Neighborhood environment and quality of life among community-living older adults in Nigeria: The moderating effect of physical activity.

Understanding how neighborhood environments are related to older adults' quality of life (QoL) and physical activity (PA) is important for public health actions on healthy ageing in sub-Saharan Africa. We examined associations of perceived neighborhood environment attributes with QoL among older adults in Nigeria and investigated the moderating effects of PA on these associations. We conducted a cross-sectional study of 353 older adults (mean age = 68.9 ± 9.1 years) selected from 5 high- and low-income communities in Maiduguri, Nigeria. QoL, attributes of the neighborhood environments and PA were self-reported using validated questionnaires. Multi-level models were used to examine the direct associations between neighborhood environment attributes and each of the four domains of QoL (physical health, psychological health, social relationships, and environmental health), as well as the moderating effects of leisure-time and total PA. Seven of nine neighborhood environment features were positively associated with multiple domains of QoL. Residential density, land-use diversity, land-use mix-access, walking infrastructure, traffic safety and 'overall walkability' were positively related to both or either physical health and environmental health QoL among those who are physically active. In contrast, walking infrastructure, traffic safety, and 'overall walkability' were negatively related to psychological health QoL among those not physically active. Our findings suggest being physically active moderates the association of neighborhood environments with QoL among Nigerian older adults. We suggest that designing age-friendly communities and simultaneously promoting PA may be needed to improve QoL and help prepare the Nigerian society for the predicted increase in the older adult population.

Comparison of exercise and physical activity routine and health status among apparently healthy Nigerian adults before and during COVID-19 lockdown: a self-report by social media users.

Background: COVID-19 is a pandemic that ravaged the world in manners that were never seen in the recent past, and one of the measures to stem the tide of this ravaging pandemic is a stay-at-home order referred to as lockdown. This study compares the physical activity status and perceived health of Nigerians before and during the lockdown. Results: Social media platform users (n = 205) were surveyed using a two-part questionnaire. The first part elicited the sociodemographic characteristics of the subject. In the second part, information about their exercise and physical activity, general health, and economic palliatives as offered by the government, non-governmental organizations, and philanthropists were elicited. The frequency of exercise was significantly more (p < 0.05) during the lockdown than before the lockdown. The duration and intensity of the exercise per week were comparable. There was also a negative relationship between the body mass index, frequency, and duration of exercise before and during the lockdown. The subjects perceived their health as worse during (3.70 ± 1.05) the lockdown than before (3.95 ± 0.97) lockdown (Z = - 3.69, p = 0.00). Conclusion: Overall, for these cohorts of social media platform users, lockdown did not adversely affect their exercise routine. It is recommended that there should be specific recommendation on exercise as an important Instrumental Activity of Daily Living [IADL]. Therefore, while this pandemic lockdown lasts and beyond, the safety measures to follow while partaking in this IADL should be included in the public health recommendation.

Associations of Neighborhood Walkability with Sedentary Time in Nigerian Older Adults.

Previous studies have investigated the potential role of neighborhood walkability in reducing sedentary behavior. However, the majority of this research has been conducted in adults and Western developed countries. The purpose of the present study was to examine associations of neighborhood environmental attributes with sedentary time among older adults in Nigeria. Data from 353 randomly-selected community-dwelling older adults (60 years and above) in Maiduguri, Nigeria were analyzed. Perceived attributes of neighborhood environments and self-reported sedentary time were assessed using Nigerian-validated and reliable measures. Outcomes were weekly minutes of total sedentary time, minutes of sitting on a typical weekday, and minutes of sitting on a typical weekend day. In multivariate regression analyses, higher walkability index, proximity to destinations, access to services, traffic safety, and safety from crime were associated with less total sedentary time and sedentary time on both a weekday and a weekend day. Moderation analysis showed that only in men was higher walking infrastructure and safety found to be associated with less sedentary time, and higher street connectivity was associated with more sedentary time. The findings suggest that improving neighborhood walkability may be a mechanism for reducing sedentary time among older adults in Nigeria.

Association between adolescent motherhood and maternal and child health indices in Maiduguri, Nigeria: a community-based cross-sectional study.

