Saudi Cultural Missions Theses & Dissertations
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Item Restricted Physical Activity Promotion in Saudi Arabia: The Potential and Challenges of Outdoor Exercise(Loughborough University, 2024-06-11) Albujulaya, Naif; Stevinson, Clare; Piggin, JoePhysical activity is a gateway to a healthier and more vibrant life, offering multiple physical and mental health benefits. Recent evidence suggests that engaging in outdoor exercise leads to many positive outcomes such as reducing stress, anxiety, & depression, providing Vitamin D and fostering social interactions and that extend beyond the boundaries of engaging in indoor exercise. In addition, the advantages of immersing oneself in nature are numerous and profound. Over the last two decades, research carried out in Saudi Arabia reveals that Saudis exhibit a concerning lack of physical activity. Despite efforts made in the field, there is still a lack of exploration into the factors that influence Saudi adults' involvement in outdoor exercise or strategies to enhance their participation. To fill this knowledge gap, the aim of this thesis is to investigate the possibilities of promoting outdoor exercise in Saudi Arabia. In order to gain a comprehensive understanding of all aspects related to the aim, three studies were conducted to address specific objectives. In the first study (in Chapter 3), the main objective was to analyse the Saudi government policy regarding the promotion of physical activity. This study employed the Comprehensive Analysis of Policy on Physical Activity framework to audit and assess the policy. Official reports and independent sources were examined to provide evidence on progress with implementing the policy objectives. In addition, semi-structured interviews were performed with policy-makers, policy-implementers and independent experts. The results indicated an evidence-based, ambitious policy with several objectives achieved. Greatest progress related to cultural change in permitting women’s sports and general physical activity attitudes and behaviour. Other goals, such as increasing female participation, have met barriers that have hindered progress. In the second study (in Chapter 4), the main objectives were to examine the barriers to exercise that face Saudis and understand the relationship between Saudis physical activity, outdoor environments and wellbeing. A representative sample of Saudi adults completed four standard scales: International Physical Activity Questionnaire - Short Form , Exercise Benefits/Barriers Scale, WHO (Five) Well-Being Index and short-form Nature Relatedness Scale. Additional questions related to physical activity contexts. The results of this study indicate that young adults perceive more barriers than other age groups such as challenges related to the exercise environment, time commitments and discouragement from family, and highlighted that males are more likely to exercise outdoors than females. Outdoor exercise and nature relatedness were significant independent predictors of wellbeing, as were social exercise and sporting activities. In the third study (in Chapter 5), the main objective was to explore in depth factors that influence physical activity, and specifically outdoor physical activity. Twenty-two semi- structured interviews with Saudi adults were conducted and qualitative content analysis was used to analyse the data. Key societal and environmental factors (e.g. discouragement from others, poor facilities, unsafe locations) negatively impacted exercise behaviour, particularly among women. Personal and societal factors were identified as motivations to exercise, such as health or mood improvement and active communities. The findings from the thesis indicate that several factors can impact engagement in outdoor exercise among Saudis. The major barriers included the significant lack of outdoor facilities and the weakness of the government's work towards enabling outdoor exercise. These barriers collectively impact individuals, making them develop a habit of engaging in indoors exercise. On the other hand, engaging in outdoor exercise during childhood, particularly among Saudi males, and seeking health benefits from physical activity are the most noticeable factors that can promote or facilitate outdoor exercise. Knowledge obtained from this thesis can potently help organisations and the Saudi government as a valuable foundation for designing effective interventions and policy modifications to gain the additional benefits of engagement in outdoor exercise.37 0Item Restricted Experiences and beliefs about fatigue, physical activity, physical fitness, and information needs in childhood cancer: Children and their parents’ perspectives(The University of Sydney, 2023) Alqahtani, Qamra Muaikel; Dylke, ElizabethThis thesis aimed to explore the experiences of beliefs about, and information needs related to fatigue, particularly in relation to physical activity and physical fitness, in childhood cancer from children’s and parents’ perspectives. The experience of fatigue, the information needed by children treated for cancer and their families and the use of physical activity as a possible coping strategy were examined in this thesis through a multitude of methods, including a systematic review, as well as quantitative