Physical activity levels, barriers, and facilitators among the university students, in the south of Jordan

  • Hammam Leimoon

Student thesis: Doctoral Thesis

Abstract

Background:
The health benefits of regular physical activity (PA) are well documented, where it plays an important role in reducing the risk of developing several non-communicable diseases (NCD), such as hypertension, diabetes mellitus, and cardiovascular diseases, as well as various types of cancer, and even for poor mental health. Therefore, people should be keen to stay physically active. However, most adults of all ages participate in insufficient physical activity levels to achieve health benefits, and it is estimated that 31% of adults worldwide are physically inactive. University students are in a transition period considered as a critical period for declining physical activity and increasing sedentary behaviour. This requires the development of effective evidence-based interventions to improve their physical activity level. To develop interventions for an understudied population such as university students in the south of Jordan, it is important to understand their physical activity patterns and provide up to date data about their physical activity levels and associated socio-demographic factors, as well as understanding their barriers and facilitators for being physically active.

Objectives:
The study aimed to assess physical activity levels and sociodemographic factors influencing physical activity (PA) behaviours among university students in Southern of Jordan, and to explore the students' perspectives on barriers and facilitators to physical activity.

Method:
The study adopted a concurrent mixed method design consisting of two phases: a cross-sectional survey with 408 undergraduate students who enrolled in Mutah University and Tafila Technical University which are two of the largest universities in the south of Jordan, aged between 18-28 years old, and can speak Arabic; followed by four focus group discussions with 28 participants who participated in the survey.

Outcome measures:
The levels of physical activity were measured using the short version of the Arabic International Physical Activity Questionnaire (A-IPAQ). Collected data were analysed using SPSS through descriptive statistics based on the current guidelines for data processing and analysis of the IPAQ. The association between demographic data and levels of physical activity was analysed by the Chi-Square test and Mann-Whitney U test, as well as by univariate and multivariate logistic regression analysis with the odds ratios. Also, the same statistical tests were employed to examine the association of sociodemographic indicators on physical activity based on gender. In four focus groups, participants answered eight open-ended questions mirroring the Social-Ecological model for capturing factors that influence physical activity. Deductive thematic analysis was used for data analysis to explore the students' perspectives on barriers and facilitators to physical activity.

Results:
Among the 408 study participants, 99 (24.3%) reported low physical activity, 159 (39.0%) moderate physical activity, and 150 (36.8%) high physical activity levels. Through the various statistical tests and models used, I found that gender, working status, family monthly income, and body weight are significant predictors (P > 0.05) for physical activity. Since male students, students who are working, students from a family with a high monthly income, and students with normal body weight are more likely to have a high physical activity than their peers. Examining the association of sociodemographic indicators of high physical activity level based on gender shows that working status was a common significant factor for both male and female students, where the working male or female students are more likely to have a high physical activity. While the family monthly income was a significant predictor for female students only and not for males (i.e., female students who belong to a family with a high monthly income are more likely than female students who belong to a family with a low monthly income to have a high level of physical activity). Whereas BMI and smoking status were the significant sociodemographic predictors of physical activity level for male students. Since non-smoker male students are more likely to have a high physical activity compare with smoker male students, and male students with normal body weight are more likely to have a high physical activity compare obese male students.
In addition, several barriers and facilitators to university student’s physical activity were identified at multiple levels of influence and categorised using the five levels of the social-ecological framework incorporating individual, interpersonal, environmental, community, and policy levels of influence. Most of the identified barriers and facilitators belong to the individual, environmental, and community levels. It was revealed that there is a difference between males and females in terms of barriers and facilitators at some levels, particularly at the community level, which contain different factors related to culture and the community's view that may affect undertaking physical activity.

Conclusion:
The current study indicates that a quarter of university students in southern Jordan have a low level of physical activity. The study also found that gender, work status, monthly family income and body weight are significant factors that influence students' physical activity level. In addition, the study revealed that there are differences in terms of factors affecting physical activity between the genders. Where the family monthly income was an influential factor only for female students, and body weight and smoking were influential factors for male students only. The study also showed that there are a lot of perceived barriers and facilitators that affect student’s physical activity level at multiple levels of influence. In addition, the study clarified the complexity of the factors (barriers and facilitators) influencing students' physical activity behaviour besides explaining the interaction between different factors spread over multiple levels of influence. All of this information should be taken into account when developing interventions to improve students' physical activity levels.
Date of AwardAug 2021
Original languageEnglish
Awarding Institution
  • University of Portsmouth
SupervisorSasee Pallikadavath (Supervisor), Jenny Roddis (Supervisor) & Ngianga Ii Kandala (Supervisor)

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