Substantial decreases in physical activity have been observed between early to late adolescence in males and females, with decreases in levels of activity into adulthood. Physical inactivity among young adults leads to medical conditions such as Type 2 diabetes, stroke, ischemic heart disease, falls resulting in hip fractures, and depression later in life. Advanced Nurse Practitioners have a significant impact on the problem of physical inactivity among young adults through education to improve knowledge regarding physical activity participation. The focus of this project was to develop a toolkit on lifestyle modification as a resource for physical education teachers and nurses to increase physical activity participation and to decrease sedentary behaviors among young adults. The project practice question asked whether an evidence-based toolkit would address the identified needs of improving lifestyle diet and physical activity in young adults. Pender’s health promotion model guided the planning and development of the project. The Computer Attitude Questionnaire together with the 3-Day Physical Activity Recall was used during a needs assessment. Feedback from the survey was included in the development of the toolkit. A 5-item survey was given to 5 content experts who evaluated the toolkit. Data were analyzed using descriptive statistics to obtain a content validity index score of 1.00. Findings show universal agreement about the content of the toolkit as a resource for physical education teachers and school nurses to encourage physical activity participation in young adults. The implications of project findings for positive social change include the potential to increase the involvement of young adults in activities that improve the lives of the individual.

Thesis (M. A. (Nursing Science)) -- University of Limpopo, 2019 / Background: Non-attendance of diabetic patients at primary health care facilities for scheduled appointments has been identified as one of the most pressing issues in chronic illness, including diabetes mellitus, management and results into uncontrolled illnesses. Diabetes mellitus has an increased mortality and morbidity rate, thus has been identified as the second most frequent killer disease in South Africa. Aim of the study: The purpose of the study is to determine self-management strategies to maintain a healthy life for diabetic patients under treatment in primary health care facilities in the Sekhukhune District. Methods: A qualitative, phenomenological, explorative and descriptive study design was conducted in 5 clinics of the Sekhukhune District in the Elias Motswaledi Municipality in Limpopo Province. Data were collected through one-to-one interviews using semi-structured guide. An non-probability purposive sampling method was used to select participants until data saturation was reached. Data were analysed using Tech’s coding qualitative data analysis approach. Results: The findings of this research reveal that diabetic patients know the importance of adherence to diet. However, they also elaborated on the challenges they face, like inability to afford proper diet and their stress levels. They are aware of predisposing factors and recommend support structures like food parcels as well as adhering to the prescribed treatment. Conclusion and recommendations: Diabetic patients lack self-management strategies to maintain their quality of life when diagnosed with diabetes. Furthermore, the study concludes that diabetics lack encouragement and empowerment from health care workers and their families. The study recommends that diabetic patients adhere to a prescribed diet and treatment and that they could be offered food parcels and taught how to avoid factors that could trigger stress. Additionally, it is recommended that support structures be developed to assist diabetic patients about self-management strategies that they could use in order to maintain a good quality of v life. It is also recommended that the Department of Health employ Home-Based Carers in the facilities to assist diabetic patients with their day-to-day care.

Various studies on compliance with anti-hypertensive medications and appropriate lifestyle modifications have been conducted worldwide but studies specific to the Island of Praslin are lacking. The purpose of this quantitative, descriptive-correlational study was to describe factors that affected compliance with hypertension medications and lifestyle modification strategies in a sample of 102 hypertensive persons. The comprehensive version of the Health Belief Model served as the conceptual framework directing the study. The researcher investigated whether there were any significant relationships between compliance and the Health Belief Model variables. Data was collected by means of structured interviews and document analysis, involving an interview schedule and a checklist. All respondents were diagnosed hypertension patients registered at either of the two public health centres on the Island of Praslin. Individual perception of the benefits and risks of hypertension treatment as well as cues to action were found to be significant determinants of compliance behaviour. The study highlighted the need for improved health education and follow-up measures to strengthen patients’ perceptions about the benefits of treatment and compliance. / Public Health / M.A. (Public Health)

