Physical activity and the built environment: perceptions of policy-makers in Oman.

The prevalence of physical activity is low in the Sultanate of Oman. The built environment is a key barrier to physical activity in the region. Our aim is to examine urban planners' perceptions of the relevance and feasibility of the proposed urban planning and design interventions in the draft WHO technical package on physical activity. Semi-structured interviews were conducted with 11 professionals using a pre-tested interview guide. Interviews were audio-recorded and transcribed. Content analysis based on the socio-ecological framework (policy, physical, socio-cultural and information environment) was used to identify the perceived urban design challenges and solutions. Urban sprawl due to haphazard urban and transport design, limited accessibility to parks and sports facilities, negative perceptions about active travel and limited understanding of physical activity were key challenges identified by interviewees. Participants suggested strengthening governance through policy and intersectoral collaboration, improving community design and accessibility to parks, considering the needs of diverse populations and improving knowledge and attitudes of physical activity as priority when adapting the WHO technical package to Oman. Mid-level managers prioritized three interventions from the package: the need for political commitment and capacity building on how the built environment can promote physical activity, a national political on physical activity that promotes a safe infrastructure for active transport, and accessibility to sports and recreational facilities. Negative perceptions of active travel and cultural expectations that constrain mobility requires a society-wide paradigm shift, the first objective of the WHO global action plan.

Construct validity of the physical activity neighborhood environment scale-Oman.

Aims: This study aims to examine the construct validity of Physical Activity Neighborhoods Environment Scales, Oman (PANES-O), and compare the subjective perceptions with objective measures in Muscat, the capital area of Oman. Methods: Walkability index scores using GIS maps were calculated for 35 study areas in Muscat based on which five low and 5 high walkable study areas were randomly selected. A community survey was then conducted in November 2020 in each study area using the 16-item PANES-O instrument to measure the participants' perception of neighborhood density, land use mix, infrastructure, safety, aesthetics, and street connectivity. Due to pandemic restrictions, a social media-based purposive sampling strategy was utilized to reach community-based networks and complete digital data collection. Results: Significant differences between the low and high walkablehigh-walkable neighborhoods were observed for 2 of 3 macroenvironment subscales, density and land use. Respondents in high walkable neighborhoods perceived their areas as having more twin villas (P = 0.001) and apartment buildings (P < 0.001), greater access to destinations (like more shops, and places to go within walking distance; P < 0.001), easy access to public transport (P < 0.001), and more places to be active (P < 0.001); than their counterparts in low walkable neighborhoods. In terms of microenvironmental attributes, respondents in high walkablehigh-walkable neighborhoods perceived their areas to have better infrastructure, better aesthetic qualities, and better social environment than their counterparts in low walkablelow-walkable neighborhoods. Significant differences in perceptions across 12 of the 16-item PANES tool confirmed that 6 of the 7 subscales were significantly sensitive to built environment attributes between the low and high walkable study areas. Respondents in high walkable neighborhoods perceived their areas as having greater access to destinations (like more shops, places to go within walking distance; P ≤ 0.001), easy access to public transport (P ≤ 0.001), more places to be active (P ≤ 0.001), better infrastructure (like more sidewalks, facilities to bicycle; P ≤ 0.001), and better aesthetic qualities (P ≤ 0.001). PANES-O also was able to rate high walkable neighborhoods to be higher in residential density and land-use mix compared to the low walkable neighborhoods demonstrating its sensitivity to the GIS maps' objective measures. Conclusions and recommendations: These results provide preliminary strong support for the construct validity of PANES-O, suggestingconfirming that it is a promising tool for assessing macroenvironmental perceptions related to physical activity in Oman. Further research using objective measures of microenvironments and device-based physical activity scores is needed to confirm the criterion validity of the 10 micro-environmental attributes of PANES-O using objective measures for the microenvironment. PANES-O could be used to generate and develop the needed evidence on the most appropriate approaches to improving the built environment to promote physical activity and urban planning in Omanthe country.

Knowledge, Attitude, and Acceptability of COVID-19 Vaccine in Oman: A Cross-sectional Study.

Objectives: To evaluate the knowledge, attitude, and acceptance of COVID-19 vaccine among the general population of Oman, on the eve of the rollout of vaccination program in the country. Methods: A cross-sectional study was conducted using a structured and validated online questionnaire. Adults residing in Oman were invited to participate in the study between 22 and 24 December 2020. Logistic regression analysis was used to identify the factors associated with COVID-19 vaccine acceptability. Results: Of the total of 966 participants, the majority (612; 63.4%) were women. Most participants were younger than 40 years (572; 59.3%). Participants displayed good awareness about COVID-19 (946; 97.9%) and the global vaccine development initiatives (831; 86.0%). Only 265 (27.4%) participants were willing to get themselves vaccinated. The majority were either uncertain 365 (37.8%) or unwilling 336 (34.8%). The main driver of vaccine acceptance was to protect oneself and others (186/265; 70.0%). The main reasons given for vaccination hesitation/refusal were concerns over possible side-effects (505/701; 72.0%), safety concerns (386/701; 55.0%), and ineffectiveness of the vaccine (107/701; 15.3%). Conclusions: On the eve of the first-ever rollout of COVID-19 vaccine in Oman in December 2020, the surveyed residents of the country expressed significant hesitancy to get themselves vaccinated. Participants' perceptions of risk of contracting COVID-19, their trust in vaccines, government, and their health system were important predictors of vaccine acceptance. These results enabled development of strategies to address such concerns to facilitate vaccine acceptance among the residents of Oman. The results of this study can be used by researchers to conduct comparative research in future, with more emphasis on Omani youth (< 40 years).

