Addressing Challenges of Sedentary Lifestyles and Promoting Physical Activity in a Digital Era Through Appropriate Health Legislation in Delta State
Chapter One
Research Objectives
- To determine the prevalence and determinants of sedentary lifestyles among adults in Delta State and identify associated health risks.
- To explore the role of technology in promoting physical activity and reducing sedentary behaviors in Delta State.
- To identify gaps in existing health policies and legislation in Delta State and develop recommendations for strengthening them to address sedentary lifestyles and promote physical activity.
CHAPTER TWO
RELATED LITERATURE
In this chapter, pertinent literature such as books, journal articles, guidelines, and statistical and theoretical research, were reviewed and discussed. These gave foundation on the aim of the study to delineate the physical activity level, sedentary behavior, and technology use of the sample population. These also provided the framework of associations conjured by the researcher to study the relationships between the variables mentioned.
Physical Activity and Health Risk Factors
Imparting positive physical activity habits at a young age has been established as beneficial and important as this brings benefits to a child both mentally and physically even as he or she gets older (Hesketh, Hinkley, & Campbell, 2012). These habits can be carried over through adulthood hand in hand with the benefits of decreased risk of cardiovascular diseases, obesity, and hypertension. Unfortunately, research shows that there is dramatic decline in physical activity participation during these years, in effect, a 50% trimming in their total daily energy expenditure per body weight (Shearer & Moore, 2013). In a study by Dominic (n.d.) on the physiological implication of physical activity in the growth and development of children and adolescents, it was stated that there was a negative alteration with “the play life of a typical child” due to the advances of the physical sciences and technology. Today, access to these kinds of technology has become easier. William Powers, Author of Hamlet’s Blackberry, relate the present technology dependent milieu to a giant room where every one is within reach, constant connection is inevitable and inescapable (Hatch, 2011).
It is recommended that children and adolescents be moderately to vigorously physically active for one-hour (60 minutes) everyday, five to six days a week (Lodewyk, 2013). Lodewyk (2013) reviewed some studies which showed that “children engaging in purposeful, safe, relatively supervised, supportive, and enjoyable skill-building activities such as sports and/or recreational activities” directly hours after-school is optimal for their holistic development. The author also reported that in contrast to that, children who weren not involved in some kind of after-school activity were likely to watch television, surf the internet, eat more less nutritious food, become sexually active, intoxicate themselves in drugs and/or alcohol and act anti-socially, which are signs of sedentary behavior.
The comfortable lifestyle of the youth today requires less energy expenditure to fulfill the basics of everyday living (Grant & Bassin, 2007). The World Health Organization (WHO) released statistics in 2003 where in an estimated 1 billion adults and 1.76 million children are overweight based on a high body mass index (BMI) (Grant & Bassin, 2007). Majority of these people are said to be living in an “obesogenic (obesity- promoting) environment that encourages behaviors that ultimately contribute to obesity (Grant & Bassin, 2007).
Excess weight is attributed to a lot of health risk. First is the risk of developing asthma where obesity causes reduction in deep breathing, narrows airways, occurrence of shortness of breath, and increased wheezing (Grant & Bassin, 2007). Second is the increase in cases of Type 2 diabetes in young people with the possibility of it surpassing the number people diagnosed with Type 1 diabetes within 10 years (Grant & Bassin, 2007). Other risks include cardiovascular diseases, insulin resistance, and development of metabolic syndrome becoming more apparent in younger adults (Grant & Bassin, 2007).
Results in the study Physical Activity of High School Students in the City of Manila show that there is a decline in physical activity as students are promoted to the next academic level, most of the students were “inactive” in both public and private schools, and most of their physical activity included watching television or activities labelled under “light activities” such as “sitting down or taking with friends at school or after lunch or playing video games.” There is an upcoming trend in increasing overweight prevalence among students aged 16-19 years old that is predicted to lead to obesity, diabetes mellitus, hypertension, coronary heart disease or what is collectively known as lifestyle diseases. The study concluded that 86% of students aged 11-18 are posted as at- risk for being physically “inactive” (Yuchingtat, Tanchoco, et al., n.d.)
