Correlates, facilitators and barriers of physical activity among primary care patients with prediabetes in Singapore – a mixed methods approach

Abstract

BackgroundPrimary care patients with prediabetes is a priority group in the clinical, organisational and policy contexts. Engaging in regular physical activity is crucial to prevent diabetes for this group. The objectives of the study were to assess factors associated with meeting the recommendation of at least 150 min of moderate/vigorous physical activity weekly, and to explore facilitators and barriers related to the behaviour among primary care patients with prediabetes in Singapore.MethodsThis was a mixed methods study, consisting of a cross-sectional survey involving 433 participants from 8 polyclinics, and in-depth interviews with 48 of them. Adjusted prevalence ratios (aPR) were obtained by mixed effects Poisson regression model. The socio-ecological model (SEM) was applied, and thematic analysis performed.ResultsThe prevalence of meeting the recommendation was 65.8%. This was positively associated with being male (aPR 1.21, 95%CI 1.09–1.34), living in 4–5 room public housing (aPR 1.19, 95%CI 1.07–1.31), living in executive flat/private housing (aPR 1.26, 95%CI 1.06–1.50), having family members/friends to exercise with (aPR 1.57, 95%CI 1.38–1.78); and negatively associated with a personal history of osteoarthritis (aPR 0.75, 95%CI 0.59–0.96), as well as time spent sitting or reclining daily (aPR 0.96, 95%CI 0.94–0.98). The recurrent themes for not meeting the recommendation included lacking companionship from family members/friends, medical conditions hindering physical activity (particularly osteoarthritis), lacking knowledge/skills to exercise properly, “no time” to exercise and barriers pertaining to exercise facilities in the neighbourhood. The recurrent themes for meeting the recommendation included family/peer influence, health/well-being concerns and education by healthcare professionals.ConclusionsMuch more remains to be done to promote physical activity among primary care patients with prediabetes in Singapore. Participants reported facilitators and barriers to physical activity at different levels of the SEM. Apart from the individual and interpersonal levels, practitioners and policy makers need to work together to address the organisational, community and policy barriers to physical activity.

Child school injury in Lebanon: A study to assess injury incidence, severity and risk factors

“…consistent with similar school injury studies in the region namely, that 'Fall' injuries are the most common mechanism, particularly among boys of a young age [13][14][15][16][17][18][19][20][21][22].…”

“…Relative to other regional studies, this study estimated a school injury rate of 419/1000, which is comparable to rates suggested by Eastern Mediterranean countries, including Jordan (437/1000), Egypt (385/1000), Oman (263/1000), and UAE (307/1000) [13][14][15][16][17][18][19][20][21], retrieved from the Global School-Based Students Health Survey (GSBHS). Findings from this study are https://doi.org/10.1371/journal.pone.0233465.g001…”

“…Limited research has explored child injuries in the Eastern Mediterranean Region, and few have examined the nature, extent and risk factors of school-based injuries in particular [13][14][15][16][17][18][19][20][21][22]. Among regional studies, the most commonly reported school injury type was a fracture, with the most prevalent injury cause being fall, sustained mainly by boys of younger age.…”

“…Among regional studies, the most commonly reported school injury type was a fracture, with the most prevalent injury cause being fall, sustained mainly by boys of younger age. Bullying, fights and physical attacks were also experienced by school children regionally [13][14][15][16][17][18][19][20][21][22]. In Lebanon, school-based injuries have received less attention in the injury research literature.…”

Predictors of unmet need for contraception among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa: A multilevel mixed effects analysis

“…Model PLOS ONE the socio-cultural norms surrounding access to contraceptives among adolescents in SSA [51][52][53]. Again, young women, compared to adolescent girls are more likely to be married and start childbearing and might not have the desire to delay or limit childbearing [54,55]. Those who have more children may however desire to limit or delay childbearing and can experience unmet need for contraception.…”