Saudi Cultural Missions Theses & Dissertations
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Item Restricted EFFECT OF ADDING NATURAL HONEY INTAKE ON LIPIDAEROBIC EXERCISETO CONTINUOUS PROFILE IN OVERWEIGHT MEN(Cairo University, 2024) Alfaqir, Mohammed; Elnahas,Nesreen; Elsheimy,Hend; Ismail,AliObjective: This study aimed to assess the effect of adding natural honey intake to continuous aerobic exercise on lipid profile in overweight men. Methods: Sixty overweight men who aged 40-50 years old - were randomly distributed into one of two groups; the study group (n=30) received 40-minute continuous aerobic exercise on treadmill three times weekly plus oral honey intake thrice daily for 12 weeks and the control group (n=30) received only the aerobic exercise thrice weekly. Patients' body mass index (BMI), waist-hip ratio (WHR), high density lipoprotein (HDL), atherogenic index of plasma (AIP), low density lipoprotein (LDL), total cholesterol (TC), and triglycerides (TG) were assessed in both groups. Results: After 12-week intervention, a significant improvement (P < 0.05) of BMI, WHR, TC, TG, LDL, HDL, and AIP was documented within both groups but the better level of improvement was detected in the study group. Post-treatment between-group comparison of all outcomes indicated a significant improvement in the direction of the study group. Conclusion: It could be concluded from this trial that adding 12-week oral honey intake to aerobic exercise maximize the improvement of lipid profile gained from aerobic exercise alone in overweight men. We recommend future research about the effect of honey intake on different grades of obesity in different ages of men.29 0Item Restricted An evaluation of the Rashaka Initiative: a school-based obesity intervention in Makkah City, Saudi Arabia(University of Technology Sydney, 2024-03) Banany, Mohammed; Sibbritt, David; Gebel, KlausBackground: Childhood overweight and obesity are public health issues worldwide. In Saudi Arabia, in 2016/2017 the Rashaka Initiative, a national school-based, multicomponent, weight-related intervention, was launched to decrease the prevalence of obesity among students by 5% within five years. Neither the development stage of the initiative nor its implementation has been evaluated to explore its processes and outcomes. Aim: This study was aimed at evaluating the implementation of the Rashaka Initiative in intermediate and secondary schools in Makkah City, Saudi Arabia, covering both process and outcome. To this end, the following objectives were pursued: (1) to develop an evaluation framework that can be used to assess the processes and outcomes of the initiative, (2) to determine whether there was a change in students’ body mass indices (BMIs) during the implementation period, and (3) to explore the knowledge and attitudes of the Rashaka stakeholders regarding the perceived barriers and facilitators of implementation in their schools. Methods: This retrospective study, conducted after the implementation of the Rashaka Initiative, was completed in three phases. In phase I, a conceptual framework called the school-based weight-related intervention evaluation framework (SWIEF) was developed by integrating some elements of the program evaluation framework used by the US Centers for Disease Control and Prevention (CDC) with the components of a logic model. In phase II, secondary data from the Rashaka Initiative were analysed. Phase III was a cross-sectional exploration of the Rashaka stakeholders’ knowledge and attitudes as well as what they perceive as facilitators and barriers to implementing the intervention at their schools. Results: The comprehensive literature review yielded a published systematic review (Banany et al. 2024, Systematic Reviews). This systematic review found 11 school-based weight-related intervention studies in the six Gulf Cooperation Council countries (GCC). Despite the methodological limitations of some of these studies, there is preliminary evidence of the possible benefits of school-based interventions on students' weight and associated lifestyle factors in these countries. A review of the literature also facilitated the development of the SWIEF. The analysis of the secondary data revealed a significant reduction in BMI (p<0.001) across schools that participated in the Rashaka Initiative over two school years (2016/17 and 2018/19). However, this reduction was not associated with the school environmental factors attributed to the initiative. The study findings found that students’ BMIs decreased more considerably in girls’ and intermediate schools than in boys’ and secondary schools (p<0.001 and p=0.031, respectively). The cross-sectional study indicated that significantly better knowledge of risk factors and interventions for childhood obesity was exhibited by female Rashaka stakeholders (vs their male counterparts), stakeholders who completed tertiary education (vs those with lower education levels) and stakeholders engaged in the initiative for more than two years (vs participants who joined more recently) (p<0.001, p<0.007 and p<0.033, respectively). School health counsellors had more positive attitudes towards children’s