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Note: thesis: Thesis (M. P. H.)--Brown University, 2018
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Abstract: Abstract of Exercise as Medicine: A Physical Activity Intervention to Reduce Sedentary Behavior and Facilitate Type 2 Diabetes and Hypertension Self-Management Amongst Older Women in a South African Township, by Kaitlin Goodman, MPH, Brown University, May 2018 Background: Obesity-related chronic diseases such as diabetes and hypertension place a disproportionate burden on women in South Africa, where over 40% of females are obese. However, little is known about what barriers women face and facilitators they employ to manage cardiometabolic disease. Additionally, few interventions in under-resourced South African communities specifically target physical activity to improve health outcomes. To address these gaps in literature and practice, this study has three key aims: to understand how health literacy is achieved amongst women in resource-limited environments, to explore the ways in which social support mechanisms serve as a facilitator to disease self-management, and to propose a physical activity intervention. Methods: The study involved overweight or obese black women ages 45-60 years with diagnosed hypertension and/or diabetes residing in Khayelitsha, a township in Cape Town, South Africa. Qualitative research methods were employed: eight semi-structured in-depth interviews and nine focus groups were conducted. Data was transcribed, coded, and analyzed using NVivo software. The intervention was developed using a research-to-practice framework and utilized an Intervention Mapping approach. Results: Key themes from qualitative findings include low levels of health literacy, which resulted in limited understanding of chronic illness and prevented successful self-management. In the face of structural barriers, women perceived social support as beneficial to their health and cited it as motivation to increase physical activity. Applying these findings, we propose an intervention to reduce sedentary behavior and improve obesity-related health outcomes amongst older black South African women. Conclusions: Social support gained from membership in community groups may help reduce sedentary behavior, even in an environment not conducive to physical activity. In the absence of upstream interventions to address social determinants of health, interventions targeted at the interpersonal level could be effective strategies to improve chronic disease self-management. As such, the proposed intervention employs methods to increase social support to reduce sedentary behavior and facilitate diabetes and hypertension self-care.
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Identifier: DOI: 10.26300/ckmg-sn24
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