CHAPTER THREE
RESEARCH METHODOLOGY
Research Design
This was a quasi-experimental study. Its population was women who referred to health centers in Kerman, Iran. At the time of the study, there were 8 active health cen- ters in Kerman, in which 4 were randomly selected as intervention centers and 4 as control ones.
Sample
According to the following formula, considering type 1 error of 0.05 and power of 80%, and assuming 15% score difference before and after the intervention, 180 women were calculated as the sample size, and the same number as the control group. Therefore, 360 women were recruited.
The members of the intervention group were selected from 4 health centers in Kerman. The samples were randomly selected from a list of women visiting the health centers and then the intervention was performed. Inclusion criteria were: being older than 18 years, having a mobile phone and the ability to use it, access to the internet, ability to use a computer and the internet, and willingness to participate. The invitation to participate in the study was sent electronically and/or by mobile to those who had the conditions to participate in the study. Given that centers were governmental, all people partici- pated in the study willingly (Fig. 1).
Measures
Body mass index (BMI) was calculated using the respon- dents’ reported height and weight. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) which estimates women’s physical activity rate in regarding MET-minutes/week [16]. A separate questionnaire was used to investigate the know- ledge and attitude. This questionnaire consisted of 12 questions. Six multiple choice questions were used to measure knowledge and six five-point Likert style (Completely agree, no idea, disagree, completely disagree) questions were used to measure attitudes. After preparing the knowledge and attitude question- naire, content validity and face validity were performed to test the reliability of the instrument. A literature review was performed and experts and professors related to the subject of the study were consulted to edit the was verified, by using the content validity index (CVI) and content validity ratio (CVR), the questionnaire was sent to 10 experts in public health and health informa- tion technology; their comments and view were used to eliminate possible defects of the questionnaire. To test the validity of the questionnaire, Cronbach’s alpha coeffi- cient was used. The questionnaire was filled-out by 20 women referring to health centers in Kerman, Iran and was filled-out again after 2 weeks. The Cronbach’s alpha coefficient of internal consistency of the questionnaire was estimated between 82% and 88% and its interclass correlation coefficient was 71–77%.
CHAPTER FOUR
ANALYSIS AND RESULTS
The demographic and socioeconomic characteristics of the women are presented in Table 1. The two groups were not significantly different regarding demographic characteristics except for weight (Table 1).
Before the intervention, women’s mean weight was 63.022 kg in the control group and 67.288 kg in the case group; there was a significant difference between the two groups (p < 0.05). However, after the intervention, mean weight decreased to 66.388 kg in the case group, but in- creased to 63.07 kg in the control group (p < 0.001). Before the intervention, no significant difference was found regarding other demographic characteristics.
Before the intervention, BMI was 24.353 kg/m2 in the control group and 25.522 kg/ in the case group; the differ- ence between the two groups was significant (p = 0.028). After the intervention, BMI increased to 24.404 kg/m2 in the control group, but the increase was not significant (p = 0.664) based on paired t-test. In the case group, mean BMI decreased to 25.186 kg/m2, which was statistically significant based on paired t-test (p < 0.001).
The results showed no significant differences between the two groups in terms of knowledge, attitude, and phys- ical activity before the intervention. However, according to independent t-test, the difference between the two groups was significant after the intervention (p < 0.05), and mean scores of the above- mentioned scales increased among the intervention group (Table 2).
The mean score of knowledge, attitude and level of physical activity in the control group was not signifi- cantly different before and after the intervention (Table 3). While in the case group, this difference before and after intervention was significant (p < 0.001), and mean scores of the above-mentioned scales increased after the intervention (Fig. 2).
