Adetoyeje Y. Oyeyemi

The short international physical activity questionnaire: cross-cultural adaptation, validation and reliability of the Hausa language version in Nigeria

BackgroundAccurate assessment of physical activity is important in determining the risk for chronic diseases such as cardiovascular disease, stroke, type 2 diabetes, cancer and obesity. The absence of culturally relevant measures in indigenous languages could pose challenges to epidemiological studies on physical activity in developing countries. The purpose of this study was to translate and cross-culturally adapt the Short International Physical Activity Questionnaire (IPAQ-SF) to the Hausa language, and to evaluate the validity and reliability of the Hausa version of IPAQ-SF in Nigeria.MethodsThe English IPAQ-SF was translated into the Hausa language, synthesized, back translated, and subsequently subjected to expert committee review and pre-testing. The final product (Hausa IPAQ-SF) was tested in a cross-sectional study for concurrent (correlation with the English version) and construct validity, and test-retest reliability in a sample of 102 apparently healthy adults.ResultsThe Hausa IPAQ-SF has good concurrent validity with Spearman correlation coefficients (ρ) ranging from 0.78 for vigorous activity (Min Week-1) to 0.92 for total physical activity (Metabolic Equivalent of Task [MET]-Min Week-1), but poor construct validity, with cardiorespiratory fitness (ρ = 0.21, p = 0.01) and body mass index (ρ = 0.22, p = 0.04) significantly correlated with only moderate activity and sitting time (Min Week-1), respectively. Reliability was good for vigorous (ICC = 0.73, 95% C.I = 0.55-0.84) and total physical activity (ICC = 0.61, 95% C.I = 0.47-0.72), but fair for moderate activity (ICC = 0.33, 95% C.I = 0.12-0.51), and few meaningful differences were found in the gender and socioeconomic status specific analyses.ConclusionsThe Hausa IPAQ-SF has acceptable concurrent validity and test-retest reliability for vigorous-intensity activity, walking, sitting and total physical activity, but demonstrated only fair construct validity for moderate and sitting activities. The Hausa IPAQ-SF can be used for physical activity measurements in Nigeria, but further construct validity testing with objective measures such as an accelerometer is needed.

Perceived crime and traffic safety is related to physical activity among adults in Nigeria

BackgroundNeighborhood safety is inconsistently related to physical activity, but is seldom studied in developing countries. This study examined associations between perceived neighborhood safety and physical activity among Nigerian adults.MethodsIn a cross-sectional study, accelerometer-based physical activity (MVPA), reported walking, perceived crime and traffic safety were measured in 219 Nigerian adults. Logistic regression analysis was conducted, and the odds ratio for meeting health guidelines for MVPA and walking was calculated in relation to four safety variables, after adjustment for potential confounders.ResultsSufficient MVPA was related to more perception of safety from traffic to walk (OR=2.28, CI=1.13- 6.25) and more safety from crime at night (OR=1.68, CI=1.07-3.64), but with less perception of safety from crime during the day to walk (OR=0.34, CI=0.06- 0.91). More crime safety during the day and night were associated with more walking.ConclusionsPerceived safety from crime and traffic were associated with physical activity among Nigerian adults. These findings provide preliminary evidence on the need to provide safe traffic and crime environments that will make it easier and more likely for African adults to be physically active.

Environmental factors associated with overweight among adults in Nigeria

BackgroundUnderstanding environmental factors related to obesity can inform interventions for the world wide obesity epidemic, yet no study has been conducted in this context in Africa. This study examined associations between neighbourhood environment variables and overweight in Nigerian adults.MethodsA total of 1818 randomly selected residents (age: 20-65 years, 40% female, 31% overweight and 61.2% response) living in high and low socioeconomic (SES) neighbourhoods in Metropolitan Maiduguri, Nigeria, participated in a cross-sectional study. Anthropometric measurements of height and weight and an interview-assisted self-reported measure of 16 items of perceived neighborhood environments were conducted. The primary outcome was overweight (body mass index [BMI] > or = 25 kg/m2) vs. normal weight (BMI = 18.5-24.9 kg/m2).ResultsAfter adjustment for sociodemographic variables, overweight was associated with distant access to commercial facilities (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.02- 2.18), poor neighbourhood aesthetics (OR, 1.58; 95% CI, 1.16-2.09), perceiving garbage and offensive odours in the neighbourhood (OR, 1.41; 95% CI, 1.05-1.89) and feeling unsafe from crime at night (OR, 1.47; 95% CI, 1.13- 1.91) and unsafe from traffic (OR, 1.56; 95% CI, 1.17-2.07) in the total sample. Significant interactions regarding overweight were found between gender and four environmental variables, with low residential density (OR, 1.39; 95% CI, 1.02-1.93) and poorly maintained pedestrian pathways (OR, 1.89; 95% CI, 1.13-3.17) associated with overweight in men only, and absence of beautiful things (OR, 2.23; 95% CI, 1.42-3.50) and high traffic making it unsafe to walk (OR, 2.39; 95% CI, 1.49-3.83) associated with overweight in women only. There were few significant interactions between environmental factors and neighborhood SES regarding overweight.ConclusionNeighbourhood environment factors were associated with being overweight among Nigerian adults. These findings support previous reports in international literature, but should be replicated in other African studies before any firm conclusions can be drawn.

