Developing and testing a culturally sensitive health information leaflet on the consequences of alcohol abuse

AbstractBackground: Alcohol consumption is one of the main modifiable risk factors that contributeto the global burden of diseases. Alcohol consumption is amongst the fast-growing non-communicable diseases commonly found in low-and middle-income countries. There is therefore a strong need to design and use health education materials that address the problem in these countries. Objectives: The objective of this study was to develop and test a context-specific and culturally sensitive health information leaflet (HIL) on the health consequences of alcohol abuse. The HIL was intended for use by support staff with limited literacy at Rhodes University. The study was conducted over a period of three months at Rhodes University, Grahamstown, South Africa. Methods: A HIL was designed using a four-draft process, and then, subjected to readability testing. The testing was carried out using seven readability formulae. This was followed by a quality and suitability assessment using the Suitability Assessment of Materials instrument and the Patient Education Materials Assessment Tool. Five support staff members and nine peer educators were selected from Rhodes University to take part inthe pilot testing and focus group discussions, respectively. Convenience sampling technique was used to select the study participants.Results: The HIL obtained a readability score of grade 12. This readability score was found to be difficult to read. However, ignoringcertain medical termssuch as disease and numbness, which were thought to be familiar, enough to the participants may result in more favourable readability scores.Conclusions: The HIL obtained an average readability score of grade 12, which fell within the target range of this study. A HIL in which care about readability, cultural sensitivity, and the extent of an end-user participation has been taken may improve the reception, by the target audience, of the intended communication. This may eventually enhance the implementation of future health interventions for support staff at Rhodes University. [Ethiop. J. Health Dev. 2018; 32(1):46-53

Studying the consumption and health outcomes of fiscal interventions (taxes and subsidies) on food and beverages in countries of different income classifications; a systematic review.

BACKGROUND: Governments use fiscal interventions (FIs) on food and beverages to encourage healthy food behaviour and positive health outcomes. The objective of this review was to study the behavioural and health outcomes of implemented food and beverage FIs in the form of taxes and subsidies in countries of different income classifications. METHODS: The present systematic review was conducted in accordance with Cochrane protocols. The search was carried out on academic and grey literature in English, for studies conducted in different countries on implemented FIs on food and non-alcoholic beverages and health outcomes, with a special focus on the income of those countries. RESULTS: Eighteen studies met the inclusion criteria and 14 were from peer- reviewed journals. Thirteen studies came from high-income (HI) countries, four from upper middle-income (UMI) countries and only one came from a lower middle-income (LMI) country. There were no studies from lower-income (LI) countries. Of these 18 studies; nine focused on taxes, all of which were from HI countries. Evidence suggests that FIs on foods can influence consumption of taxed and subsidized foods and consequently have the potential to improve health. CONCLUSION: Although this review supports previous findings that FIs can have an impact on healthy food consumption, it also highlights the lack of evidence available from UMI, LMI and LI countries on such interventions. Therefore, evidence from HI countries may not be directly applicable to middle-income and LI countries. Similar research conducted in middle and low income countries will be beneficial in advocating policy makers on the effectiveness of FIs in countering the growing issues of non-communicable diseases in these countries

Age-related comparisons by sex in the domains of aerobic physical activity for adults in Scotland.

OBJECTIVE: To investigate the age-related differences in the contributions of the domains of physical activity (PA) for men and women in Scotland who met the current PA guidelines or who were insufficiently active. METHODS: We analysed data from the 2013 Scottish Health Survey (4885 adults (≥ 16 years)). Average weekly minutes of moderate or vigorous PA (MVPA) and the relative contributions to total MVPA were calculated for the domains of: walking, cycling, domestic, leisure, occupational, outdoor, non-team sport, team sport, and exercise & fitness. We performed linear regression analyses to assess differences by 10-year age group, stratified by sex and activity status (1-149 or ≥ 150 min of MVPA per week). These were repeated excluding occupational activity due to concerns with its measurement. RESULTS: For the 64.3% of the sample that met the guidelines, occupational activity was the most prevalent domain accounting for 18-26% of all MVPA for those under 65 years. When excluded, there was no age-related decline in total MVPA (p > 0.05). For the 18.6% of the sample that reported 1-149 min of MVPA per week, domestic activity was the most prevalent domain. Across both sexes and activity statuses, exercise & fitness declined with age and walking was most prevalent in the oldest age group. CONCLUSION: The domains in which adults in Scotland undertake MVPA vary by age group. Policies designed to increase PA should take this into account. Our findings challenge current thinking on age-related changes in activity, with the exclusion of occupational activity mitigating any age-related decline in MVPA.University of Edinburgh College Research Awar

‘Making every contact count’ with patients with musculoskeletal conditions : a qualitative exploration of acceptability to physiotherapists

Funding Information: The authors would like to thank the participants for their contribution to this research. The lead researcher, Amelia Parchment, would also like to thank Funds for Women Graduates for awarding her with a grant enabling her to complete this study, within a programme of research, following severe disruptions caused by the COVID-19 pandemic. Funding PhD studentship funded by University of Bath and Health Education England.Peer reviewedPublisher PD

How useful is the Making Every Contact Count Healthy Conversation Skills approach for supporting people with musculoskeletal conditions?