INTRODUCTION: Adolescent motherhood (childbearing below 18 years of age) is a major global health and social problem. Understanding the impact of early motherhood on maternal and child health indices is important to community and population health promotion in developing countries. This study examined the association between adolescent motherhood and maternal and child health indices in Maiduguri, Nigeria. METHODS: A cross-sectional design method was used to recruit 220 mothers (age=14-25 years) from four communities in the city of Maiduguri, Northeastern Nigeria. Participants were surveyed using a self-developed interviewer-administered questionnaire that assesses maternal and child health indices and sociodemographic characteristics. Logistic regression analysis was used to compute adjusted OR and 95% CI of the associations between motherhood in adolescence (mothers below 18 years old) and maternal and child health indices. RESULTS: Compared to adult mothers, adolescent mothers were more likely to experience fistula (OR=5.01, 95% CI=3.01 to 14.27), to have postpartum haemorrhage (OR=6.83, 95% CI=2.93 to 15.92), to have sexually transmitted infections (OR=6.29, 95% CI=2.26 to 17.51) and to lose a child within 5 years of birth (OR=3.52, 95% CI=1.07 to 11.60). Children born to adolescent mothers were less likely to have normal weight at birth (OR=0.34, CI=0.15 to 0.73) than those born to adult mothers. CONCLUSION: Adolescent motherhood was associated with negative maternal and child health indices. The findings can be used by public health professionals including physiotherapists in this role to inform effective primary healthcare practice and community health advocacy to improve maternal and child health indices among adolescent mothers in Maiduguri. Future studies are needed to confirm the evidence at the regional or national level including the rural population in Nigeria.

Neighborhood environmental factors are related to health-enhancing physical activity and walking among community dwelling older adults in Nigeria.

Introduction: Health promotion strategies grounded by evidence-based determinants of physical activity constitute an important focus of physiotherapy practice in the twenty-first century. This study investigated associations between neighborhood environmental factors and health-related moderate-to-vigorous physical activity (MVPA) and walking for transportation and recreation among community dwelling Nigerian older adults. Methods: A representative sample of 353 Nigerian older adults (age = 68.9 ± 9.13 years) in a cross-sectional survey provided self-reported min/week of MVPA and walking for transportation and recreation and perceived neighborhood environmental factors. Results: In multilevel linear regression analyses, proximity of destinations (ß = 3.291; CI = 0.392, 6.191), access to services and places (ß = 4.417; CI = 0.995, 7.838), esthetics (ß = 3.603; CI = 0.617, 6.590), traffic safety (ß = 5.685; CI = 3.334, 8.036), and safety from crime (ß = 1.717; CI = 0.466, 2.968) were related to more MVPA. Also, proximity of destinations (ß = 1.656; CI = 0.022, 3.291) and safety from crime (ß = 2.205; CI = 0.018, 4.579) were related to more transport walking. Access to services and places (ß = 2.086; CI = 0.713, 3.459) and walking infrastructure and safety (ß = 1.741; CI = 0.199, 3.282) were related to more recreational walking. Conclusions: Six of eight supportive environmental factors were associated with more physical activity among community dwelling older Nigerian adults. Policy makers including physiotherapists in this role can use the evidence to inform community-based physical activity and health promotion programs for older adults in Nigeria.

Relationship between Physical Activity and Health Related Quality of Life among Pregnant Women.

The study aimed to investigate the association between health-related quality of life (HQoL) and physical activity (PA) among pregnant women. Sample of pregnant women (N= 398; mean age=27.86±5.15 years) were surveyed using the Pregnancy Physical Activity and Health Related Quality of Life (SF 12) Questionnaires. Spearman correlation coefficient and logistic regression analyses were used to determine the bivariate relationship and association between HQoL and PA intensities and domain respectively. Overall, sedentary behaviour was positively albeit tenuously related to HQoL (r=0.111, P <0.01) whereas sport/exercise was the only domain of PA tenuously associated with the Physical health of HQoL (r=0.142, p <0.01). Also, pregnant women with sufficient PA were 4 times likely to report good quality of life in physical component not in the mental component of HQoL (OR: 4.33, 95% CI: 1.36-13.80). In conclusion, sports/exercise may be an important domain of PA to target when delivering interventions to improve the physical wellbeing among pregnant women in Maiduguri, Nigeria.

Patterns of objectively assessed physical activity and sedentary time: Are Nigerian health professional students complying with public health guidelines?