Metabolic syndrome (MetS), a global public health problem, is the primary cause of type 2 diabetes and cardiovascular disorders. Lifestyle modification interventions (dietary and physical activity modifications) are effective in preventing and ameliorating MetS and associated comorbidities. However, the impact of lifestyle changes on MetS among Mexican Americans has yet to be investigated, particularly due to high attrition rates in this population. The overall goal of the explanatory mixed-methods study presented in this dissertation was to identify efficacious lifestyle modification efforts directed towards Mexican Americans to promote their retention in lifestyle modification programs, ameliorate the severity of MetS, and understand underlying behavior modification process. In particular, we examined secondary data from an extensive study Beyond Sabor to 1) examine predictors of program completion, 2) compare variation in MetS severity scores (z-scores) between intervention (Beyond Sabor) and attention control (Healthy Living) groups, over time and, 3) investigate processual development of self-efficacy in a sample of 1153 disadvantaged Mexican Americans participants. Findings suggest that program completers were more likely to be older, had more years of education, lower fasting blood glucose levels, and participated in sites with high group cohesiveness. Results also revealed that when compared with the standard nutrition program, Healthy Living, the lifestyle modification intervention, Beyond Sabor, was more effective in ameliorating MetS severity, systolic blood pressure, triglyceride, and fasting plasma glucose levels among study participants. Qualitative results demonstrate the high acceptability of Beyond Sabor intervention. Four sub-themes emerged illustrating important underlying conditions contributing to participants’ improved self-efficacy: desire to gain knowledge about ways to improve health, development of social support, adoption of program teachings in family lifestyle, and improvement in health outcomes. Findings of the current study may allow researchers to identify Mexican Americans at risk of non-completion and to develop strategies to improve lifestyle modification program attendance, and thus health outcomes. Qualitative findings underscore the importance of sociocultural context on individuals’ attempts to make lifestyle changes to manage their chronic illnesses. Successful adaptation of lifestyle interventions such as Beyond Sabor for at-risk populations in community-based settings will be critical in stemming the tide of MetS.

Various studies on compliance with anti-hypertensive medications and appropriate lifestyle modifications have been conducted worldwide but studies specific to the Island of Praslin are lacking. The purpose of this quantitative, descriptive-correlational study was to describe factors that affected compliance with hypertension medications and lifestyle modification strategies in a sample of 102 hypertensive persons. The comprehensive version of the Health Belief Model served as the conceptual framework directing the study. The researcher investigated whether there were any significant relationships between compliance and the Health Belief Model variables. Data was collected by means of structured interviews and document analysis, involving an interview schedule and a checklist. All respondents were diagnosed hypertension patients registered at either of the two public health centres on the Island of Praslin. Individual perception of the benefits and risks of hypertension treatment as well as cues to action were found to be significant determinants of compliance behaviour. The study highlighted the need for improved health education and follow-up measures to strengthen patients’ perceptions about the benefits of treatment and compliance. / Public Health / M.A. (Public Health)

The purpose of this study was to describe diet and/or physical activity-based interventions and their control in cardiometabolic risk factors of diabetes for the South Asian (SA) population. A systematic review was conducted in accordance with the PRISMA guidelines. Seventeen randomized control trials meeting the inclusion criteria were included for analysis. Interventions with type-2 diabetic SA showed significant improvements in HbA1c% (4/5 studies), fasting blood glucose (3/4 studies), and postprandial glucose (2/2 studies). Interventions with at-risk/prediabetic and non-diabetic SA showed a modest change in overall outcomes, with significant change reported for post-prandial insulin (3/4 studies), BMI and weight (2/4 studies), and waist circumference (2/5 studies). These intervention studies showed modest control of risk factors particularly when the interventions included aspects of the culture and the attrition rate was lower. To be effective with South Asians, future studies need to have a culturally specific design, and a focus on both diet and physical activity.

The purpose of this project was to evaluate the effectiveness of an educational lifestyle modification (LM) intervention on blood pressure (BP) among adults with prehypertension. Prehypertension is a precursor to hypertension (HTN) and is a public epidemic in the United States. Approximately 68 million (31%) U.S. adult’s aged ≥18 years have hypertension. Hypertension can cause significant target organ damage, lead to coronary heart disease, heart failure, stroke, and kidney failure. Early identification and the primary treatment of persons with prehypertension with LM have the potential to minimize the progression and delay the onset of comorbidities associated with hypertension. This quality improvement project retrospectively reviewed changes in blood pressure for a small sample (n=5) of patients diagnosed with prehypertension who received education about modifying lifestyle behaviors according to nationally accepted clinical practice guidelines. Blood pressure measurements were extracted from the medical record beginning at the time of the education through a three month period. Descriptive data indicates that all five patients had a decrease in systolic and diastolic blood pressure. The median systolic blood pressure at baseline was 129 mmHg decreasing to 121 mmHg at end of study period. The median diastolic blood pressure was 86 mmHg decreasing to 76 mmHg. Integration of lifestyle modification education and subsequent blood pressure monitoring during a routine primary care visit is feasible and may help motivate patients to implement changes and subsequently reduce blood pressure. Future studies should include identifying strategies for improving patient participation.