and qualitative research methods. Clearly, fatigue is a complex and variable experience, which places a burden both on children and their parents (Chapter 3,4,5). Fatigue has adverse consequences on all aspects of the child’s life (Chapter 3,4), including hindering their physical activity (Chapter 3,5), emotionally affecting parents (Chapter 3,4), and restricting social and family activities (Chapter 3). Children have different perspective on their information needs on cancer-related symptoms, including fatigue (Chapter 2,3) and their beliefs about fatigue (Chapter 4) than their parents. Children and their parents reported their needs for individualised informational support from healthcare providers about all aspects of the child’s fatigue (Chapter 2,3). Addressing questions and providing information about the child’s fatigue in verbal and written formats would better support both parents (Chapter 2,3) and children (Chapter 3). Physical activity appeared to be underappreciated strategy for the management of fatigue in children (Chapter 3,4,5). Children’s dichotomy perceptions on how physical activity helps with fatigue (Chapter 5), diversity of the beliefs around fatigue between children and their parents and between parents and each other (Chapter 4), and the complexity of fatigue experience (Chapter 3), indicate that fatigue is an issue that requires further discussion and multiple encounters with healthcare providers across and beyond the cancer treatment phases.29 0Item Restricted The Feasibility of Pulmonary Rehabilitation in Patients with Interstitial Lung Diseases Including Patients with Combined Pulmonary Fibrosis and Emphysema(2023-08-14) Alsomali, Hana; Ward, ChrisIntroduction: Interstitial lung diseases (ILD) are characterized by interstitial inflammation or fibrosis, leading to impaired gas exchange, shortness of breath, decreased exercise tolerance, and reduced quality of life. Combined pulmonary fibrosis and emphysema (CPFE) is the co-existing presence of pulmonary fibrosis and emphysema. Data describing the experience of tailored pulmonary rehabilitation program (PRP) in people with ILD is rare and in particular in patients with CPFE are lacking. This PhD aimed to determine the characteristics and prognosis of patients with CPFE in a United Kingdom cohort, and to assess the feasibility of inspiratory muscle training (IMT) as part of a PRP for patients with ILD including patients with CPFE. Methods: A five-year retrospective single centre study was conducted at the regional ILD clinic. Then a feasibility study with a randomized controlled trial design was conducted Patients were randomized into intervention group IMT + PRP and a control group PRP only. The IMT was performed using POWERBreathe® twice daily. The PRP consisted of one session a week for 6-8 weeks. Results: Retrospective study showed that 203 patients with CPFE were diagnosed. Mean age and Body Mass Index (BMI) for patients with CPFE were 72 years (SD = 8.7), and 28.1 kg/m² (SD = 4.4) respectively. Median survival time for patients with idiopathic pulmonary fibrosis (IPF) subtype CPFE n= 93 was 3.2 years (2.1-4.2).. Kaplan Meier analysis showed statistically significant differences between Gender at birth-Age-Physiology (GAP) stages with a p-value of 0.012 in patients with IPF subtype CPFE. PRP had an attendance and completion rates of mean of 87% and 64% respectively. No side effects were reported during the study. The maximum inspiratory pressure (MIP) improved in all participants. Conclusion: Patients with CPFE were relatively old, majority male, with a history of smoking, and had poor prognosis. The GAP index and staging system demonstrated prognostic capability in patients with IPF subtype CPFE. At least half the patients with CPFE were not referred to PRP, indicating low referral rates. A tailored PRP program was feasible and well received in patients with CPFE, indicating that this was a viable and beneficial treatment option for patients with CPFE where therapeutic options are limited.5 0Item Restricted Factors Influencing Physical Activity Among U.S. Adults With Chronic Health Conditions: Mediation And Moderation Analyses(Saudi Digital Library, 2023-03-09) Alqahtani, Sami; Fontaine, KevinThe prevalence of chronic health conditions (CHCs) is rising across all age groups, genders, and racial/ethnic groupings, making them the main cause of death globally. The majority of CHCs deaths occur in middle-to-low-income countries, although they are also a significant health issue in developed countries. A higher risk of developing CHCs is linked to physical inactivity. Global societies are experiencing increased prevalence of CHCs, which are directly assoicated with rising healthcare costs, workforce attendance, productivity challenges, and academic success. However, increased exercise and physical activity (PA) are linked to lower odds of developing CHCs. In fact, regular PA can help reduce the risk of developing at least 20 CHCs and help with the management of these conditions. However, only 1 in 4 adults in the United States (US) meet the current PA recommendations for aerobic and muscle-strengthening activities. In addition even fewer individuals with CHCs meet current PA recommendations. To that end, the current dissertation explores factors influencing the relationship