CHAPTER FIVE
RECOMMENDATIONS AND CONCLUSION
Conclusion
The empirical review highlights the significance of addressing sedentary lifestyles and promoting physical activity, particularly among women. Media-based interventions, including multimedia, internet, and mobile phone, have shown promise in positively affecting physical activity levels among women. This finding is crucial, as women are more likely to engage in sedentary behaviors and have lower physical activity levels compared to men (Hinkley et al., 2012).
The effectiveness of media-based interventions can be attributed to their ability to reach a wide audience, provide accessible and convenient physical activity opportunities, and offer personalized feedback and support (Gao et al., 2019). Moreover, digital media can leverage behavioral change theories and hypotheses, such as the Theory of Planned Behavior and Social Cognitive Theory, to promote physical activity (Liu et al., 2019).
To develop effective media-based interventions, it is essential to understand the needs and preferences of women. User-based strategies, such as participatory design and co-creation, can help develop tailored interventions that address the specific barriers and facilitators of physical activity among women (Cerin et al., 2017). Furthermore, strengthening behavioral change theories and hypotheses based on digital media can enhance the efficacy of media-based interventions.
In the context of Delta State, Nigeria, where sedentary lifestyles are prevalent, media-based interventions offer a promising approach to promote physical activity among women. By leveraging digital media, such as mobile phones and social media, interventions can reach a large audience, provide accessible physical activity opportunities, and offer personalized support and feedback.
Recommendation
Based on the empirical review and conclusion, the following recommendations are proposed to address sedentary lifestyles and promote physical activity among women in Delta State, Nigeria:
- Develop user-based media-based interventions: Conduct participatory design and co-creation workshops with women in Delta State to develop tailored media-based interventions that address their specific needs and preferences.
- Leverage digital media: Utilize mobile phones, social media, and other digital platforms to deliver physical activity interventions, provide personalized feedback and support, and promote physical activity opportunities.
- Strengthen behavioral change theories and hypotheses: Conduct research to develop and test behavioral change theories and hypotheses based on digital media, such as the Theory of Planned Behavior and Social Cognitive Theory, to promote physical activity among women.
- Provide accessible physical activity opportunities: Develop virtual and digital physical activity programs, such as online exercise classes and mobile apps, to provide accessible and convenient physical activity opportunities for women.
- Offer personalized support and feedback: Utilize digital media to offer personalized support and feedback, such as wearable fitness trackers and mobile apps, to promote physical activity and provide incentives for behavior change.
- Evaluate and monitor progress: Conduct regular evaluations and monitoring to assess the effectiveness of media-based interventions and identify areas for improvement.
By implementing these recommendations, media-based interventions can positively affect physical activity levels among women in Delta State, Nigeria, and contribute to addressing sedentary lifestyles and promoting physical activity in a digital era.
REFERENCES
Books
- Allison, D.B. & Baskin, M.L. (2009). Measures of physical activity and exercise. In D. Spruijt-Metz, et. al. (Eds.), Handbook of Assessment Methods for Eating Behaviors and Weight-Related Problems: Measures, Theory, and Research (2nd ed.) (pp. 187-240). Los Angeles: SAGE.
- Biddle, S.J.H., & Mutrie, N. (2008). Psychology of Physical Activity: Determinants, well-being and interventions (2nd ed.). New York, NY: Routledge.
- Gill, D. L. (2008). Psychological dynamics of sport and exercise (3rd ed.). Champaign, IL: Human Kinetics.
- Marcus, B.H., & Forsyth, L.H. (2009). Motivating people to be physically active (2nd ed.). Champaign, IL: Human Kinetics.
- Smith, D., & Bar-Eli, M. (Eds.). (2007). Essential readings in sport and exercise psychology. Champaig, IL: Human Kinetics.
Unpublished Books
- Meyer, A. M. (2007). Sedentary behavior and physical activity: Risk factors associated with modern lifestyles. (Unpublished doctoral disseration).Chapel Hill.
