Browsing by Author "Okop, Kufre Joseph"

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    Factors associated with excessive body fat in men and women: cross-sectional data from Black South Africans living in a rural community and an urban township
    (Public Library of Science, 2015) Okop, Kufre Joseph; Levitt, Naomi; Puoane, Thandi
    Objective To determine the factors associated with excessive body fat among black African men and women living in rural and urban communities of South Africa. METHODS: This is a cross-sectional analysis of data from the Prospective Urban and Rural Epidemiology (PURE) study, Cape Town, South Africa conducted in 2009/2010. The study sample included 1220 participants (77.2% women) aged 35-70 years, for whom anthropometric measurements were obtained and risk factors documented through face-to-face interviews using validated international PURE study protocols. Sex-specific logistic regression models were used to evaluate socio-demographic, lifestyle and psychological factors associated with three excessive body fat indicators, namely body mass index (BMI), waist circumference (WC) and body fat percent (BF%). RESULTS: The prevalence of excessive body fat based on BF%, WC and BMI cut-offs were 96.0%, 86.1%, and 81.6% for women respectively, and 62.2%, 25.9%, and 36.0% for men respectively. The significant odds of excessive body fat among the currently married compared to unmarried were 4.1 (95% CI: 1.3-12.5) for BF% and 1.9 (95% CI: 1.3-2.9) for BMI among women; and 4.9 (95% CI: 2.6-9.6), 3.2 (95% CI: 1.6-6.4) and 3.6 (95% CI: 1.9-6.8) for BF%, WC and BMI respectively among men. Age ≤50 years (compared to age >50 years) was inversely associated with excessive BF% in men and women, and less-than-a-college education was inversely associated with excessive BMI and WC in men. Tobacco smoking was inversely associated with all three excessive adiposity indicators in women but not in men. Unemployment, depression, and stress did not predict excessive body fat in men or women. CONCLUSION: The sex-differences in the socio-demographic and lifestyle factors associated with the high levels of excessive body fat in urban and rural women and men should be considered in packaging interventions to reduce obesity in these communities.
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    "Perceived neighborhood walkability" and physical activity in four urban settings in South Africa
    (2019) Isiagi, Moses; Lambert, Estelle; Okop, Kufre Joseph
    Introduction. In Africa, studies on the associations between the perceived neighbourhood walkability and physical activity, particularly, by socio-economic status (SES) remain scarce. This study explores these associations by validating the Neighbourhood Environmental Walkability Scale (NEWS-Africa) in an urban setting of South Africa to gain a better understanding of the construct of neighbourhood “walkability”. Methods. A convient sample of residents from four suburbs in urban metropole (n=52, 18-65yr, 81% women) in the Western Cape Province, South Africa (viz. Langa, Khayelitsha, Pinelands and Table View) were recruited through invitations following community gatherings and church services. Measures were obtained on perceived neighbourhood walkability, self-reported and measured physical activity and socio-economic status. Langa and Khayelitsha represented two primarily low-SES townships, whereas Pinelands and Table View represented suburbs of a higher-SES. Participants completed the 76-item (13 subscales) NEWS-Africa survey by structured interviews and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire. Objective data on physical activity was collected using accelerometers, and ground-truthing was used to assess the neighbourhood environment using global information systems (GIS) in a 1000m buffer around each geocoded household. The research was carried out in three parts: 1) Evaluating the reliability and construct validity of the NEWS-Africa instrument between the two-SES groups. 2) Examining some of the walkability constructs and subscales of the NEWS-Africa instrument using GIS and ground-truthing, and the extent to which the SES of communities influenced these associations. 3) Examining the differences in self-reported physical activity (domains), measured physical activity (MVPA) when groups are divided according to SES, GIS walkability (1000m buffers) and if the data support the notion of utilitarian walking in low SES groups, irrespective of the built environment attributes. Results. For the combined-SES groups, the test-retest reliability indicated a good reliability with 10 out of the 13 scales of the NEWS-Africa being significantly and positively correlated. The Spearman’s correlations ranged from (rs = -0.43, p=0.00 to rs = 0.79, p=0.00). For construct validity of the NEWS -Africa instrument against self-reported physical activity, only three scales were related to walking for transport: Neighbourhood surroundings scale (rs= -0.34, p=0.01), Safety from Traffic scale (rs =0.34, p< 0.05) and people in the low-SES and combined SES perceived public bus/ train stops to be nearer than they actually were (rs =-0.50, P< 0.05). Of the 13 