BACKGROUND: Understanding patterns of physical activity and sedentary time is important to effective population-wide primary prevention and control of non-communicable diseases. This study examined the patterns of objectively assessed physical activity and sedentary time, and the prevalence of compliance with physical activity guidelines according to different public health recommendations in a sub-population of health professional students in Nigeria. METHODS: A cross-sectional study was conducted among 102 health professional students (age = 19-34 years old, 43.1% women) of the University of Maiduguri, Nigeria. Participants wore Actigraph accelerometers on their waist for minimum of 5 days/week to objectively measure intensity and duration of physical activity and sedentary time. Prevalence and demographic patterns of physical activity and sedentary time were examined using descriptive and inferential statistics. RESULTS: The students spent most time in sedentary activity (458.6 ± minutes/day, about 61% of daily time) and the least in vigorous-intensity activity (2.1 ± 4.4 minutes/day, about 0.3% of daily time). Sedentary time was higher among older than younger students (P<0.038) and among medical laboratory science students than physiotherapy and nursing students (P = 0.046). Total physical activity was higher among nursing and medical students than medical laboratory science students (P = 0.041). Although, 85.3% of the students engaged in 150 minutes/week of moderate-to-vigorous physical activity, only 2.9% met the guideline of 75 minutes/week of vigorous intensity activity. CONCLUSIONS: Prevalence of sedentary time was high while that of vigorous-intensity activity was very low among health professional students in Nigeria. Compliance with physical activity guidelines was mainly through accumulation of moderate intensity activity. The results suggest that age and academic programme may influence physical activity level and sedentary behaviour of health professional students in Nigeria. These findings provide preliminary evidence that could be used to inform the needs to develop interventions to improve and support active lifestyle behaviour among students in Nigerian universities.

Cardiovascular responses to millet pounding activity among women in a rural community in Northeastern Nigeria.

BACKGROUND: Pounding food items in a wooden mortal is a common home chore in many communities in African and Asian countries. However, no empirical data exist on energy expenditure during this activity, and whether the activity can be considered a light, moderate, or vigorous intensity physical activity is unknown. PURPOSE: This study was aimed at gaining insights into energy expenditure during millet pounding through cardiovascular responses to millet pounding activity, and to explore possible differences in response between women who pound millet as their occupation (habitual millet pounders) and those who pound millet only for their own home cooking but not as a job (nonhabitual pounders). METHODS: A total of forty apparently healthy women performed millet pounding activity in standing position for 15 min durations, and their cardiovascular parameters including heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressures (DBPs), and rated perceived exertion (RPE) at rest, and immediately after pounding activity were assessed. RESULTS: Significant increases in the subjects' cardiovascular parameters in the range of 7-12, 1-5, and 19-21 point values above the resting levels for SBP, DBP, and HR, respectively, were observed. Significantly higher SBP was also observed for the habitual pounders than the values for the nonhabitual pounders, whereas RPE was significantly higher for the nonhabitual pounders than for the habitual pounders in response to pounding. CONCLUSION: This study suggests that millet pounding substantially stresses the cardiovascular system sufficiently to place the activity within the moderate intensity category. Further studies on energy cost of this house chore, using instrumentation that is capable of direct measure of oxygen consumption, is warranted. Résumé Contexte: Le fait de battre des aliments dans un mortier en bois est une corvée à domicile fréquente dans de nombreuses communautés des pays d'Afrique et d'Asie. cependant, Il n'existe pas de données empiriques sur la dépense énergétique au cours de cette activité et si l'activité peut être considérée comme une activité légère, modérée ou vigoureuse Intensité est inconnue. Objectif: La présente étude visait à mieux comprendre les dépenses énergétiques au cours de la Les réponses cardiovasculaires à l'activité battue du mil, et d'explorer les différences possibles dans la réponse entre les femmes qui pound millet comme leur (Millet pounders habituels) et ceux qui pound millet seulement pour leur propre cuisine à la maison, mais pas comme un emploi (pounders nonhabituel). Méthodes: Un total de quarante femmes apparemment saines ont effectué une activité de pilage du mil en position debout pendant 15 min de durée, et leurs Les paramètres cardiovasculaires, y compris la fréquence cardiaque (FC), la pression artérielle systolique (PAS) et les pressions artérielles diastoliques (PAD) (RPE) au repos, et immédiatement après l'activité de pilonnage ont été évalués. Résultats: Augmentation significative des taux de On a observé des paramètres situés dans la plage des valeurs de 7-12, 1-5 et 19-21 points au-dessus des niveaux de repos pour la PAS, la PAD et la HR respectivement. On a également observé une PAS significativement plus élevée pour les pounders habituels que pour les pounders non habituels, alors que la PPE était Significativement plus élevé pour les pounders non habituels que pour les pounders habituels en réponse à pounding. CONCLUSION: Cette étude suggère Que le broyage du millet souligne sensiblement suffisamment le système cardiovasculaire pour placer l'activité dans la catégorie d'intensité modérée. D'autres études sur le coût de l'énergie de cette corvée maison, en utilisant une instrumentation qui est capable de mesure directe de la consommation d'oxygène, est justifiée.

