Influence of Subject Characteristics on Adoption of Multiple Preventive Health Behaviours against Noncommunicable Diseases: A survey of Female Students at Makerere University

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DOI: 10.21522/TIJPH.2013.07.03.Art005

Authors : Stanley Tom Asaku, Juliet Kiguli, Judith Agaba Kiiza

Abstract:

Many researchers worldwide report that health behaviours tend to be highly clustered, and can be addressed simultaneously. Yet, more remains unknown than known about how to optimize multiple preventive health behaviour change to mitigate health risks associated with noncommunicable diseases, which currently presents major public health concerns, and represents the greatest global health security threats in the future. There are emerging shifts in epidemiology of these chronic diseases, not only by gender, socio-economic status, disability, ethnicity, but most recently by age- albeit subject characteristics, as they are increasingly causing premature deaths. Nevertheless, the problem remains a neglected public health issue in Uganda, and at Makerere University in particular.

A cross-sectional sample of 381 undergraduate female students completed the self-administered questionnaire, whose results were subjected to binary logistic regression modeling to determine extents to which subject characteristics influenced adoption of preventive health behaviours.

Multivariate regression models suggest that course of study significantly (p=.013) influenced physician visits, with adjusted odds ratio of 0.32. Pentecostal (p=.018) and Anglican (p=.002) affiliations significantly influenced screening behaviour, with corresponding odd ratios of 0.37 and 0.34. Pentecostal (p= .021), like Science course (p=.030) significantly influenced physical activity, with corresponding odds ratios of 0.34 and 0.44. With respect to multiple preventive health behaviours, only course of study showed significant (p=.036) influence on adoption of all three desired behaviours, with adjusted odds ratio of 3.15.

The study contributes to body of knowledge on multiple health behavioral change and the healthy Universities concept. Future health promotions should consider issues around equitable access to essential information, and take advantage of religious places of worship and leaders to channel messaging.

Keywords: Noncommunicable diseases, subject characteristics, multiple preventive health behavior.

References:

[1].   Arah O. A. (2008). On the relationship between individual and population health. Medicine, health care, and philosophy, 12(3), 235–244. doi:10.1007/s11019-008-9173-8.

[2].   Amin, M. F. (2005). Social Science Research: Conceptions, methodology and Analysis. Makerere University, Kampala.

[3].   Asaku, S.T., Kiguli, J. & Agaba, J.K. (2019). Public Health Concerns and Risk Perceptions of Noncommunicable Diseases among Undergraduate Female Students at Makerere University: A qualitative study, submitted to World Journal of Healthcare Research (accepted for publishing on May 3rd, 2019).

[4].   Beauchamp, T. L., & Childress, J. F. (2013). Principles of Bioethics (7th ed.): Oxford University press.

[5].   Benjamins, M. & Brown, C R. (2004). Religion and preventative health care utilization among the elderly. Social Science & Medicine. 58 (1):109–118. [PubMed: 14572925].

[6].   Bray, S.R., & Born, H.A. (2004). Transition to university and vigorous physical activity: Implications for health and phychological well-being. Journal of American College Health, 52(4):181-188. Doi:10.3200/JACH.52.4.181-188.

[7].   Brighenti-Zogg, S., Mundwiler, J., Schüpbach, U., Dieterle, T., Wolfer, D.P., Leuppi, J.D.& Miedinger, D. (2016). Physical Workload and Work Capacity across Occupational Groups. PLoS ONE 11(5): e0154073.doi:10.1371/journal.pone.0154073. https://doi.org/10.1371/journal.pone.0154073.

[8].   Champion, V. L. (1984). Instrument development for health belief model constructs. Advances in Nursing Science, 6(3), 73–85. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/6426380.

[9].   da-Franca, C. & Colares, V. (2008). Comparative study of health behavior among college students at the start and end of their courses, Rev. Saúde Pública, 42 (3). http://dx.doi.org/10.1590/S0034-89102008000300005.

[10].     de Souza Dantas, M., Dos Santos, M. C., Lopes, L., Guedes, D. P., Guedes, M., & Oesterreich, S. A. (2018). Clustering of Excess Body Weight-Related Behaviors in a Sample of Brazilian Adolescents. Nutrients, 10(10), 1505. doi:10.3390/nu10101505.

[11].     DiDomenico, A. & Nussbaum, M.A. (2011). Effects of different physical workload parameters on mental workload and performance, International Journal of Industrial Ergonomics, 41,(3), 255-260, https://doi.org/10.1016/j.ergon.2011.01.008.

[12].     Fagaras, S. P., Radu, L.E. & Vanvu, G. (2015). The Level of Physical Activity of University Students: 7th World Conference on Educational Sciences, (WCES-2015), 05-07 February 2015, Novotel Athens Convention Center, Athens, Greece, Procedia - Social and Behavioral Sciences, 197, 1454 – 1457.

[13].     Harrington, J., Perry, I. J., Lutomski, J., & et al. (2010). Living longer and feeling better: healthy lifestyle, self-rated health, obesity and depression in Ireland. Eur J Pub Health, 20, 91–95. doi:10.1093/eurpub/ckp102.

[14].     Jamison, D.T., summers, L.H., Alleyne, G., Arrow, K.J., Berkley, S., Binagwaho, A., et al. (2013). Global health 2035: a world converging within a generation. Lancet, 382 (9908):1898-955. http://dx.doi.org/10.1016/S0140-6736 (13)62105-4.