scales of the NEWS-Africa questionnaire, 6 were significantly correlated to GIS-measured walkability index parameters. The Roads and walking paths scale was positively associated with GIS-measured walkability (rs = 0.3), and the Stranger danger scale was negatively associated with GIS-measured walkability (rs = -0.4). When we considered GIS-measured Land use mix, 3 of the NEWS- Africa scales were correlated (For the entire sample, the scales including Places for walking, cycling and playing overall scale (rs = 0.3), and Neighbourhood surroundings scale (rs = 0.3), were positively associated respectively). Conversely, Stranger danger scale was inversely correlated (rs = -0.6). Intersection density measured with GIS was significantly and positively associated with the Roads and walking paths scale for all groups combined (rs = 0.3). For GIS-measured walkability, self-report physical and measured physical activity, there were no associations in any of the domains for self-reported physical activity within the 1000m buffer for all groups. However, for the objectively measured physical activity in the 1000m buffer, vigorous physical activity (rs = -0.39) was inversely associated with intersection density in the low-SES and moderate (rs = -0.29) and total MVPA (rs = -0.31) were inversely associated with Intersection density in the high SES. Conclusions: The overall results of the current study across all chapters generally show a mismatch between the perceived and objectively-assessed built environment, particularly in low-income communities. Furthermore, in low-SES communities, we failed to show the expected relationships between attributes of the built environment and physical activity, suggesting that physical activity in these communities is more utilitarian in nature, and as such, may not be as influenced by aspect of the built environment. In summary, the data suggest that the environment (including crime rates, poor access to physical activity facilities and public transportation predominantly made by buses) has less of an association with physical activity in LMICs and more disadvantaged communities, where physical activity is used for utilitarian, rather than recreational purposes. This study stemmed from the need to broaden research on the relationship between the built environment and physical activity, considering walkability constructs. These findings also suggest that the definition of the construct of walkability be re-examined, in relation to low SES settings.
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    Perceptions of body size, obesity threat and the willingness to lose weight among black South African adults: a qualitative study
    (2016) Okop, Kufre Joseph; Mukumbang, Ferdinand C; Mathole, Thubelihle; Levitt, Naomi; Puoane, Thandi
    Abstract Background The obesity epidemic is associated with rising rates of cardiovascular disease (CVD) among adults, particularly in countries undergoing rapid urbanisation and nutrition transition. This study explored the perceptions of body size, obesity risk awareness, and the willingness to lose weight among adults in a resource-limited urban community to inform appropriate community-based interventions for the prevention of obesity. Method This is a descriptive qualitative study. Semi-structured focus group discussions were conducted with purposively selected black men and women aged 35–70 years living in an urban South African township. Weight and height measurements were taken, and the participants were classified into optimal weight, overweight and obese groups based on their body mass index (Kg/m 2 ). Participants were asked to discuss on perceived obesity threat and risk of cardiovascular disease. Information on body image perceptions and the willingness to lose excess body weight were also discussed. Discussions were conducted in the local language (isiXhosa), transcribed and translated into English. Data was analysed using the thematic analysis approach. Results Participants generally believed that obesity could lead to health conditions such as heart attack, stroke, diabetes, and hypertension. However, severity of obesity was perceived differently in the groups. Men in all groups and women in the obese and optimal weight groups perceived obesity to be a serious threat to their health, whereas the overweight women did not. Obese participants who had experienced chronic disease conditions indicated strong perceptions of risk of obesity and cardiovascular disease. Obese participants, particularly men, expressed willingness to lose weight, compared to the men and women who were overweight. The belief that overweight is ‘normal’ and not a disease, subjective norms, and inaccessibility to physical activity facilities, negatively influenced participants’ readiness to lose weight. Conclusion Low perception of threat of obesity to health particularly among overweight women in this community indicates a considerable challenge to obesity control. Community health education and promotion programmes that increase awareness about the risk associated with overweight, and improve the motivation for physical activity and maintenance of optimal body weight are needed.