A survey of physicians and physiotherapists on physical activity promotion in Nigeria.

BACKGROUND: Effective control of non-communicable diseases and promotion of population-wide physical activity participation require the active engagement of health professionals. Physiotherapists and physicians, as part of their practice, routinely screen and assess physical activity status, and recommend health enhancing physical activity participation for their patients. This study aims to compare Nigerian physiotherapists and physicians' knowledge of physical activity message, role perception and confidence, perceived feasibility and barriers, and overall disposition to promoting physical activity in their practice. METHODS: A total of 153 physicians and 94 physiotherapists recruited from 10 government hospitals in five states in Northern Nigeria completed a standardized physical activity promotion questionnaire that elicited information on the knowledge of physical activity, role perception and confidence, feasibility, and barriers to physical activity promotion. Descriptive and inferential statistics were used to analyze the data. RESULTS: The physiotherapists and physicians were fairly knowledgeable on physical activity message (14.2 ± 2.1/20), reported minimal or little barrier to physical activity promotion (23.7 ± 3.1/30), perceived physical activity promotion as their role (13.0 ± 1.8/15), were confident in their ability to discuss and recommend physical activity promotion (7.6 ± 1.6/10) and believed promoting physical activity was feasible for them (15.6 ± 2.6/20). However, over 40% of the physiotherapists and physicians do not know the correct dosage of physical activity that could confer health benefits to patients. The physicians showed better overall disposition to physical activity promotion than the physiotherapists (P = 0.048), but more physiotherapists than the physicians believed 'it is part of their role to suggest to patients to increase their daily physical activity' (95.7% vs 88.2%, P = 0.043) and were more 'confident in suggesting specific physical activity programs for their patients' (87.2% vs 64.5%, P < 0.001). CONCLUSION: Physiotherapists and physicians in Nigeria demonstrated good disposition to promoting physical activity but many of them have knowledge deficits on the correct dosage required for better health for their patients. These health professionals can serve as good advocates for physical activity promotion in Nigeria, but many of them may require knowledge update on health enhancing physical activity for effective health promotion and primary prevention of non-communicable diseases.

Patterns and Associated Factors of Physical Activity among Adolescents in Nigeria.

INTRODUCTION: Understanding the context where adolescents' physical activity (PA) takes place could impact a more targeted approach to implement PA promotion and interventions in Africa. However, standardized data on adolescents' PA behaviour is lacking in Nigeria. We described PA patterns in the various domains (home, school, transport, leisure-time) and intensity categories (light-intensity PA, moderate- to vigorous- intensity physical activity [MVPA] and total PA), and their associations with sociodemographic factors and socioeconomic status (SES) among secondary school adolescents in Nigeria. METHODS: A cross-sectional survey was conducted in a representative sample of 1006 secondary school adolescents (12-18 years, 50.4% girls) in Maiduguri, Nigeria. Self-reported PA was assessed with an adapted version of the Activity Questionnaire for Adolescents and Young Adults. Outcomes were weekly minutes (min/wk) of PA spent in the various domains and intensity categories. Multivariate ANOVA was used to examine associations of PA scores (domains and intensity levels) with adolescents' sociodemographic characteristics and SES, and track differences in PA scores between subgroups. RESULTS: The total sample reported most PA at school (1525 min/wk), the least during active transportation (210 min/wk), and only 37% engaged in 60 min of MVPA daily. Boys reported significantly more leisure-time PA (P<0.001), active transportation (P<0.001), MVPA (P = 0.023) and total PA (P = 0.003) than girls, while girls reported more school-based PA (P = 0.009), home-based PA (P<0.001) and light-intensity PA (P<0.001) than boys. Moderate-intensity PA (P = 0.024) and total PA (P = 0.049) were significantly higher in younger age group than in older group. Household car ownership was associated with less active transportation (P = 0.009), less moderate-intensity PA (P = 0.048) and with more leisure-time PA (P = 0.013). High parental SES was associated with more leisure-time PA (P = 0.002), more MVPA (P = 0.047) and less active transportation (P<0.001). Adolescents of various weight status differed significantly in their leisure-time PA (P<0.001), moderate-intensity PA (P = 0.011) and total PA (P = 0.033). CONCLUSIONS: The patterns and levels of physical activity among adolescents in Nigeria vary according to the adolescents' age, gender, weight status and SES. These findings have important public health implications for identifying subgroups of Nigerian adolescents that should be targeted for effective physical activity promoting interventions.