Assessing COVID-19 Vaccine's Acceptability Amongst Health Care Workers in Oman: A cross-sectional study.

BACKGROUND: COVID-19 vaccines are considered to be a vital tool in controlling the pandemic. Hesitation with COVID-19 immunization has been reported worldwide. The acceptability of the COVID-19 vaccine among health care workers (HCWs) is an important step in determining the success of any new vaccination program. This study aims to estimate the acceptability of COVID-19 vaccines among HCWs in Oman. METHODS: A cross-sectional study using a self- administered questionnaire was conducted among HCWs in December 2020. Data were analyzed using a bivariate level to identify the statistical association with acceptability using the Chi-squared test. At the multivariate level, we determined the socio-demographic and knowledge factors associated with vaccine acceptability. RESULTS: A total of 608 out of 700 HCWs participated (response rate 87 %), of which 64.8 % were Oman citizens and 53.8 % were aged between 30 and 39 years. The majority of the participants were female (62.8 %) and married (87.0 %), while 48.5 % of the respondents were doctors. Only 43 % of the participants were willing to be vaccinated against COVID-19, while 57 % were either uncertain 35 % or unwilling 22 % to be vaccinated. The main reason for not being willing to receive the vaccine was their perceived adverse events after vaccination. The male participants (OR: 1.96 95 % CI 1.22-3.13) and those with a positive attitude towards the vaccine (OR: 9.17(95 %) CI-1.78-47.07) were more willing to receive the COVID-19 vaccine. Similarly, trust in the government (OR: 2.41 95 % CI 1.57-3.71) and having sound knowledge of the COVID-19 vaccine (OR: 15.91 95 % CI 9.81-25.88) improved the acceptability to vaccinate among the HCWs. In contrast, having a previous experience with SARS-CoV-2 (OR: 1.65, 95 % CI: 1.08-2.54), was associated with a significant decrease in COVID-19 vaccine acceptability. CONCLUSION: 50 % of HCWs reported being uncertain or unwilling to be vaccinated against the COVID-19 vaccine. Male gender, positive attitude towards the vaccines, trust in government and knowledge of COVID-19 vaccine as key factors that determine improved vaccine acceptability among HCWs. Therefore, to facilitate herd immunity among the population, it is necessary to initiate effective communication strategies among HCWs in order to sensitize them towards the acceptability of the COVID-19 vaccine.

A Critique of National Physical Activity Policy in Oman Using 3 Established Policy Frameworks.

BACKGROUND: This paper aimed to assess the development process, content, and early implementation of Oman's national physical activity plan of action to identify strengths and areas for improvement. METHODS: Data were extracted from 4 documents: national noncommunicable diseases policy, physical activity plan of action, and 2 World Health Organization Mission Reports. Three policy frameworks and approaches (physical activity content analysis grid, health-enhancing physical activity policy audit tool, and policy cube approach for diet-related noncommunicable diseases) were used. RESULTS: The findings demonstrated that policymakers engaged a broad range of sectors in developing a national plan. It aligned with many of the elements from the 3 policy frameworks (ie, multisectoral approach, political commitment/leadership, identification of national goals and targets, time frame for implementation). The main gaps included the lack of a specified sustainable funding mechanism, systems for monitoring progress, and an emphasis on general interventions, with limited focus on specific target groups. CONCLUSION: A range of sectors were engaged in the development of Oman's national physical activity plan of action, with strong political commitment and using global guidance and local evidence. Establishing a strong accountability framework, including a clear financing mechanism, is critical for Oman to meet its target for a 10% relative reduction in physical inactivity by 2025.

Adaptation of the Physical Activity Neighborhood Environment Scale in Oman.

OBJECTIVES: This study aimed to adapt the Physical Activity Neighborhood Environment Scale (PANES), which is a 17-item tool for assessing environmental factors relevant for walking and bicycling in the community, to the Omani context. METHODS: The adaptation process was conducted in three steps: (1) revision by local experts, (2) Arabic translation and cognitive testing and (3) test-retest reliability testing with a sample of 33 Omani women and men, between September 2016 and August 2017. RESULTS: Four of the 17 items of the PANES were modified and one was removed, resulting in a 16-item PANES, Oman (PANES-O) questionnaire. The test-retest reliability scores ranged from 0.436-1.000; scores for more than half (n = 9) were almost perfect (0.8-1.0), demonstrating a good level of consistency and good psychometric performance similar to other studies. CONCLUSION: The PANES-O demonstrated good test-retest reliability and appears to be a promising tool for assessing environmental perceptions related to physical activity in Oman. However, construct validity should be confirmed before wider use.

