Low-Income, Urban Children’s Perspectives on Physical Activity: A Photovoice Project

Background:Eular give’ s a lot of attention to outline the need of a change in RMD patients life style that is very well outlined into the 2018 Eular recommendations for Physical Activity (PA).Objectives:Driven by those recommendations that says that “PA should be an integral part of standard care throughout the course of disease”, CypLAR decided to create a campaign to promote PA through educating RMD patients on the PA benefits, make them to change their life style and enroll them to PA programs. More over we want to inform Rheumatologist and HPR’s on that effort and enroll them to that campaign.The CypLAR’ s goal through that campaign is to manage and enroll as much as possible patients to PA Programs for a continual period of about 10 months.Methods:To achieve all the above we decided to move to the following steps:Offer PA Programs organized by CypLAR or HPR associatesIncrease awareness regarding the benefits of the PA (Land based & Aquatic) programs to Rheumatologists, HPR’s and RMD patientsIntegrate PA into National Health System and proceduresOffer incentivesResults:We managed to increase the PA programs that we used to offer from 1 to 3 in every major cities with also some more opportunities ahead. That also increases the number of participants attracting around 100 participants instead of 20 that we uses to before.Towards awareness, we presented Exercise rehabilitation in conferences around Europe (Agora 2017,2018,2019, Eular 2018, Cyprus – Crete Conference 2017, 2019, Enfa 2019, Pain Conference, Athens 2019) and also published related articles on CypLAR’s magazine that is published twice a year that is distributed to more than 5000 members.We managed to include the Aquatic Exercise Rehabilitation to the new National Strategic plan for Rheumatic Diseases.As incentives, we created a fund that is addressed to partially support low income patients. Furthermore we acquire special discount membership fees to our members on PA programs that are offered by associates.We organize our own sport related fund events and also participate in others sport funding events. Especially the Charity Swimming Event “Swim for my fellow” which is co-organized by the Iacovou Swimming Centre and Cyplar for the last 5 years is also under the Limassol Municipality Annual Sport Events called “Lemesia” which this year will have an International promotion due Limassol’s Award as the “European City of Sports” for 2020.We are in the process and in contact with big companies in order to become our campaign SponsorsWe attracted a fund of €2000 from Cyprus Sport Organization that offered a partial financial support to 30 patients for their participation in PA programs for 3 months.Conclusion:We all believe that the success on that campaign is based on Education (articles, presentations), the available options (programs/positions to participate) and Incentives (financial) that all of them needs further development.Disclosure of Interests:None declared

Download Full-text

A positive deviance-based qualitative study of stress, coping, and feeding practices among low-income, Hispanic mothers whose children do versus do not meet guidelines for fruit and vegetable intake

Health Education Research ◽

10.1093/her/cyaa037 ◽

2020 ◽

Vol 35 (6) ◽

pp. 584-604

Author(s):

Eleanor Shonkoff ◽

Sara C Folta ◽

Theodore Fitopoulos ◽

Cynthia N Ramirez ◽

Ricky Bluthenthal ◽

...

Keyword(s):

Physical Activity ◽

Qualitative Study ◽

Low Income ◽

Comparison Group ◽

Vegetable Intake ◽

Feeding Practices ◽

The United States ◽

Positive Deviance ◽

Healthy Weight ◽

Hispanic Mothers

Abstract Less than 1% of children in the United States concurrently meet guidelines for fruit/vegetable intake, physical activity, screen time, and sugar-sweetened beverages. Prior evidence suggests that parents of this 1% potentially cope with stress differently. This qualitative study used a positive deviance-based approach to locate mothers whose children avoided negative feeding outcomes despite being ‘high-risk’ for obesity. Semi-structured interviews were conducted in Spanish for two groups: low-income, Hispanic mothers whose children were normal weight and met recommendations for fruits/vegetables and physical activity (n = 5); and a comparison group whose children had obesity and did not meet guidelines (n = 8). Topics included weight-related parenting practices, attitudes toward health, and stress management. Interviews were transcribed, translated, and coded using NVivo for theoretically driven thematic analysis. Results suggested that mothers viewed stress differently. Mothers of healthy weight children believed stress could be prevented, such as by paying children more attention or directing one’s attention away from stressors; comparison group mothers tended to report stress about managing their child’s eating and about financial worries. Future research is needed to understand the underlying sources of these differences (e.g. personality traits, coping practices) and test whether stress prevention interventions can promote healthy parental feeding practices.