Casual blood pressure of adolescents attending public secondary schools in Maiduguri, Nigeria.

INTRODUCTION: Although evidence exists that adolescents' hypertension could lead to adults' hypertension, it is a general belief that measures for early detection and treatment of this condition is seldom undertaken especially in medically underserved communities such as Maiduguri, Northeastern Nigeria. This study investigated the prevalence of undiagnosed hypertension among adolescents in Maiduguri, Nigeria, and explored the association between undiagnosed hypertension and adolescents' physical characteristics and parental socio-demographic factors. METHODS: Participants' physical characteristics were assessed, and information on their socio-demographics including parental socioeconomic status were obtained. Blood pressures and heart rates of the participants were also measured three times at 5-10-min period. RESULTS: The prevalence of undiagnosed hypertension among the students was 13.2 %, and overwhelming majority (82.4 %) of the hypertensive students were in the prehypertensive stage, while 17.6 % were in the stage 1 classification of hypertension. Higher prevalence of undiagnosed hypertension was observed for the females compared to the male adolescents (X (2) = 15.49, p = 0.001), and presence of undiagnosed hypertension is positively but tenuously linked to age (r = 0.11, p = 0.01), body mass index (r = 0.10, p = 0.01), and parental income (r = 0.26, p = 0.02) of the students. DISCUSSION: This study suggests that any effective programs designed to mitigate undiagnosed hypertension among adolescents in this city should include strategies that address possible barriers to physical activity and exercise among female adolescents in the society.

Examining the reliability and validity of a modified version of the International Physical Activity Questionnaire, long form (IPAQ-LF) in Nigeria: a cross-sectional study.

OBJECTIVES: To investigate the reliability and an aspect of validity of a modified version of the long International Physical Activity Questionnaire (Hausa IPAQ-LF) in Nigeria. DESIGN: Cross-sectional study, examining the reliability and construct validity of the Hausa IPAQ-LF compared with anthropometric and biological variables. SETTING: Metropolitan Maiduguri, the capital city of Borno State in Nigeria. PARTICIPANTS: 180 Nigerian adults (50% women) with a mean age of 35.6 (SD=10.3) years, recruited from neighbourhoods with diverse socioeconomic status and walkability. OUTCOME MEASURES: Domains (domestic physical activity (PA), occupational PA, leisure-time PA, active transportation and sitting time) and intensities of PA (vigorous, moderate and walking) were measured with the Hausa IPAQ-LF on two different occasions, 8 days apart. Outcomes for construct validity were measured body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP). RESULTS: The Hausa IPAQ-LF demonstrated good test-retest reliability (intraclass correlation coefficient, ICC>75) for total PA (ICC=0.79, 95% CI 0.65 to 0.82), occupational PA (ICC=0.77, 95% CI 0.68 to 0.82), active transportation (ICC=0.82, 95% CI 0.75 to 0.87) and vigorous intensity activities (ICC=0.82, 95% CI 0.76 to 0.87). Reliability was substantially higher for total PA (ICC=0.80), occupational PA (ICC=0.78), leisure-time PA (ICC=0.75) and active transportation (ICC=0.80) in men than in women, but domestic PA (ICC=0.38) and sitting time (ICC=0.71) demonstrated more substantial reliability coefficients in women than in men. For the construct validity, domestic PA was significantly related mainly with SBP (r=-0.27) and DBP (r=-0.17), and leisure-time PA and total PA were significantly related only with SBP (r=-0.16) and BMI (r=-0.29), respectively. Similarly, moderate-intensity PA was mainly related with SBP (r=-0.16, p<0.05) and DBP (r=-0.21, p<0.01), but vigorous-intensity PA was only related with BMI (r=-0.11, p<0.05). CONCLUSIONS: The modified Hausa IPAQ-LF demonstrated sufficient evidence of test-retest reliability and may be valid for assessing context specific PA behaviours of adults in Nigeria.

