Motivational program to promote physical activity

WCPT-AWP Congress 2013

Hana Al-Sobayel, MSc, PhDEinas Al-Eisa, MSc, PhD

KING SAUD UNIVERSITYRIYADH, SAUDI ARABIA

COMBINED MOTIVATION PROGRAM AND PEDOMETER USE TO PROMOTE PHYSICAL ACTIVITY: A RANDOMIZED

CONTROLLED TRIAL



Saudi Women’s Health


Physical Inactivity a Major Risk

According to MOH / WHO 2012 - 2013

hypertension diabetes hyperlipedeamia obesity central obesity smoking physical inactivity0

5

10

15

20

25

30

35

40

Risk Factors for NCD (%)


Non-Communicable Diseases Cause of Death

According to WHO 2010


Globally, 31% of adults aged 15+ were insufficiently active (men 28% and women 34%)

(WHO 2008)


In May 2004, the 57th World Health Assembly (WHA) endorsed the WorldHealth Organization (WHO) Global Strategy on Diet, Physical Activityand Health. The Strategy was developed through a wide-ranging series ofconsultations with all concerned stakeholders in response to a request fromMember States at World Health Assembly 2002 (Resolution WHA55.23).


Conference on healthy lifestyle and non-communicable diseases in the Arab world and the Middle east


Relevance

Alarming level of physical inactivity among the Saudi population: inactivity prevalence 97% (Al-Nozha et al, 2007; Al-Rafaee & Al-Hazzaa, 2001)

Saudi populations studied: males, children, adolescents

(Al-Hazzaa, 2002; Al-Hazzaa & Sulaiman, 1993)


Saudi Females?

The literature suggests a specific gender-based consideration when making recommendations to promote physical activity

gender as a primary consideration (White et al.,

2005)

Prevalence of obesity related to sedentary life style has been escalating among Saudi females

(El-Hazmi & Warsy, 2000)

How active?? Step count..

KSA vs Target Step count0

2000

4000

6000

8000

10000

12000

KSATarget

(Al-Eisa and Al-Sobayel 2012)

Step counts around the world

Country0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

KSAUKUSACanadaGerJapanSwissFinlandAust

(Al-Eisa and Al-Sobayel 2012)


Prescribing PA

There is no universally accepted method to promote physical activity due to the multiple factors that influence physical activity


Why walking?

The most likely to increase physical activity: • a population level (Hillsdon & Thorogood, 1996)

• for sedentary adults (Ogilvie et al, 2007)

• Physical & psychological health benefits• Low intensity & high accessibility• Ease to physically perform • Low cost

(Blacklock et al., 2007; Duncan & Mummery, 2005; Manson et al., 2002; Rhodes et al, 2006)


Pedometer Promote PA?

Using a pedometer can provide a reminder to be more active

Pedometers when used in combination with other strategies improved physical activity

(Chan et al., 2004; Dinger et al., 2007; De Cocker et al., 2008)


Objective

Effectiveness of the use of a pedometer, in addition to a motivational education program, in improving adherence to a walking program , and improving physical activity levels and general

health parameters of Saudi women.


Methods

Inclusion criteria

-Saudi females (18-45 yrs)

-Residing in Riyadh -Able to read and write

Exclusion criteria

-History of fracture or surgery to the back, pelvis, or lower limb- Contraindications to increased walking - Current complain of conditions affecting the ability to walk - Pregnancy- Eating disorders- Conditions affecting cognitive function or communication


Measurement of walking

Pedometers are small devices that can be worn at the waist or ankle, and are capable of counting number of steps (Vitolins et al, 2000)

Pedometers are considered valid and reliable tools with which to measure physical activity

(Tudor-Locke, 2004)


Measurement of Health Parameters

BMIBlood pressure

Heart rateBlood glucose level

Percutaneous oxygen saturation (SpO2) ,Fat composition


Intervention

A single 2 hour educational session:conducted by two senior physical therapists, both of whom were

experienced in patient education, and included information regarding the importance of physical activity and provision of a

handout on the benefits of regular walking .

Weekly motivational text messages sent to the participants’ mobile phones .


Study group (n=81) Control group (n=80)

2 hrs educational sessionWeekly motivational text

messagesPedometer daily record

2 hrs educational sessionWeekly motivational text

messages

Procedure


Results


Participants


Step Count

1 2 3 4 5 6 7 85000

5200

5400

5600

5800

6000

6200

Step count

Weeks

Aver

age

Step

Cou

nt


Low step count

The social & environmental context could be a barrier to increasing physical activities.

(Mabry et al. 2010 )

Prevalence of physical inactivity is high among women world wide.

(WHO 2009)

Step count did not improve after the intervention


Environment


Effectiveness of the Intervention

Adherence to the intervention by the experimental group was significantly higher (p = 0.021)

Other measures: no significant difference

90%

40%

Intervention Control


Health outcomes

No change of health outcomes:Good health status on baseline

Short term intervention

Combining pedometer with an intervention toolkit on physical activity did no difference in Denmark.

(Petersen et al. 2012 )


What’s Next

“Number of steps or walking duration may not be a good estimator of time being active, and that a considerable

underestimation may occur”.(Bussmann & van den Berg-Emon 2013)

Consider physical behavious not only physical activity

Need for multi-sectorial interventions

Consider context and beliefs



Acknowledgment

King Saud University

King Abdulaziz City for Science & Technology

Health & Medicine

Motivational program to promote physical activity