Qualitative study of practices and attitudes towards physical activity among prediabetic men and women in urban and rural Malawi

Banda, J., Bunn, C. , Crampin, A. C. , Gill, J. M.R. and Gray, C. M. (2023) Qualitative study of practices and attitudes towards physical activity among prediabetic men and women in urban and rural Malawi. BMJ Open, 13(1), e058261. (doi: 10.1136/bmjopen-2021-058261)

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Abstract

Objectives: Given the decline in physical activity levels in Malawi, like other sub-Saharan African countries, and its implication for non-communicable disease (NCD) prevention, this study aimed to compare and contrast accounts of practices and attitudes towards physical activity among Malawian men and women (previously identified as having pre-diabetes) in urban and rural settings. Setting: Two communities: one urban (Lilongwe) and one rural (Karonga). Participants: 14 men (urban N=6, rural N=8) and 18 women (urban N=9, rural N=9) classified as prediabetic during their participation in an NCD survey 3-5 years previously. Design: A qualitative focus group study (N=4) and thematic analysis, with the ecological model used as a framework to characterise the types of physical activity people engaged in and potential ways to support them to exercise more. Results: Participants reported undertaking different types of physical activity across all ecological model domains (household, occupational, transport, recreational). Rural participants reported more vigorous physical activities than urban participants, and women reported more household activities than men. Many participants recognised a need to promote physical activity in Malawi, and the health benefits of doing so, including the importance of physical activity in helping them stay strong to maintain physical functioning. Barriers to physical activity included competing priorities (especially urban men), societal expectations around wealth, use of motorised transport, lack of accessible facilities for women, ageing and ill health. Conclusions: Physical activity is declining in Malawi as working and transport practices change in response to economic development, making promotion of alternative forms of physical activity a public health priority. Multilevel interventions emphasising the personal benefits/value of physical activity for all ages, and routine and group-based exercising, as well as investment in accessible recreational facilities (including for women) and active travel infrastructure should be considered to improve physical activity levels in Malawi.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gray, Professor Cindy and Gill, Professor Jason and Bunn, Dr Christopher and Crampin, Professor Mia
Authors: Banda, J., Bunn, C., Crampin, A. C., Gill, J. M.R., and Gray, C. M.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Social Scientists working in Health and Wellbeing
College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Published Online:17 January 2023
Copyright Holders:Copyright © 2023 The Authors
First Published:First published in BMJ Open 13(1): e058261
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
301830Development of nutritional strategies for diabetes prevention in Malawian adults at high diabetes riskJason GillMedical Research Council (MRC)MC_PC_MR/R019428/1CAMS - Cardiovascular Science