Funding: PhD studentship funded by University of Bath and Health Education England. Ethical approvals were granted by the NHS Health Research Authority (REC reference: 20/HRA/2919) and University of Bath’s Research Ethics Approval Committee for Health (reference: EP 19/20 057).Peer reviewedPublisher PD

Life in lockdown:a qualitative study exploring the experience of living through the initial COVID-19 lockdown in the UK and its impact on diet, physical activity and mental health.

Background In response to the COVID-19 pandemic, the UK imposed a national lockdown prompting change to daily routines. Among behaviours impacted by the lockdown, diet and physical activity may be particularly important due to their association with mental health and physical health. The aim of this study was to explore people’s experiences of how lockdown impacted their physical activity, dietary behaviours and mental health, with a view to informing public health promotion. Methods This phenomenological qualitative study used semi-structured telephone interviews. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was conducted, guided by the Framework Approach. Results Forty participants (28 female) completed an interview (mean duration: 36 min) between May and July 2020. The overarching themes identified were (i) Disruption (loss of routines, social interaction and cues to physical activity) and (ii) Adaptation (structuring the day, accessing the outdoor environment, finding new ways for social support). The disruption to daily routines altered people’s cues for physical activity and eating; some participants spoke of comfort eating and increased alcohol intake in the early days of lockdown, and how they consciously tried to change these when restrictions lasted longer than first anticipated. Others spoke of adapting to the restrictions using food preparation and meals to provide both routine and social time for families. Disruptions from the closure of workplaces resulted in flexible working times for some, allowing for physical activity to be built into the day. In later stages of restrictions, physical activity became an opportunity for social interaction and several participants reported intending to continue to replace sedentary means of socialising (e.g., meeting in cafes) with more active, outdoor activities (e.g., walking) once restrictions were lifted. Staying active and building activity into the day was seen as important to support physical and mental health during the challenging times of the pandemic. Conclusions Whilst many participants found the UK lockdown challenging, adaptations to cope with the restrictions presented some positive changes related to physical activity and diet behaviours. Helping people sustain their new healthier activities since restrictions have lifted is a challenge but presents an opportunity for public health promotion

Freshman 15 in England:a longitudinal evaluation of first year university student's weight change.

BACKGROUND: Weight change in first year university students, often referred to as ‘Freshman 15’, has been shown to be a common problem in North America. Studies have reported weight gain to be between 1 kg and 4 kg over the academic year and a recent meta-analysis found a mean gain of 1.34 kg and that 61 % of students gained weight. A limited number of studies have investigated weight change in England and large scale studies are needed to understand better weight change trends and to conduct subgroup analyses. This is important in the context of rising obesity prevalence, especially as behaviours and unhealthy weight in early adulthood often remains over the lifetime. METHODS: We recruited students across 23 universities in England to complete a web-based survey at three time points in 2014–2015: beginning of academic year, December, end of academic year. Students were asked to self-report height and weight. We calculated weight change of each student between time points and conducted t-tests and pared analysis of variance to investigate the effect of time, sex and initial BMI. We also investigated weight change amongst weight gainers and in weight losers separately. RESULTS: We followed 215 students over three time points and found a mean weight change of 0.98 kg (95%CI 0.49–1.47) over a mean length of 34 weeks of follow-up. The weight change rate was not significantly different over different terms. Over 51 % of the sample gained more than 0.5 kg by the end of the academic year, with a mean gain of 3.46 kg. Female weight gainers had a significantly lower baseline weight than non-weight gaining females. Twenty-five percent of the sample lost more than 0.5 kg with a mean of −3.21 kg. Within weight losers, males lost significantly more weight than females. CONCLUSION: Our findings reinforce that the first year of university is a crucial time in the life of students during which the majority tend to gain weight. However, we also found that 25 % lost weight, indicating that 75 % of students undergo a meaningful weight change in their first year. Universities must recognise their role in promoting healthy weight maintenance

Assessing the social validity of a brief dietary survey for Sri Lankan adults with a focus on gender:a qualitative study

BACKGROUND: As the World Health Organization urges countries to strengthen their noncommunicable disease monitoring and surveillance activities, setting-specific innovations are emerging. Diet – a key, modifiable risk factor for chronic diseases – is particularly challenging to capture reliably. By socially validating self-report dietary survey tools, we may be able to increase the accuracy and representativeness of data for improved population health outcomes. The purpose of this study was to explore the factors that impact Sri Lankan Brief Dietary Survey (a newly developed tool) and 24-h Dietary Recall participation, engagement, and social validity among Sri Lankan adults. METHODS: We conducted semi-structured interviews with 93 participants (61 women and 32 men) in three Sri Lankan districts (Colombo, Kalutara, and Trincomalee). Interview data were analysed thematically and are presented as non-hierarchical thematic networks. RESULTS: Participants identified a number of factors that influenced their survey participation and engagement. These included the time of day interviews occur, recall ease, level of commitment required, perceived survey value, emotional response to surveys, and interviewer positionality. Many of these factors were gendered, however, both female and male participants expressed a preference for engaging with socially valid research that they felt justified their personal investment in data collection. When explicitly asked to share ideas about how to improve the surveys, many participants opted not to provide suggestions as they felt they lacked the appropriate expertise. CONCLUSIONS: Our findings have implications for the accuracy and equity of dietary surveillance activities, and ultimately the appropriateness and effectiveness of programmes and policies informed by these data. Only through understanding how and why the target population engages with dietary research can we develop socially valid methods that assess and address the dietary risks of individuals and groups that are underrepresented by current conventions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40795-021-00481-9