health and weight than principals (p<0.008). Significantly more favourable attitudes towards the Rashaka intervention were also found among female stakeholders (p<0.011) and those with better knowledge of the initiative’s objectives, components, activities, and outcomes (p<0.049). Among the stakeholders, 73% perceived collaboration with different government and private sector institutions as the most common facilitator of the Rashaka implementation at their schools, while 69% perceived a lack of time as the main barrier. Conclusions: Addressing childhood obesity is a public health priority that requires substantial efforts from all relevant key stakeholders in Saudi Arabia. The evidence derived in this thesis revealed that the Rashaka Initiative has yet to satisfy its objectives. Future studies should be more rigorous, theory-based, and holistic to tackle obesity among school students. Evaluations of school-based obesity interventions should use control groups, validated and reliable measures and rigorous data analysis. Long-term monitoring of the implemented interventions is highly recommended for their improvement and sustainability.56 0Item Restricted Assess the Effectiveness of School-Based Interventions on Obesity-Related Behaviours among Children And Adolescents (5-19 Years Old) in Saudi Arabia: A Systematic Review(2023) AlNassar Noura; Pockett RhysBackground: Childhood obesity poses a public health concern in Saudi Arabia. School-based interventions have been recommended to modify obesity-related behaviours in children and adolescents. Nevertheless, their effectiveness remains unclear, particularly in Saudi Arabia. Aim: This review examined the effectiveness of school-based interventions in positively changing obesity-related behaviour and/or BMI/BMI-Z in Saudi Arabia. The review also attempted to identify the characteristics of the intervention that contributed to its success. Methods: Six databases were searched: Medline (EBSCO host), PsycINFO (EBSCO host), SPORTDiscus (EBSCO host), Education Research Complete (EBSCO host), EMBASE, and Web of Science. Google Scholar was searched for unpublished studies, and reference lists were reviewed by hand. This review included all study designs from inception written in English, aimed at children or adolescents aged 5-19 in Saudi Arabia who received a school-based intervention and reported at least one obesity-related behaviour outcome and/or BMI/BMI-Z. Studies were assessed using the EPHPP quality assessment tool. Findings: Eight studies met the inclusion criteria and were incorporated into a narrative synthesis. 75% of the studies were performed on female participants and 50% on intermediate school students aged 12-15. About 63% of the studies focused on Saudi Arabia's Western region. The duration of the interventions varied from two days to six months. Various intervention approaches are employed in Saudi schools, including environmental modification, educational, behavioural, and sporing interventions. 63% of the interventions were theoretically based. Parents were included in 38% of the studies. Obesity-related behaviours were measured subjectively in most interventions. BMI/BMI-Z was measured using various reference charts. Five studies used multi-component approaches, with 60% achieving positive results. Three studies used single-component approaches, with 67% achieving positive results. Discussion: According to this review, 75% of Saudi Arabian school-based interventions improved obesity-related behaviours or BMI/BMI-Z. Therefore, Saudi Arabian schools could be a focal point for preventing obesity and promoting healthy behaviour. The effectiveness of multi-component interventions in Saudi schools is comparable to single-component interventions. It appears that duration is not a factor in the effectiveness of interventions targeted at the personal level. Also, this study indicated that interventions based on theoretical bases and involving parents are likely effective. Conclusion & Recommendations: This review indicates that most interventions implemented in Saudi schools have successfully modified children and adolescents' obesity-related behaviours and/or BMI/BMIZ. However, school-based interventions are limited in Saudi Arabia, with considerable heterogeneity. The strengths and limitations of the included interventions may have influenced the outcomes. Therefore, health promotion and prevention efforts should be improved methodologically and consider previous experiences when developing evidence-based interventions. In addition, long-term school-based interventions are necessary to evaluate the true impact of these interventions on childhood and adolescent obesity in Saudi Arabia. Implications for public health and health promotion: School-based interventions are suggested as a strategic approach to positively change obesity-related behaviours among children and adolescents. Schools are crucial to health promotion and can be especially beneficial in Saudi Arabia, given the high obesity rate. Investing in school-based interventions can help create a healthier generation of students equipped to make informed decisions and lead healthier lives.116 0