Saudi Cultural Missions Theses & Dissertations
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Item Restricted Exploring the Challenges and Opportunities Involved in Increasing Physical Activity among Children and Young People in Saudi Arabian Schools(The University of Sheffield, 2024-05) Alalawi, Abdullah; Goyder, Elizabeth; Blank, LindsayBackground: The growing global burden of noncommunicable diseases, exacerbated by insufficient physical activity (PA), is a significant health issue in the Kingdom of Saudi Arabia (KSA). Cultural and environmental factors limit opportunities for PA, especially among school children in urban areas. Aim: This study explores the challenges and opportunities for school-based PA to inform future interventions among schoolboys aged 13 to 15 years in KSA. Methods: Systematic reviews assessed international and Arabic country-specific evidence for school-based PA interventions. Qualitative data were collected through semi-structured interviews with 16 school staff, seven parents and workshops with 37 students in two contrasting schools one private and one public sector in Jeddah City, KSA. Follow-up interviews were conducted with a total of nine school staff members at both schools. Results: Review evidence identified promising interventions for increasing PA in schools including The Daily Mile, active breaks, active desks, and multi-component programmes. In Arabic countries, interventions focusing on PA, nutrition, and education showed potential to increase PA and decrease BMI. Primary research revealed that PA among adolescents is influenced by multiple factors. Individual-level motivators included enjoyment, competition, and health benefits, while barriers comprised academic pressures and sedentary preferences. Interpersonally, variable support from parents, friends, and teachers impacted PA levels. Organisationally, the school environment, facilities, and policies affected PA availability. Community-level insights indicated broader societal and policy interventions, including adapting international programmes to local contexts. Conclusion: This study underscores the need for a multi-dimensional approach to enhance PA among adolescents in Jeddah. Stakeholders should pilot and adapt effective international PA interventions, address school resource disparities, increase PA time in the curriculum, and enhance parental awareness about PA’s importance. These measures are crucial for creating an environment that supports PA to improve public health and enhance youth well-being in KSA.7 0Item Restricted The Effectiveness of School-Based Nurse Intervention in Managing Obesity among Students Aged 6-18 years old(University of Glasgow, 2024-07-29) Almuqeet, Balssam; Rosemary, MullenAbstract Background: Schools play a crucial role in shaping healthy lifestyles; however, school nurses are often excluded from obesity intervention programs. In 2022, 390 million children aged 5-19 were overweight and 160 million were obese, therefore effective methods of intervention are more important than ever. Aims: This review aims to explore the effectiveness of school-based nurse interventions in managing obesity among school-aged students from 6-18 years old. Methods: A comprehensive literature search of Medline Ovid, CINAHL, Cochrane library, and PubMed databases identified randomised controlled trials and quasi experimental studies from the last ten years. The inclusion criteria included school students aged from 6-18 years, interventions delivered by nurses in school, and reported outcome measures on weight or BMI. Studies that were not experimental designs were excluded. Joanna Briggs critical appraisal tools were used to appraise methodological quality. Results: Seven studies met the eligibility criteria. Interventions delivered by school nurses included educational sessions, physical activity programs, and dietary guidance. The measurable outcomes included improvements in dietary behaviour, decreases in BMI, and increases in physical activity levels among students. None of the studies used blinding, some studies did not clearly report the attrition rate. Despite these limitations, all studies used appropriate study designs and applied rigorous statistical analyses. Six out of seven studies reported significant improvement in dietary habits, five studies found an increase in physical activity levels among the students, and four studies observed a decrease in BMI. Conclusions: The findings of the review suggest that school-based nurse interventions are effective in managing obesity among school students. Future research should include objective measures and use longitudinal designs to assess the sustainability and impact on BMI.38 0Item Restricted A critique of the World Health Organisation's and World Dental Federation's Policy Recommendations for Oral Health Interventions Through the Lens of Intervention-Generated Inequalities(Saudi Digital Library, 2023-09-28) Alsaleh, Ahmed; Watt, RichardBACKGROUND Oral health inequalities remain a global health issue that has been neglected and overlooked. Its impact affect everyone in a socially graded manner where the greatest impacts are experienced by the most the marginalised, vulnerable, and disadvantaged people, making them suffer the most from oral diseases. Some preventive interventions can increase oral health inequalities rather than reducing them by favourably benefiting the most advantaged groups. This is what is known as interventiongenerated inequalities (IGIs). Considering the momentum of oral health globally and the golden opportunity for transformative policy change towards a more upstream intervention approach, it is crucial not only to focus on addressing and documenting the causes of existing oral health inequalities but also to focus on evidence-based policy interventions, to not generate more oral health inequalities and widened the gap unintentionally. AIM The aim of this project was to critically review of the World Health Organisation (WHO) Global Oral Health Action Plan (2023-2030 and World Dental Federation’s (FDI) selected oral health policy recommendations and intervention initiatives through the lens of intervention-generated inequalities METHODS This review provides timely and necessary critiques of such interventions that may increase inequalities. Specifically, it critically reviews the World Health Organisation and World Dental Federation's policy recommendations for oral health interventions through the lens of intervention-generated inequalities. RESULTS The findings of this review support the notion that support the notion that preventive individualistic downstream interventions targeting health behaviours, such as untargeted oral health education and mass media campaigns at the population level, have