Health promotion strategy as part of Vision 2050 in Oman: the way forward.

INTRODUCTION: Non-communicable diseases (NCDs) have become a significant cause of morbidity and mortality in Oman. The adoption of unhealthy and sedentary lifestyles associated with rising income is trending with a large number of individuals and is contributing to the emergence of substantial health issues. Ultimately, the incidence of NCDs has increased considerably. This review aims to define strategies that can help in attaining Oman's national health promotion goals. RESULTS: The current health promotion strategies have not been adequate or sufficient to meet the national Health Vision 2050 of Oman. CONCLUSION: Unsafe behaviors and unhealthy lifestyles that led to a significant increase in NCDs have emerged in Oman. Careful re-planning and continuous monitoring and evaluation of health promotion activities are necessary for effective implementation of health policies, with the ultimate goal of reducing the NCD burden in Oman.

Community Participation Approaches for Effective National COVID-19 Pandemic Preparedness and Response: An Experience From Oman.

Oman, like other countries in the world, was affected by the COVID-19 pandemic. Since the WHO's declaration of the pandemic, the Ministry of Health of Oman has initiated its preparedness and response to the pandemic, with community participation as one of the key components of the national preparedness and response plan. This paper is a descriptive study aims at describing the three community approaches that exist in Oman and reviewing their role in preparedness and response strategies to COVID-19 pandemic and discuss the lessons learned. Community participation approaches in Oman were translated into action during the pandemic through empowering community members, mobilizing resources, and strengthening the ownership among the local community to ensure effective advocacy, proper networking, and dissemination of information and, subsequently, actions at the level of the community. The first community participation approach is community organizations within the healthy cities and villages initiative, which facilitated networking and acted as a platform for community engagement, reviewing the health information and updating them accordingly to meet evloving demands. The second approach is Willayat (District) health committees, with their unique multi-sectoral structure, that enhanced collaboration at the state level with different community leaders and groups to develop pandemic action plans, which were implemented using available local resources. The third approach is community volunteers that remain the key information providers, particularly when physical access becomes limited due to physical distancing measures. Based on this review, we advocate to further strengthen these approaches and recommends that they are implemented for the protection and promotion of health and well-being, including for health emergencies.

Control of the 2018-2019 dengue fever outbreak in Oman: A country previously without local transmission.

BACKGROUND: In December 2018, routine surveillance identified an autochthonous outbreak of dengue fever in Muscat Governorate, Oman, a region previously free of dengue fever. METHODS: Routine surveillance confirmed locally acquired cases in the second week of December, leading to a rapid public health response including case management guidance and epidemiological investigations. The main activity was the vector survey using systematic sampling to assess extent of previously unreported Aedes aegypti presence followed by a campaign aimed to eliminate breeding sites of A. aegypti". RESULTS: During a 5-month period, 343 suspected cases were reported from Muscat Governorate with 122 from the outbreak affected area. Out of 207 probable cases eligible for laboratory testing as per guidelines issued, 59 cases were confirmed. The vector elimination campaign started on January 8, 2019 after a media advocacy using television and social media and concluded on January 23. By the end of campaign, the case load had decreased significantly in the affected area with no reports of locally acquired cases from adjoining areas of Muscat Governorate, indicating no further spread. CONCLUSIONS: Rapid notification and early community-wide, extensive vector control activities effectively contained the autochthonous dengue fever virus outbreak.

Move for health: addressing the built environment and physical activity in Oman.

Rapid modernization in Oman has resulted in a massive population shift to the cities, urban sprawl, and a car-dependent culture associated with lowered levels of physical activity and elevated rates of noncommunicable diseases. Since the built environment is a major contributing factor to physical inactivity in the Region, this policy brief identifies key steps for creating an urban environment more supportive of physical activity. Such transformations would also have wide-ranging health, social and economic benefits. Design standards appropriate for the local terrain and social-cultural context should be developed using existing neighbourhoods that provide environmental support for physical activity (residential density, mixed land use and street connectivity) and a participatory approach to urban planning. When policy- makers recognize the links between physical activity, urban planning and design, and transportation modalities, a national vision for promoting physical activity can be created and endorsed at the highest levels, thereby providing a government mandate for multisectoral action.

Limited Wegener's granulomatosis presenting as multiple retinal vascular occlusions.

In the early stages of Wegener's granulomatosis, and in the atypical forms, the classic clinicopathologic features of the disease are often absent, delaying diagnosis. Recognition of the disease and its variant is aided by serological markers.