Perceived environmental correlates of physical activity and walking in African young adults

Purpose. Evidence on environmental correlates of physical activity (PA) conducted in Western developed countries may not be generalizable to Africa. This study examined the associations between perception of the neighborhood environment and PA and walking in African young adults. Design. Cross-sectional analysis of self-reported survey. Setting. University of Ibadan, in the capital city of Oyo State, Nigeria. Subjects. A representative sample of undergraduates of a Nigerian university, age 16 to 39 years and 50.7% female. Measures. Total walking activity and PA were measured with the short version of the International Physical Activity Questionnaire. Sixteen perceived neighborhood environmental variables were measured using the Physical Activity Neighborhood Environment Scale (PANES), which was used to assess environmental correlates of PA that are internationally relevant. Outcomes were meeting health-related guidelines for sufficient PA and walking activity. Results. After adjustments for demographics and dormitory site, the proximity of bus/transit stop (odds ratio [OR] = 1.41), traffic as not a problem (OR = .45; unexpected direction), and not many four-way intersections (OR = .72; unexpected direction) were significantly associated with sufficient PA. Low crime rate at night (OR = 1.53), many interesting things to look at (OR = 1.90), and seeing many people active (OR = .59; unexpected direction) were significantly associated with sufficient walking. Inconsistent patterns were also observed in gender-specific analyses. Conclusion. Few neighborhood environment correlates of PA or walking reported in the international literature were replicated with African young adults. Environmental measures need to be developed that are tailored to low- and middle-income countries, such as those in Africa, so that research in understudied regions can advance. (Am J Health Promot 2011;25[5]:e10-e19.)

Accelerometer-Determined Physical Activity and Its Comparison with the International Physical Activity Questionnaire in a Sample of Nigerian Adults

Introduction Accurate assessment of physical activity to identify current levels and changes within the population is dependent on the precision of the measurement tools. The aim of this study was to compare components of physical activity measured with an adapted version of the International Physical Activity Questionnaire (Hausa IPAQ-SF) and the accelerometer in a sample of Nigeria adults. Methods One hundred and forty-four participants (Mean ageu200a=u200a32.6±9.9 years, 40.3% women) in a cross-sectional study wore an accelerometer for seven consecutive days and completed the Hausa IPAQ-SF questionnaire on the eighth day. Total physical activity, time spent in moderate-to-vigorous activity (MVPA) and sedentary time assessed by Hausa IPAQ-SF and accelerometer were compared. The absolute and criterion- related validity of the Hausa IPAQ-SF was assessed by Bland-Altman analysis and Spearman Correlation Coefficients, respectively. Specificity and sensitivity were calculated to classify individuals according to the global standard guideline for sufficient physical activity. Results Compared with the accelerometer, higher time in MVPA and total physical activity were reported on the Hausa IPAQ-SF (p<0.001), while low to moderate correlations (Rsu200a=u200a0.03–0.38) were found between the two methods. The 95% limits of agreement were wide between methods for total physical activity (−23019 to 20375 METmin.d−1) and sedentary time (−510 to 150 min.d−1). The sensitivity (76.2%) of Hausa IPAQ-SF to identify insufficiently active people was good, but its specificity (33.3%) to correctly classify sufficiently active people was low. Conclusions The Hausa IPAQ-SF overestimated components of physical activity among Nigerian adults, and demonstrated poor to moderate evidence of absolute and criterion validity. Further evaluation of IPAQ and other self-report physical activity instruments in other Africa populations could enhance accurate evaluation of physical activity data in the region countries.