Perception of built environmental factors and physical activity among adolescents in Nigeria.

BACKGROUND: Understanding environmental factors related to adolescents' physical activity can inform intervention for obesity control and prevention, but virtually no study has been conducted in the African region, where adolescents' physical inactivity and chronic diseases rates are rising. This study assessed associations between perceived built environmental variables and adolescents' physical activity (active transportation to school and leisure-time moderate-to- vigorous physical activity), and the moderating effects of neighborhood-level income on association between environmental variables and physical activity among Nigerian boys and girls. METHODS: Participants were 1006 adolescents (12-19 years, 50.4% girls) randomly selected from 11 secondary schools in Maiduguri city, Nigeria. Physical activity and perceptions of environmental characteristics were assessed by validated self-report questionnaires. Separate gender-based, hierarchical multiple moderated linear regression analyses were used to examine the direct associations between the environmental perceptions and physical activity variables (active transportation and leisure-time MVPA; dependent variables), as well as the moderating effects of neighborhood-level income. RESULTS: Only in boys were direct associations and interaction effect of neighborhood-level income found. Access to destinations was positively associated with active transportation to school (ß = 0.18; CI = 0.67, 2.24); while residential density (ß = 0.10; CI = 0.01, 1.74) and availability/quality of infrastructures (ß = 0.14; CI = 0.49, 2.68) were positively associated with leisure-time MVPA. Also, neighborhood-level income moderated the association between perceived safety and leisure-time MVPA, with more perceived safety related to less MVPA (ß = -0.16; CI = -0.01, -0.70) in boys living in high SES neighborhood but marginally related to more MVPA (ß = 0.11; CI = -0.04, 2.88, p = 0.06) in boys living in low SES neighborhood. CONCLUSIONS: Few environmental attributes were associated with adolescents' physical activity in Nigeria. Future studies are needed to determine the multidimensional correlates of physical activity that may be relevant for both adolescents' boys and girls in Nigeria.

Accelerometer-determined physical activity and its comparison with the International Physical Activity Questionnaire in a sample of Nigerian adults.

INTRODUCTION: Accurate assessment of physical activity to identify current levels and changes within the population is dependent on the precision of the measurement tools. The aim of this study was to compare components of physical activity measured with an adapted version of the International Physical Activity Questionnaire (Hausa IPAQ-SF) and the accelerometer in a sample of Nigeria adults. METHODS: One hundred and forty-four participants (Mean age = 32.6 ± 9.9 years, 40.3% women) in a cross-sectional study wore an accelerometer for seven consecutive days and completed the Hausa IPAQ-SF questionnaire on the eighth day. Total physical activity, time spent in moderate-to-vigorous activity (MVPA) and sedentary time assessed by Hausa IPAQ-SF and accelerometer were compared. The absolute and criterion- related validity of the Hausa IPAQ-SF was assessed by Bland-Altman analysis and Spearman Correlation Coefficients, respectively. Specificity and sensitivity were calculated to classify individuals according to the global standard guideline for sufficient physical activity. RESULTS: Compared with the accelerometer, higher time in MVPA and total physical activity were reported on the Hausa IPAQ-SF (p<0.001), while low to moderate correlations (Rs = 0.03-0.38) were found between the two methods. The 95% limits of agreement were wide between methods for total physical activity (-23019 to 20375 METmin.d(-1)) and sedentary time (-510 to 150 min.d(-1)). The sensitivity (76.2%) of Hausa IPAQ-SF to identify insufficiently active people was good, but its specificity (33.3%) to correctly classify sufficiently active people was low. CONCLUSIONS: The Hausa IPAQ-SF overestimated components of physical activity among Nigerian adults, and demonstrated poor to moderate evidence of absolute and criterion validity. Further evaluation of IPAQ and other self-report physical activity instruments in other Africa populations could enhance accurate evaluation of physical activity data in the region countries.

