Socio-ecological influences of leisure-time physical activity among Nepalese adults: a qualitative study

Background With economic and social changes, participation in occupational and transport-related physical activity is declining among Nepalese adults, highlighting the growing importance of leisure-time physical activity. However, limited information is available to guide public health policies and interventions to promote leisure-time physical activity in Nepal. This study aimed to qualitatively explore the socioecological influences of participation in leisure-time physical activity among Nepalese adults aged 40 years and above. Methods A total of 51 adults (30 females and 21 males) participated in one of the nine focus groups conducted in Kathmandu, Nepal. A semi-structured guide based on the social-ecological model of physical activity was used to facilitate these focus groups. Data were analysed using a reflexive thematic analysis approach in NVivo 12. Results Participation in leisure-time physical activity was minimal and leisure time was mostly spent resting, socialising, or engaging in sedentary activities such as watching television. Walking was the most common form of leisure-time physical activity, and men reported being more active than women. Individual-level barriers included lack of knowledge, lack of skill, lack of motivation, considering oneself as sufficiently active and engagement in sedentary screen activities. Family and household responsibilities, lack of support and fear of being judged constituted the interpersonal barriers while environmental barriers included an absence of a supportive social norm, lack of open spaces, weather conditions and perceived lack of safety. Health benefits, prioritising physical activity, social support, provision of group-based activities and age-appropriate public exercise facilities were identified as major facilitators. Conclusion Critical issues that need to be addressed to increase leisure-time physical activity among Nepalese adults include traditional gender roles, family and social support, and social norms. Modifications of the built environment, such as public exercise facilities, offer further opportunities and will require coordination beyond the health sector.

Peacebuilders and the Pandemic

This research explores how participants who self-identify as peacebuilders have been affected by the COVID-19 pandemic personally and professionally. Twenty-seven peacebuilders worldwide reflect on their experience of the COVID-19 pandemic in an online survey and text-based reflective interview, sharing insight into how it has affected them and their work in the peace sector. Peacebuilders have experienced the ambiguity of the COVID-19 pandemic in differing ways, with some seeing opportunities in their work and personal life, and others, threats. The results reveal 12 common aspects that have affected the peacebuilders' lives during the COVID-19 pandemic. Notably, in their work, peacebuilders have experienced changes in their relationships with colleagues and stakeholders because of interpersonal barriers due to COVID-19 lockdowns and distancing measures. Concerning the impact the COVID-19 pandemic has had on peacebuilders' personal lives, the research reveals that their mental health has been negatively affected and peacebuilders see an increase in anxiety. The causes of this anxiety include an inability to make plans and conduct pre-planned peacebuilding projects. The theoretical foundation in this study understands the COVID-19 pandemic as a period of ambiguity and grief. This approach results in a previously unexplored and timely examination of how the pandemic has affected peacebuilders personally and professionally. This paper offers peacebuilding organisations insight into what aspects peacebuilders require support with, to ensure they can continue their essential work now, and in the post-pandemic world.

Adolescent condom use in Southern Africa: narrative systematic review and conceptual model of multilevel barriers and facilitators

Background Adolescent HIV and pregnancy rates in Southern Africa are amongst the highest in the world. Despite decades of sexual and reproductive health (SRH) programming targeting adolescents, recent trends suggest there is a continued need for interventions targeting condom use for this age group. Methods This review synthesises evidence from qualitative studies that describe the determinants of condom use among adolescents in Southern Africa. We conducted systematic searches in four databases. Data were extracted, appraised for quality and analysed using a ‘best-fit’ framework synthesis approach. Results We coded deductively findings from 23 original studies using an a priori framework and subsequently conducted thematic analysis. Synthesised findings produced six key themes relating to: 1) pervasive unequal gender norms and restrictive masculinities favouring male sexual decision-making and stigmatising condom use in committed relationships; 2) other social norms reflecting negative constructions of adolescent sexuality and non-traditional family planning; 3) economic and political barriers including poverty and a lack of policy support for condom use; 4) service-level barriers including a lack of youth-friendly SRH services and comprehensive sex education in schools; 5) interpersonal barriers and facilitators including unequal power dynamics in sexual partnerships, peer influences and encouraging condoning condom use, and inadequate communication about SRH from parents/caregivers; and 6) negative attitudes and beliefs about condoms and condom use among adolescents. A conceptual model was generated to describe determinants of condom use, illustrating individual-, interpersonal- and structural-level barriers and facilitating factors. Conclusion SRH programming targeting barriers and facilitators of condom use at multiple levels is recommended in Southern Africa. We present a multilevel integrated model of barriers and facilitators to guide adolescent SRH decision-making, programme planning and evaluation. Given the existence of multilevel barriers and facilitators, interventions should, likewise, take a multilevel approach that incorporates locally relevant understanding of the individual-, interpersonal- and structural-level barriers and facilitators to condom use among adolescents in the region.