Download Full-text

Feelings of safety during daytime walking: associations with mental health, physical activity and cardiometabolic health in high vacancy, low-income neighborhoods in Detroit, Michigan

International Journal of Health Geographics ◽

10.1186/s12942-021-00271-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Amber L. Pearson ◽

Kimberly A. Clevenger ◽

Teresa H. Horton ◽

Joseph C. Gardiner ◽

Ventra Asana ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Low Income ◽

Spatial Data ◽

Vigorous Physical Activity ◽

Future Research ◽

Cardiometabolic Health ◽

Multilevel Regression ◽

Critical Pathway ◽

Perceived Safety

Abstract Introduction Individuals living in low-income neighborhoods have disproportionately high rates of obesity, Type-2 diabetes, and cardiometabolic conditions. Perceived safety in one’s neighborhood may influence stress and physical activity, with cascading effects on cardiometabolic health. Methods In this study, we examined relationships among feelings of safety while walking during the day and mental health [perceived stress (PSS), depression score], moderate-to-vigorous physical activity (PA), Body Mass Index (BMI), and hemoglobin A1C (A1C) in low-income, high-vacancy neighborhoods in Detroit, Michigan. We recruited 69 adults who wore accelerometers for one week and completed a survey on demographics, mental health, and neighborhood perceptions. Anthropometrics were collected and A1C was measured using A1CNow test strips. We compiled spatial data on vacant buildings and lots across the city. We fitted conventional and multilevel regression models to predict each outcome, using perceived safety during daytime walking as the independent variable of interest and individual or both individual and neighborhood-level covariates (e.g., number of vacant lots). Last, we examined trends in neighborhood features according to perceived safety. Results In this predominantly African American sample (91%), 47% felt unsafe during daytime walking. Feelings of perceived safety significantly predicted PSS (β = − 2.34, p = 0.017), depression scores (β = − 4.22, p = 0.006), and BMI (β = − 2.87, p = 0.01), after full adjustment. For PA, we detected a significant association for sex only. For A1C we detected significant associations with blighted lots near the home. Those feeling unsafe lived in neighborhoods with higher park area and number of blighted lots. Conclusion Future research is needed to assess a critical pathway through which neighborhood features, including vacant or poor-quality green spaces, may affect obesity—via stress reduction and concomitant effects on cardiometabolic health.

Download Full-text

An ecological momentary assessment study of physical activity behaviors among mothers of toddlers from low-income households

BMC Women s Health ◽

10.1186/s12905-021-01243-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Katherine L. Campbell ◽

Yan Wang ◽

Ann Pulling Kuhn ◽

Maureen M. Black ◽

Erin R. Hager

Keyword(s):

Physical Activity ◽

Low Income ◽

Ecological Momentary Assessment ◽

Normal Weight ◽

Activity Count ◽

Group Relations ◽

Environment Factors ◽

Group Relation ◽

Ecological Momentary ◽

Momentary Assessment

Abstract Background Mothers of young children from low-income communities may be vulnerable to barriers associated with low physical activity. The purpose of this study was to examine associations between home environment factors and maternal physical activity among mothers of toddlers. Methods Mothers of toddlers (n = 200) recruited from low-income communities simultaneously wore an ankle-placed accelerometer and were given a personal digital assistant for ecological momentary assessment. Mothers received randomly prompted questions about their current environment, activity, and social setting several times a day over eight consecutive days. Data were analyzed using linear mixed-effects regression models with random intercepts; within-group and between-group relations between physical activity and environment factors were disaggregated. Results Within-group relations included higher physical activity counts for specific mothers with television off versus on (95% CI = 130.45, 199.17), children absent versus present (95% CI = 82.00, 3.43), engaging with a child versus not (95% CI = 52.66, 127.63), and outside versus inside location (95% CI = 277.74, 392.67). Between-group relations included higher physical activity on average when other adults were absent versus present (95% CI = − 282.63, − 46.95). Recruitment site (urban vs. semi-urban) significantly moderated the within-group relation between being outside versus inside and activity count (β = − 243.12, 95% CI = − 358.74, − 127.47), and showed stronger relations among urban mothers (β = 440.33, 95% CI = 358.41, 522.25), than semi-urban (β = 190.37, 95% CI = 109.64, 271.11). Maternal body weight significantly moderated the within-group relation between being located outside versus inside the home and activity count (β for interaction = − 188.67, 95% CI = − 308.95, − 68.39), with a stronger relation among mothers with normal weight (β = 451.62, 95% CI = 345.51, 557.73), than mothers with overweight/obesity (β = 271.95, 95% CI = 204.26, 339.64). Conclusions This study highlights home environmental factors, including screen time, the presence of others (adults and children), and location (i.e., outside versus inside) that may relate to maternal physical activity behaviors. Understanding factors associated with physical activity could reduce physical activity disparities. Trial registry ClinicalTrials. NCT02615158, April 2006

Download Full-text

Evaluation of a Low-Cost Commercial Actigraph and Its Potential Use in Detecting Cultural Variations in Physical Activity and Sleep

Sensors ◽

10.3390/s21113774 ◽

2021 ◽

Vol 21 (11) ◽

pp. 3774

Author(s):

Pavlos Topalidis ◽

Cristina Florea ◽

Esther-Sevil Eigl ◽

Anton Kurapov ◽

Carlos Alberto Beltran Leon ◽

...

