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      Prevalence, patterns, and correlates of physical activity in Nepal: findings from a nationally representative study using the Global Physical Activity Questionnaire (GPAQ)

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          Abstract

          Background

          The promotion of a physically active lifestyle might help address the increasing burden of non-communicable diseases in Nepal. However, there is a lack of nationally representative estimates of physical activity (PA) prevalence in Nepal. The aim of this nationwide cross-sectional study was to determine domain-specific PA levels and the association of socio-demographic and lifestyle characteristics with total PA among Nepalese adults aged 15–69 years.

          Methods

          The data were collected using self-administered questionnaires in a nationally representative sample of 4143 adults (66.5% females), comprised of both rural and urban populations in Nepal. PA levels were assessed using the Global Physical Activity Questionnaire (GPAQ).

          Results

          Based on self-reported estimates, around 97% (95% confidence interval [CI]: 96–98%) of men and 98% (95% CI: 98–99%) of women were found to meet the recommended levels of PA. Both men and women reported high occupational PA, whilst most participants of both sexes did not report engaging in any leisure-time PA. A multiple regression analysis showed that less self-reported total PA was associated with older age, higher level of education, urban place of residence, never been married, being underweight, and smoking in both sexes and with overweight and obesity in males ( p < 0.05 for all).

          Conclusion

          According to self-reported estimates, majority of Nepalese men and women are meeting the recommended levels of PA. The total self-reported PA in Nepalese adults is high, because many of them have labour intensive jobs. Although older age, higher level of education, urban place of residence, never been married, being underweight, and smoking in both sexes, as well as overweight and obesity in males were inversely associated with self-reported PA, the overall level of PA in all these groups was very high. Given the high overall self-reported PA found in the current study, promoting more PA in Nepal may not be as important as in some other countries; not even in the population groups for which we found a negative association with PA. Nevertheless, future studies should examine whether a more balanced distribution of occupational and leisure-time PA would promote better health among Nepalese adults.

          Electronic supplementary material

          The online version of this article (10.1186/s12889-019-7215-1) contains supplementary material, which is available to authorized users.

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          Most cited references29

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          Limits to the measurement of habitual physical activity by questionnaires.

          Despite extensive use over 40 years, physical activity questionnaires still show limited reliability and validity. Measurements have value in indicating conditions where an increase in physical activity would be beneficial and in monitoring changes in population activity. However, attempts at detailed interpretation in terms of exercise dosage and the extent of resulting health benefits seem premature. Such usage may become possible through the development of standardised instruments that will record the low intensity activities typical of sedentary societies, and will ascribe consistent biological meaning to terms such as light, moderate, and heavy exercise.
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            Translating social ecological theory into guidelines for community health promotion.

            D Stokols (2015)
            Health promotion programs often lack a clearly specified theoretical foundation or are based on narrowly conceived conceptual models. For example, lifestyle modification programs typically emphasize individually focused behavior change strategies, while neglecting the environmental underpinnings of health and illness. This article compares three distinct, yet complementary, theoretical perspectives on health promotion: behavioral change, environmental enhancement, and social ecological models. Key strengths and limitations of each perspective are examined, and core principles of social ecological theory are used to derive practical guidelines for designing and evaluating community health promotion programs. Directions for future health promotion research are discussed, including studies examining the role of intermediaries (e.g., corporate decision-makers, legislators) in promoting the well-being of others, and those evaluating the duration and scope of intervention outcomes.
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              Global physical activity questionnaire (GPAQ): nine country reliability and validity study.

              Instruments to assess physical activity are needed for (inter)national surveillance systems and comparison. Male and female adults were recruited from diverse sociocultural, educational and economic backgrounds in 9 countries (total n = 2657). GPAQ and the International Physical Activity Questionnaire (IPAQ) were administered on at least 2 occasions. Eight countries assessed criterion validity using an objective measure (pedometer or accelerometer) over 7 days. Reliability coefficients were of moderate to substantial strength (Kappa 0.67 to 0.73; Spearman's rho 0.67 to 0.81). Results on concurrent validity between IPAQ and GPAQ also showed a moderate to strong positive relationship (range 0.45 to 0.65). Results on criterion validity were in the poor-fair (range 0.06 to 0.35). There were some observed differences between sex, education, BMI and urban/rural and between countries. Overall GPAQ provides reproducible data and showed a moderate-strong positive correlation with IPAQ, a previously validated and accepted measure of physical activity. Validation of GPAQ produced poor results although the magnitude was similar to the range reported in other studies. Overall, these results indicate that GPAQ is a suitable and acceptable instrument for monitoring physical activity in population health surveillance systems, although further replication of this work in other countries is warranted.
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                Author and article information

                Contributors
                zeljko.pedisic@vu.edu.au
                drnipunsth@gmail.com
                pdloprin@olemiss.edu
                sureshmht@gmail.com
                shivarajmishra@gmail.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                3 July 2019
                3 July 2019
                2019
                : 19
                : 864
                Affiliations
                [1 ]ISNI 0000 0001 0396 9544, GRID grid.1019.9, Institute for Health and Sport, , Victoria University, ; Melbourne, Australia
                [2 ]ISNI 0000 0001 2169 2489, GRID grid.251313.7, Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management, , The University of Mississippi, ; Oxford, USA
                [3 ]GRID grid.500537.4, Ministry of Health and Population, ; Kathmandu, Nepal
                [4 ]Nepal Development Society, Chitwan, Nepal
                Article
                7215
                10.1186/s12889-019-7215-1
                6610855
                31269984
                18dc8431-54f1-4bfa-b3e3-3c1c0c6ec59c
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 12 March 2019
                : 20 June 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Public health
                physical activity,steps survey,nepal
                Public health
                physical activity, steps survey, nepal

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