Temporary stays with housed family and friends among older adults experiencing homelessness: Qualitative findings from the HOPE HOME study

Background The proportion of adults age 50 and older experiencing homelessness is growing. People at risk for homelessness may stay with family and friends during homelessness episodes. Moving in with housed family and friends is a strategy used to exit homelessness. Little is known about these stays with family and friends. This study examined the motivations for and challenges of older adults experiencing homelessness staying with or moving in with family or friends. Methods We purposively sampled 46 participants from the HOPE HOME study, a cohort of 350 community-recruited adults experiencing homelessness age ≥50 in Oakland, CA. Inclusion criteria included having stayed with housed family/friends for ≥1 nights in the prior 6 months. We sampled 19 family/friends who had hosted participants experiencing homelessness. We conducted separate, semi-structured interviews, summarized, memoed and coded data consistent using a grounded theory approach. Results Older adults experiencing homelessness reported primarily temporary stays. Motivations for stays on the part of participants included a need for environmental, physical, and emotional respite from homelessness. Both individuals experiencing homelessness and hosts cited the mutual benefits of stays. Barriers to stays included feelings of shame, concerns about burdening the hosts, and interpersonal conflicts between older adults experiencing homelessness and host participants. Conclusions There are potential opportunities and concerns surrounding temporary stays between older adults experiencing homelessness and their family or friends. Policy solutions should support the potential mutual benefits of temporary stays, while addressing interpersonal barriers to strengthen kinship and friendship networks and mediate the negative impacts of homelessness.

Understanding the Barriers of HIV Testing Services for Men Who Have Sex With Men and Transgender Women in Bangladesh: A Qualitative Study

Coverage of HIV testing services (HTS) is generally low among men who have sex with men (MSM) and transgender women ( hijra) in Bangladesh, thus impeding the national goal of attaining the 90-90-90 target. In this context, this article delineates HTS uptake barriers among these populations. This qualitative study entailed 30 in-depth interviews, six focus groups and seven key-informant interviews with purposively selected MSM and hijra, alongside service providers. Participants cited individual and interpersonal barriers such as low risk perception and misconceptions about HIV testing, programmatic barriers such as knowledge gaps among peer service providers, as well as community and structural barriers such as the criminalization and stigmatization of male-to-male sex. Considering these contexts, it is essential for stakeholders to improve the HTS modality using multipronged approaches to address the multifaceted barriers of HTS uptake.

Exploration of Physical Activity Barriers and Facilitators Among Adults in Kathmandu, Nepal

Previous research suggests that a range of factors influence an individual’s physical activity (PA) participation, but studies among Nepalese adults are limited. In this qualitative study, we aimed to explore the multilevel influences upon PA participation among community-dwelling adults aged 40 years and above living in an urban setting in Kathmandu, Nepal. Men ( n = 21) and women ( n = 30) were purposively sampled to participate in one of nine focus group discussions. Types of PA undertaken constituted activities related to housework, farm work, and active travel. Individual-level barriers included lack of knowledge, lack of motivation, perceptions of already being active, personal limitations, and lack of time. Interpersonal barriers included household responsibilities and lack of support. Broader environmental barriers included lack of infrastructure for active commuting, poor safety, rising use of motorized transport, lack of resting areas, weak social norms about PA, declining agricultural engagement, mechanization, and improved access to technology and facilities. Some differences were observed between the gender and disease groups. Health benefits, integration into domestic work, opportunities for social interaction, and social support were the facilitators. Interventions focusing on families, highlighting the short- and long-term benefits of PA, addressing gender roles, and ensuring women are better supported represent opportunities to promote PA. Community-based interventions will be essential to establish social norms around PA and improve social support.