Medical students' awareness of the role of physiotherapists in multidisciplinary healthcare.

BACKGROUND: Successful implementation of multidisciplinary healthcare approach may among other things depend on students' education and knowledge of the roles of healthcare professions other than their own. This study investigated medical students' awareness of the role of physiotherapists in multidisciplinary healthcare teams. METHODS: One hundred and ninety-eight medical students of the University of Maiduguri, Nigeria, participated in this study. Each student completed a self-administered questionnaire that obtained information on demographics, awareness of role of physiotherapists and educational sources of information as well as suggestions about other sources of information about physiotherapy. Chi-square test was used to analyze differences in awareness by gender and year of study. RESULTS: Although rates of awareness regarding some physiotherapy roles were high, many of the medical students were unaware that physiotherapists can practice on first-contact basis and autonomously. About 60% of the students also viewed the role of physiotherapists in the health team as one of providing assistance for medical work. Clinical ward round was the most common source of information on physiotherapy although many of the students suggested classroom lecture as a preferred means of obtaining information. Year of study resulted in significantly different level of awareness (p < 0.05) with a higher proportion of final year students exhibiting awareness of physiotherapists' roles. CONCLUSION: Clinical ward rounds facilitated the students' awareness of the role of physiotherapists. Interprofessional education involving lectures and clinical ward rounds may assist in building medical students' level of awareness and appreciation of the physiotherapy profession.

Prevalence of physical activity among adults in a metropolitan Nigerian city: a cross-sectional study.

BACKGROUND: Baseline information on physical activity is relevant to controlling the epidemic of chronic noncommunicable diseases occurring in many African countries. However, standardized data on physical activity are lacking in Nigeria. We assessed the prevalence of physical activity and its relationships with sociodemographic characteristics in a subnational sample of Nigerian adults. METHODS: A cross-sectional survey was conducted among a representative sample of 934 adults (age, 20-82 years) living in metropolitan Maiduguri, Nigeria. Physical activity was measured using the validated Nigerian version of the International Physical Activity Questionnaire (Hausa IPAQ-SF). Using the World Health Organization (WHO) guideline, participants were classified as sufficiently active or insufficiently active. Sociodemographic correlates of sufficient physical activity were identified using multinomial logistic regression. RESULTS: Overall, 68.6% of Nigerian adults were sufficiently active. There was no significant difference (P > 0.05) in prevalence of physical activity between men (68.0%) and women (69.3%), but physical activity tended to decrease with increasing age category, especially among men. Physical activity prevalence was positively associated with being married (OR = 1.52, CI = 1.04-4.37) and blue collar work (OR = 2.19, CI = 1.16-4.12) and negatively associated with car ownership (OR = 0.38, CI = 0.17-0.86) and higher income (OR = 0.54, CI = 0.10-0.95). CONCLUSIONS: The prevalence of physical activity varied between sociodemographic subgroups of Nigerian adults; thus, public health policies and interventions based on ecologic models of health behaviors may be warranted in promoting physical activity in Nigeria.

Evaluation of the neighborhood environment walkability scale in Nigeria.

BACKGROUND: The development of reliable and culturally sensitive measures of attributes of the built and social environment is necessary for accurate analysis of environmental correlates of physical activity in low-income countries, that can inform international evidence-based policies and interventions in the worldwide prevention of physical inactivity epidemics. This study systematically adapted the Neighborhood Environment Walkability Scale (NEWS) for Nigeria and evaluated aspects of reliability and validity of the adapted version among Nigerian adults. METHODS: The adaptation of the NEWS was conducted by African and international experts, and final items were selected for NEWS-Nigeria after a cross-validation of the confirmatory factor analysis structure of the original NEWS. Participants (N = 386; female = 47.2%) from two cities in Nigeria completed the adapted NEWS surveys regarding perceived residential density, land use mix - diversity, land use mix - access, street connectivity, infrastructure and safety for walking and cycling, aesthetics, traffic safety, and safety from crime. Self-reported activity for leisure, walking for different purposes, and overall physical activity were assessed with the validated International Physical Activity Questionnaire (long version). RESULTS: The adapted NEWS subscales had moderate to high test-retest reliability (ICC range 0.59 -0.91). Construct validity was good, with residents of high-walkable neighborhoods reporting significantly higher residential density, more land use mix diversity, higher street connectivity, more traffic safety and more safety from crime, but lower infrastructure and safety for walking/cycling and aesthetics than residents of low-walkable neighborhoods. Concurrent validity correlations were low to moderate (r = 0.10 -0.31) with residential density, land use mix diversity, and traffic safety significantly associated with most physical activity outcomes. CONCLUSIONS: The NEWS-Nigeria demonstrated acceptable measurement properties among Nigerian adults and may be useful for evaluation of the built environment in Nigeria. Further adaptation and evaluation in other African countries is needed to create a version that could be used throughout the African region.