the risk of generating oral health inequalities. This review also highlights the potential role of public-private partnerships and the influence of corporate funding in driving and directing the focus of interventions towards downstream approaches that risk generating oral health inequalities. CONCLUSION This review has assessed how recommended, un-targeted individualistic downstream prevention interventions on a population level could adversely widen oral health inequalities. A key policy priority should be reducing oral health inequalities; therefore, a transformative upstream approach is required.43 0Item Restricted Burnout and Associated Stigma Among Saudi Arabian Healthcare Workers(Saudi Digital Library, 2023-11-06) Algahtani, Lina; Collins, KirstineBurnout and its associated stigma are critical issues affecting healthcare workers worldwide. This study examines the prevalence of burnout and stigma among healthcare workers in Saudi Arabia. The data was gathered through an online survey with 75 healthcare workers participants to explore their experiences with burnout, stigma, coping strategies, and potential workplace interventions. The results revealed a high prevalence of burnout, with 76% of participants reporting experiencing it. Numerous psychological and physical symptoms were associated with burnout, including exhaustion, lack of motivation, and sleep problems. Many participants felt unsupported in their workplace, highlighting the need for more effective communication and resources. 56% reported experiencing stigma when speaking about burnout at work and expressing worries about appearing incompetent. Fear of judgment and toxic work environments contributed to this stigma. Participants provided valuable insights on improving work conditions through a healthy environment, reduced hours, raising awareness, prioritising wellbeing, and offering counselling. This study sheds light on the interconnecting challenges of burnout and the stigma Saudi healthcare professionals face. The findings emphasise the importance of multifaceted strategies to address this issue. This research contributes to the limited existing knowledge on burnout and stigma in the Saudi healthcare system.38 0Item Restricted Self-Management Interventions To Improve Mobility In The Community Post-Stroke(Saudi Digital Library, 2023-05-18) Sahely, Ahmad; Rosewilliam, SheebaIndividuals’ lives after stroke are affected by multiple levels of disability. Appropriate rehabilitation services can help them to regain their functions and improve their quality of life. In the UK and other developed countries, there has been a tendency toward the early supported discharge from hospital after a stroke with the aim of providing care at home after discharge. However, stroke survivors’ needs after discharge from the hospital have been unmet as the health care services lack sufficient resources. Self-management strategies have been developed to help stroke survivors improve their self-efficacy and independence and play an active role in their rehabilitation process. The efficacy and appropriateness of self-management as an additional component to the current practice have been examined in several contexts, but there has been limited research around self-management strategies to improve mobility after stroke. The overarching aim of this thesis was to develop, implement, and test the feasibility of a self- management (SM) intervention to improve functional mobility for stroke survivors in the community. Chapter 1 (the introduction) provides a background of the research problem and the knowledge to practice gap. It demonstrates the prevalence, impact, and management of stroke with focus on mobility rehabilitation as a main physical impairment. It also discusses the gap in current practice regarding the delivery of optimum amount of therapy and the role of SM in bridging the gap and facilitating the recovery of stroke survivors. Chapter 2 demonstrates the philosophical stance taken by the researcher to select the appropriate methodology for each stage of this research work. It shows the advantages of applying different methods to address the specific objectives of the thesis. Chapter 3 includes a systematic review of the evidence about specific SM interventions that can be applied for the rehabilitation of mobility post-stroke. A new intervention was then developed in consultation ii with senior clinicians and stroke patients to adapt the use of evidence to a local context of stroke rehabilitation within the West Midlands. In study 2 (chapter 4). A qualitative exploratory study was carried out during the Covid-19 pandemic exploring needs and experiences of stroke patients and NHS therapists who worked with stroke patients with a special focus on the utility of self-management strategies post discharge. This study found four main themes that described the modifications in the care system because of the pandemic, impact on the stroke survivors at different stage, needs and priorities of stroke rehabilitation, and management strategies that have been used in stroke rehabilitation. The findings from the study contributed to the modification of the intervention developed to integrate technology and promote remote strategies for self-management. Study 3 (chapter 5), aimed to evaluate feasibility of implementation, to explore participants’ perspectives about the acceptability, practicality, and fidelity of the new intervention and to scope out methodological feasibility of a future randomised control trial of the new self-management intervention for mobility following stroke (SIMS). A mixed-methods study design was carried out including a feasibility randomised control design and focus groups to collect data. The study recruited 24 participants (14 males: 10 females; age range (36-87 years)) into both the intervention and control groups. The study findings showed that it was feasible to recruit participants from hospital and community, but the rate was low due to effects of the COVID-19 pandemic. Randomisation and blinding were successful. Retention rate was 83% at 3 months and 79.2% at 6 months assessments. Adherence to the intervention varied mainly due to post stroke fatigue, COVID-19 and the impact of mood changes. It was feasible to deliver the intervention online with no serious events related to the study. Focus groups discussed participants’ motivations for joining the programme, their perspectives on the intervention (fidelity and acceptability) and methodology, perceived improvements in walking outcomes, facilitators and challenges for self-management, and suggestions for improvement. Lastly, chapter 6 provides a summary of findings and discussion points about the key findings from all three studies included in this thesis work.23 0