hypertension. Factors that independently influenced participation in physical activity were gender, age, stages of physical activity behaviour change and sedentary behaviour. Also, gender, age, marital status, alcohol consumption and family history are the factors that independently predicted the likelihood of developing NCDs Keywords: Physical activity, Stages of physical activity behaviour change, physical activity recommendations, non-communicable diseases, sedentary behaviour.