between CHCs and PA status among US adults to address this important research gap via three independent studies. In the first study (Chapter 2), and as a first step, we wanted to present an updated estimate of American adults' with CHCs adherence to the current Centers of Disease Control (CDC) recommendations for PA based on the presence or absence of CHCs using a nationally representative data (BRFSS). Specifically, we estimated the prevalence of US adults with self-reported CHCs who meet the current PA recommendations according to their sociodemographic characteristics, number of CHCs, and type of CHCs. Additionally, we identified important research gaps and proposed recommendations for future studies. Briefly, we found that only 18% of US adults with self-reported CHCs met the PA recommendations for both aerobic and muscle-strengthening, and almost 35% did not meet both PA recommendations. Another important finding is that the prevalence of American adults who do not adhere to both PA recommendations increases as the number of CHCs increases. Furthermore, after examining each CHC independently, it was found that American adults with COPD had the highest prevalence of not meeting the PA recommendations for both aerobic and muscle-strengthening exercise. In the second study (Chapter 3), we conducted two mediation analyses to test whether mental health status and then separately physical health status mediate the relationship between self-reported CHCs and self-reported PA status. Specifically, the inverse odds weighting approach (IOW) was used to estimate the total effect, the direct effect, the indirect effect, and the percent of effect related to mediation in weighted logistic regression models. Our analysis of BRFSS data showed lower odds of PA, poorer mental health, and poorer physical health among American adults with CHCs. Most importantly, we found that the relationship between CHCs and PA is due, in part, to the influence of CHC on poorer mental and physical health, which, in turn, influences physical inactivity, supporting our hypotheses. In the third study (Chapter 4), five weighted logistic regression models were performed to examine the relationship between CHCs and PA. Tests of moderation were conducted by including an interaction term between CHCs and each substance use variable (binge drinking, tobacco smoking, smokeless tobacco, marijuana, and polysubstance). We found that individuals who reported having CHCs and individuals who are current tobacco smokers had statistically significant lower odds of being physically active. CHCs management has risen to the forefront of modern medicine as our population ages, and medical costs continue to rise. Hence, there is a need for more research that prioritize CHCs preventative and mitigating strategies, such as PA behavior promotion. The findings from this dissertation may guide clinicians, public health professionals, policymakers, and researchers to better understand the factors that might influence the relationship between PA and CHCs. This information will help design more effective and evidence-based PA promotion interventions and policies aiming to help American adults (with or without CHCs) to be more physically active.10 0Item Restricted Exploring And Assessing The Level Of Physical Activity Among Physiotherapists In Saudi Arabia: A Cross-Sectional Survey(2023-03-06) Alnaji, Abdulelah Hussain; Phillips, NicolaBackground: Physical activity (PA) is an essential part of good health. There is considerable evidence of declining PA globally, including in the Kingdom of Saudi Arabia (KSA). One of the primary goals of physiotherapists is to advocate for a healthy lifestyle. Since physiotherapists act as healthy role models for their patients. However, there is a lack of information about PA among physiotherapists in KSA. Aim of the study: The current research aimed to explore the level of PA among physiotherapists in KSA and to understand the barriers to and facilitators of PA. Design: A cross-sectional survey. Methods: This study included 172 physiotherapists currently working in the KSA as citizens or residents, a large percentage of whom were male (71%; n: 122). Between 28 December 2022 and 2 February 2023, the investigator distributed an online form of the international physical activity questionnaire (short version) via various social media platforms such as Twitter and Facebook. Results: The study's findings demonstrate: (1) 9.3% (n = 16) of the study respondents did not engage in any PA; (2) the majority of the participants (90.7%, n:156) engaged in various intensities of moderate, vigorous, and a combination of moderate and vigorous PA; (3) more than half (61%, n: 105) of the respondents followed the international PA recommendations; (4) lack of time and work commitments were the most significant challenges that the participants faced when they engaged in PA; (5) motivation to improve health and losing or maintaining weight were the most notable facilitators for participating in PA among the participants. Conclusion: According to the results, a high percentage of physiotherapists in this study participated in PA. However, nearly 39% of study participants did not meet international PA recommendations. Thus, a study with large sample size is needed to improve the generalisability of the findings.13 0