Determinants of return to work among Nigerian stroke survivors.

PURPOSE: Employment, an important aspect of life, could be adversely affected by a disabling condition like stroke. This study explores the frequency and determinants of return to work (RTW) among Nigerian stroke survivors. METHOD: One-hundred and one stroke patients attending Physiotherapy clinics at seven teaching and specialist hospital centers in north-eastern Nigeria participated in the study. Socio-demographic, clinical and RTW data were obtained from participants while the modified Rankin Scale was used to assess functional ability. Chi-square statistics and multivariable logistic regression analysis was used to identify the determinants of RTW among the participants. RESULTS: About half of the participants (55%) had returned to work. Absence of disability [Odds Ratio (OR) = 57.7; 95% CI = 12.0-276.8) and mild disability (OR = 15.1; 95% CI = 3.9-58.3) were the significant determinants of RTW, while post-stroke duration of a year or less was associated with lower chance of returning to work (OR = 0.2; 95% CI = 0.0-0.8). CONCLUSIONS: The prominence of functional independence among the determinants of RTW implies that rehabilitation efforts and support programmes to optimize functional ability, especially within the first year after stroke, will greatly enhance RTW among Nigerian stroke survivors.

Adaptation, test-retest reliability, and construct validity of the Physical Activity Neighborhood Environment Scale in Nigeria (PANES-N).

BACKGROUND: This study adapted the Physical Activity Neighborhood Environment Scale (PANES) to the Nigerian context and assessed the test-retest reliability and construct validity of the Nigerian version (PANESN). METHODS: A multidisciplinary panel of experts adapted the original PANES to reflect the built and social environment of Nigeria. The adapted PANES was subjected to cognitive testing and test retest reliability in a diverse sample of Nigerian adults (N = 132) from different neighborhood types. Intraclass Correlation Coefficients (ICC) was used to assess test-retest reliability, and construct validity was investigated with Analysis of Covariance for differences in environmental attributes between neighborhoods. RESULTS: Four of the 17 items on the original PANES were significantly modified, 3 were removed and 2 new items were incorporated into the final version of adapted PANES-N. Test-retest reliability was substantial to almost perfect (ICC = 0.62-1.00) for all items on the PANES-N, and residents of neighborhoods in the inner city reported higher residential density, land use mix and safety, but lower pedestrian facilities and aesthetics than did residents of government reserved area/new layout neighborhoods. CONCLUSION: The PANES-N appears promising for assessing environmental perceptions related to physical activity in Nigeria, but further testing is required to assess its applicability across Africa.

Perceived crime and traffic safety is related to physical activity among adults in Nigeria.

BACKGROUND: Neighborhood safety is inconsistently related to physical activity, but is seldom studied in developing countries. This study examined associations between perceived neighborhood safety and physical activity among Nigerian adults. METHODS: In a cross-sectional study, accelerometer-based physical activity (MVPA), reported walking, perceived crime and traffic safety were measured in 219 Nigerian adults. Logistic regression analysis was conducted, and the odds ratio for meeting health guidelines for MVPA and walking was calculated in relation to four safety variables, after adjustment for potential confounders. RESULTS: Sufficient MVPA was related to more perception of safety from traffic to walk (OR=2.28, CI=1.13- 6.25) and more safety from crime at night (OR=1.68, CI=1.07-3.64), but with less perception of safety from crime during the day to walk (OR=0.34, CI=0.06- 0.91). More crime safety during the day and night were associated with more walking. CONCLUSIONS: Perceived safety from crime and traffic were associated with physical activity among Nigerian adults. These findings provide preliminary evidence on the need to provide safe traffic and crime environments that will make it easier and more likely for African adults to be physically active.