Keyword(s):

Physical Activity ◽

Low Income ◽

Large Scale ◽

Low Cost ◽

Low Income Countries ◽

Time Data ◽

Cultural Variations ◽

Step Counts ◽

Scale Step ◽

Potential Use

The purpose of the present study was to evaluate the performance of a low-cost commercial smartwatch, the Xiaomi Mi Band (MB), in extracting physical activity and sleep-related measures and show its potential use in addressing questions that require large-scale real-time data and/or intercultural data including low-income countries. We evaluated physical activity and sleep-related measures and discussed the potential application of such devices for large-scale step and sleep data acquisition. To that end, we conducted two separate studies. In Study 1, we evaluated the performance of MB by comparing it to the GT3X (ActiGraph, wGT3X-BT), a scientific actigraph used in research, as well as subjective sleep reports. In Study 2, we distributed the MB across four countries (Austria, Germany, Cuba, and Ukraine) and investigated physical activity and sleep among these countries. The results of Study 1 indicated that MB step counts correlated highly with the scientific GT3X device, but did display biases. In addition, the MB-derived wake-up and total-sleep-times showed high agreement with subjective reports, but partly deviated from GT3X predictions. Study 2 revealed similar MB step counts across countries, but significant later wake-up and bedtimes for Ukraine than the other countries. We hope that our studies will stimulate future large-scale sensor-based physical activity and sleep research studies, including various cultures.

Download Full-text

Economics of physical activity in low-income and middle- income countries: a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-037784 ◽

2021 ◽

Vol 11 (1) ◽

pp. e037784

Author(s):

Priyanga Diloshini Ranasinghe ◽

Subhash Pokhrel ◽

Nana Kwame Anokye

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Economic Evaluation ◽

Drug Treatment ◽

Chronic Diseases ◽

Low Income ◽

Economic Burden ◽

Eligibility Criteria ◽

Middle Income ◽

Middle Income Countries

BackgroundPromotion of physical activity (PA) among populations is a global health investment. However, evidence on economic aspects of PA is sparse and scattered in low-income and middle-income countries (LMICs).ObjectiveThe objective of this study was to summarise the available evidence on economics of PA in LMICs, identify potential target variables for policy and report gaps in the existing economic evidence alongside research recommendations.Data sourcesA systematic review of the electronic databases (Scopus, Web of Science and SPORTDiscus) and grey literature.Study eligibility criteriaCost-of-illness studies, economic evaluations, interventions and descriptive studies on economic factors associated with PA using preset eligibility criteria.Study appraisal and synthesis of methodsScreening, study selection and quality appraisal based on standard checklists performed by two reviewers with consensus of a third reviewer. Descriptive synthesis of data was performed.ResultsThe majority of the studies were from upper-middle-income countries (n=16, 88.8%) and mainly from Brazil (n=9, 50%). Only one economic evaluation study was found. The focus of the reviewed literature spanned the economic burden of physical inactivity (n=4, 22%), relationship between PA and costs (n=6, 46%) and socioeconomic determinants of PA (n=7, 39%). The findings showed a considerable economic burden due to insufficient PA, with LMICs accounting for 75% of disability-adjusted life years (DALYs) globally due to insufficient PA. Socioeconomic correlates of PA were identified, and inverse relationship of PA with the cost of chronic diseases was established. Regular PA along with drug treatment as a treatment scheme for chronic diseases showed advantages with a cost–utility ratio of US$3.21/quality-adjusted life year (QALY) compared with the drug treatment-only group (US$3.92/QALY) by the only economic evaluation conducted in the LMIC, Brazil.LimitationsMeta-analysis was not performed due to heterogeneity of the studies.Conclusions and recommendationsEconomic evaluation studies for PA promotion interventions/strategies and local research from low-income countries are grossly inadequate. Setting economic research agenda in LMICs ought to be prioritised in those areas.PROSPERO registration numberCRD42018099856.

Download Full-text