Perception of built environmental factors and physical activity among adolescents in Nigeria

BackgroundUnderstanding environmental factors related to adolescents’ physical activity can inform intervention for obesity control and prevention, but virtually no study has been conducted in the African region, where adolescents’ physical inactivity and chronic diseases rates are rising. This study assessed associations between perceived built environmental variables and adolescents’ physical activity (active transportation to school and leisure-time moderate-to- vigorous physical activity), and the moderating effects of neighborhood-level income on association between environmental variables and physical activity among Nigerian boys and girls.MethodsParticipants were 1006 adolescents (12–19 years, 50.4% girls) randomly selected from 11 secondary schools in Maiduguri city, Nigeria. Physical activity and perceptions of environmental characteristics were assessed by validated self-report questionnaires. Separate gender-based, hierarchical multiple moderated linear regression analyses were used to examine the direct associations between the environmental perceptions and physical activity variables (active transportation and leisure-time MVPA; dependent variables), as well as the moderating effects of neighborhood-level income.ResultsOnly in boys were direct associations and interaction effect of neighborhood-level income found. Access to destinations was positively associated with active transportation to school (βu2009=u20090.18; CIu2009=u20090.67, 2.24); while residential density (βu2009=u20090.10; CIu2009=u20090.01, 1.74) and availability/quality of infrastructures (βu2009=u20090.14; CIu2009=u20090.49, 2.68) were positively associated with leisure-time MVPA. Also, neighborhood-level income moderated the association between perceived safety and leisure-time MVPA, with more perceived safety related to less MVPA (βu2009=u2009-0.16; CIu2009=u2009-0.01, -0.70) in boys living in high SES neighborhood but marginally related to more MVPA (βu2009=u20090.11; CIu2009=u2009-0.04, 2.88, pu2009=u20090.06) in boys living in low SES neighborhood.ConclusionsFew environmental attributes were associated with adolescents’ physical activity in Nigeria. Future studies are needed to determine the multidimensional correlates of physical activity that may be relevant for both adolescents’ boys and girls in Nigeria.

Evaluation of the neighborhood environment walkability scale in Nigeria.

BackgroundThe development of reliable and culturally sensitive measures of attributes of the built and social environment is necessary for accurate analysis of environmental correlates of physical activity in low-income countries, that can inform international evidence-based policies and interventions in the worldwide prevention of physical inactivity epidemics. This study systematically adapted the Neighborhood Environment Walkability Scale (NEWS) for Nigeria and evaluated aspects of reliability and validity of the adapted version among Nigerian adults.MethodsThe adaptation of the NEWS was conducted by African and international experts, and final items were selected for NEWS-Nigeria after a cross-validation of the confirmatory factor analysis structure of the original NEWS. Participants (Nu2009=u2009386; femaleu2009=u200947.2%) from two cities in Nigeria completed the adapted NEWS surveys regarding perceived residential density, land use mix – diversity, land use mix – access, street connectivity, infrastructure and safety for walking and cycling, aesthetics, traffic safety, and safety from crime. Self-reported activity for leisure, walking for different purposes, and overall physical activity were assessed with the validated International Physical Activity Questionnaire (long version).ResultsThe adapted NEWS subscales had moderate to high test-retest reliability (ICC range 0.59 –0.91). Construct validity was good, with residents of high-walkable neighborhoods reporting significantly higher residential density, more land use mix diversity, higher street connectivity, more traffic safety and more safety from crime, but lower infrastructure and safety for walking/cycling and aesthetics than residents of low-walkable neighborhoods. Concurrent validity correlations were low to moderate (ru2009=u20090.10 –0.31) with residential density, land use mix diversity, and traffic safety significantly associated with most physical activity outcomes.ConclusionsThe NEWS-Nigeria demonstrated acceptable measurement properties among Nigerian adults and may be useful for evaluation of the built environment in Nigeria. Further adaptation and evaluation in other African countries is needed to create a version that could be used throughout the African region.