[15].     Kasl, S. V., & Cobb, S. (1966). “Health Behavior, Illness Behavior, and Sick-Role Behavior: I. Health and Illness Behavior. Archives of Environmental Health, 12, 246–266. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/5322534.

[16].     Kelloway, E.K. & Gottlieb, B. H. (1998). The effect of alternative work arrangements on women's well-being: a demand-control model. Womens Health, 4, 1-18. pmid:9520604.

[17].     Kim, K.H., Sobal J, et al. (2003). Religion and body weight. Int J Obes Relat Metab Disord. 27(4):469–477. [PubMed: 12664080].

[18].     Koenig, H.G., Dana E. K. & Carson, V.B. (2011. Handbook of Religion and Health. Oxford and New York: Oxford University Press.

[19].     Kwan, M.Y., Cairney, J., Faulkner, G.E., & Pullenavegum, E.E. (2012). Physical activity and other health-risk behaviours during the transition into adulthood: A longitudinal cohort study, American Journal of Preventive Medicine, 42(1), 14-20. Doi: 10.1016/j.amepre.2011.08.026.

[20].     Levin JS. Religion and health: are there an association, is it valid, and is it causal? Soc Sci Med. 1994; 38(11):1475–1482. [PubMed: 8036527].

[21].     Lim, S. S., Vos, T., Flaxman, A.D., Danaei, G., Shibuya, K., Adair-Rohani, H. et al. (2012). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380(9859):2224−60. doi:10.1016/S0140-6736(12)61766-8.

[22].     Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012 Dec 15; 380 (9859):2095-128. http://dx.doi.org/10.1016/S0140-6736(12)61728-0 pmid: 23245604.

[23].     Meader, N., King, K., Moe-Byrne, T., Wright, K., Graham, H., Petticrew, M., Power, C., White., M. & Sowden, A.J. (2016). A systematic review on the clustering and co-occurrence of multiple risk behaviours. BMC Public Health. https://doi.org/10.1186/s12889-016-3373-6.

[24].     Saha, A. & Alleyne, G. (2018). Recognizing noncommunicable diseases as a global health security threat. Bulletin of the World Health Organization. 96, 792-793. Doi: http://dx.doi.org/10.2471/BLT.17.205732.

[25].     Schlundt, D.G., Franklin, M.D., Patel, K., McClellan, L., Larson, C., Niebler, S. & Hargreaves, M. (2008). Religious Affiliation and Health Behaviors and Outcomes: Data from the Nashville REACH 2010 Project. Am J Health Behav. 2008; 32(6): 714–724. doi:10.5555/ajhb.2008.32.6.714.

[26].     Sigmundova, D., Chmelik, F., Sigmund, E., Feltlova, D., & Fromel, K. (2013). Physical activity in the lifestyle of Czech university students: Meeting health recommendations, European Journal of Sport Science, 13:6, 744-750. Doi:10.1080/17461.2013.776638.

[27].     Spring, B., Moller, A. C., & Coons, M. J. (2012). Multiple health behaviours: overview and implications. Journal of public health (Oxford, England), 34 Suppl 1(Suppl 1), i3–i10. doi:10.1093/pubmed/fdr111.

[28].     Marmot, M. & Bell, R. (2019). Social Determinants and Noncommunicable disease: Time for integrated actions. BMJ 364 (1251). https://doi.org/10.1136/bmj.l251.

[29].     Marmot, M., Friel, S., Bell, R., Houweling, T. A. J., & Taylor, S. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. Lancet (London, England), 372(9650), 1661–1669. https://doi.org/10.1016/S0140-6736 (08)61690-6.

[30].     Masselli, M., Ward, P.B., & Gobbi, E. (2018). Promoting Physical Activity Among University Students: A Systematic Review of Controlled Trials. American Journal of Health Promotion, 32 (7). https://doi.org/10.1177/0890117117753798.

[31].     McCullough ME, Hoyt WT, et al. Religious involvement and mortality: A meta-analytic review. Health Psychology. 2000; 19(3):211–222. [PubMed: 10868765].

[32].     UNCST. (2014). Uganda National Council for Science and Technology (UNCST): National Guidelines for Research involving Humans as Research Participants. Kampala, Uganda.

[33].     Van Ness, P.H., Kasl, S.V, et al. (2003). Religion, race, and breast cancer survival. Int J Psychiatry Med. 33(4):357–375. [PubMed: 15152786].

[34].     Walsh, F. Spiritual Resources in Family Therapy. New York: The Guilford Press; 1999.

[35].     WHO (2014). World Health Organization global status report on noncommunicable diseases. Geneva: World Health Organization. http://www.who.int/nmh/publications/ncd-status-report-2014/en/.

[36]. WHO (2010). Global recommendations on physical activity for health Geneva, http:// whqlibdoc.who.int/publications/2010/9789241599979_eng.pdf.

[37]. WHO (2011). World Health Organization. NCD Summary report. http://www.who.int/nmh/publications/ncd_report_summary_en.pdf.

[38].     WHO (2009). Women and Health: today's evidence, tomorrow's agenda. Geneva, Switzerland: WHO Library Cataloguing-in-Publication Data.