Perceived barriers to and suggested interventions for physical activity during pregnancy among participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Southern California

Background The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women engage in at least 20 to 30 min of moderate-intensity physical activity on most days of the week. Regular exercise during pregnancy is associated with many benefits for the mother and the developing fetus; yet, a large number of pregnant women do not engage in the recommended amounts. This study aimed to investigate barriers to and interventions for physical activity among pregnant WIC participants in Southern California. Methods We conducted four focus groups (FGs) with pregnant low-income women aged 18 years or older in either their second or third trimester. FGs were conducted at a WIC center in Southern California. The FGs were held according to language (English vs. Spanish-speaking) and BMI category (normal weight vs. overweight and obese). A total of 28 women participated. We used ATLAS. ti. to analyze the focus group transcripts. The study adhered to the Consolidated Criteria for Reporting Qualitative Research. Results The mean age of focus group participants was 28.9 years (SD = 6.6), and the majority were Latina. Intrapersonal barriers to physical activity were fatigue and lack of energy, pain and swelling, lack of childcare, medical restrictions and safety concerns, lack of knowledge about exercise safety, and lack of time. Interpersonal barriers included concerns and lack of support from partners and families, conflicting advice from friends and neighbors, and lack of advice on safe exercise from physicians. Women in all four groups suggested a community-based intervention where they can mingle with each other and share their challenges and concerns. Other suggestions to interventions differed among groups and reflected the women’s experiences and backgrounds. Specifically, to promote education, English-speaking women preferred a brochure while Spanish-speaking women preferred a video. Overweight women emphasized including children in their exercise activities to promote healthy behavior in youth. Conclusions Interventions should be tailored to pregnant women’s needs. Primary care providers should provide reassurance and information to pregnant women and their partners on the type and frequency of safe exercise.

Repensando la enseñanza de la sustentabilidad.

The social commitment to educate and teach under the approach of sustainability requires a change: to stop reducing Nature to a simple commodity and what changes, strategies and resources to use to train future professionals under a multidisciplinary, interdisciplinary, transdisciplinary and critical approach . The University of Guadalajara faces a great challenge, as an institution it must assume commitments and joint actions as an institution of higher education to train a new type of professionals; carry out modifications in all the study plans of the different careers; train their professors, which implies facing institutional and interpersonal barriers relying on collaborative work with other universities, companies, government and NGOs under a social commitment. Although the need for these changes is recognized and it is desired to do so, it is necessary to design the course of action to carry them out.

The “Comida de República” web-based course to promote healthy eating among college students

ABSTRACT Objective The work aimed to investigate dietary practices of university students after an action aiming to promote adequate and healthy food. Methods The article reports the experience of the distance education course Comida da República, promoted by the Universidade Federal de São Paulo as an educational space for sharing and exchanging knowledge, experiences, and thoughts on eating in the university context, especially in student homes or fraternities (repúblicas). Online questionnaires assessed the profile of participants and changes in their perception or relationship with food. The Students’ t-test was adopted to compare perceptions before and after the intervention, and content analysis for qualitative data. Results The course had 201 students enrolled and 82 who concluded it, with 35.4% living in repúblicas. Before the course, 89.6% of those who completed the course indicated the need to improve their diets, and 57.3% classified their diets as “regular”. There was a significant change in perception after the course: 58.5% of those who completed it rated their food as “good”. Dietary changes were categorized into two themes: “vision on food production and distribution” and “food and meal consumption”. The emerging codes show a greater awareness and criticism about food systems and a greater appreciation of cooking, commensality, and unprocessed and minimally processed foods. Participants identified environmental, personal, and interpersonal barriers (67.1%) to dietary changes. The course emerged as a facilitator of these changes. Conclusions This intervention proved to be an important educational tool to promote adequate and healthy eating, in addition to contributing to the planning and execution of student affairs and food security policies.