Examining the reliability and validity of a modified version of the International Physical Activity Questionnaire, long form (IPAQ-LF) in Nigeria: a cross-sectional study

Objectives To investigate the reliability and an aspect of validity of a modified version of the long International Physical Activity Questionnaire (Hausa IPAQ-LF) in Nigeria. Design Cross-sectional study, examining the reliability and construct validity of the Hausa IPAQ-LF compared with anthropometric and biological variables. Setting Metropolitan Maiduguri, the capital city of Borno State in Nigeria. Participants 180 Nigerian adults (50% women) with a mean age of 35.6 (SD=10.3) years, recruited from neighbourhoods with diverse socioeconomic status and walkability. Outcome measures Domains (domestic physical activity (PA), occupational PA, leisure-time PA, active transportation and sitting time) and intensities of PA (vigorous, moderate and walking) were measured with the Hausa IPAQ-LF on two different occasions, 8u2005days apart. Outcomes for construct validity were measured body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Results The Hausa IPAQ-LF demonstrated good test–retest reliability (intraclass correlation coefficient, ICC>75) for total PA (ICC=0.79, 95% CI 0.65 to 0.82), occupational PA (ICC=0.77, 95% CI 0.68 to 0.82), active transportation (ICC=0.82, 95% CI 0.75 to 0.87) and vigorous intensity activities (ICC=0.82, 95% CI 0.76 to 0.87). Reliability was substantially higher for total PA (ICC=0.80), occupational PA (ICC=0.78), leisure-time PA (ICC=0.75) and active transportation (ICC=0.80) in men than in women, but domestic PA (ICC=0.38) and sitting time (ICC=0.71) demonstrated more substantial reliability coefficients in women than in men. For the construct validity, domestic PA was significantly related mainly with SBP (r=−0.27) and DBP (r=−0.17), and leisure-time PA and total PA were significantly related only with SBP (r=−0.16) and BMI (r=−0.29), respectively. Similarly, moderate-intensity PA was mainly related with SBP (r=−0.16, p<0.05) and DBP (r=−0.21, p<0.01), but vigorous-intensity PA was only related with BMI (r=−0.11, p<0.05). Conclusions The modified Hausa IPAQ-LF demonstrated sufficient evidence of test–retest reliability and may be valid for assessing context specific PA behaviours of adults in Nigeria.

Job satisfaction traits of Nigerian physical therapists

In recent years emigration of highly trained health personnel has caused manpower shortages that were of real concern to the developing countries. This study was designed to (1) determine whether physical therapists (PTs) in Nigeria were satisfied with their jobs, and (2) assess whether Nigerian PTs practicing in the United States (U.S.) were more satisfied with their jobs than the PTs in Nigeria. A questionnaire was administered to PTs in Nigeria ( N = 110) and Nigerian PTs based in the US ( N = 31). The questionnaire consisted of two parts: Part 1 sought demographic information and Part 2 consisted of ten statements relating to paperwork, job challenge, physical demand, job autonomy, fulfillment, and stress. Overall, these cohorts of PTs were satisfied with the clinical practice aspects of their jobs. The two groups were comparable except in areas relating to stress, paperwork, and physical demand. Nigerian PTs practicing in the U.S. were not more satisfied than their counterparts in Nigeria. The study suggests that factors other than those related to clinical practice aspects of physical therapy were responsible for the wave of emigration of PTs from Nigeria in the past decade.

Determinants of return to work among Nigerian stroke survivors

Purpose: Employment, an important aspect of life, could be adversely affected by a disabling condition like stroke. This study explores the frequency and determinants of return to work (RTW) among Nigerian stroke survivors. Method: One-hundred and one stroke patients attending Physiotherapy clinics at seven teaching and specialist hospital centers in north-eastern Nigeria participated in the study. Socio-demographic, clinical and RTW data were obtained from participants while the modified Rankin Scale was used to assess functional ability. Chi-square statistics and multivariable logistic regression analysis was used to identify the determinants of RTW among the participants. Results: About half of the participants (55%) had returned to work. Absence of disability [Odds Ratio (OR) = 57.7; 95% CI = 12.0–276.8) and mild disability (OR = 15.1; 95% CI = 3.9–58.3) were the significant determinants of RTW, while post-stroke duration of a year or less was associated with lower chance of returning to work (OR = 0.2; 95% CI = 0.0–0.8). Conclusions: The prominence of functional independence among the determinants of RTW implies that rehabilitation efforts and support programmes to optimize functional ability, especially within the first year after stroke, will greatly enhance RTW among Nigerian stroke survivors. Implications for Rehabilitation Functional outcome influenced vocational outcome, hence the need for rehabilitation efforts at improving functional status of stroke survivors to encourage return to work (RTW). The low rate of RTW within the first year after stroke may be addressed by the establishment of specilized sub-acute and long-term rehabilitation centers in Nigeria instead of depending only on existing inadequate outpatient rehabilitation practices