Journal Article

Sociodemographic inequities associated with participation in leisure-time physical activity in sub-Saharan Africa: an individual participant data meta-analysis

Sandhu, Manjinder S., Partap, Uttara, Bahendeka, Silver K., Mwalim, Omar, Guwatudde, David, Barr, Anna Louise, Motala, Ayesha A., Mayige, Mary T., Jørgensen, Jutta M. Adelin, Kagaruki, Gibson B., Mutungi, Gerald, Bovet, Pascal, Agoudavi, Kokou, Balde, Naby, Longo-Mbenza, Benjamin, Wesseh, Chea S., Young, Elizabeth H.

2020

Overview

Background Leisure-time physical activity (LTPA) is an important contributor to total physical activity and the focus of many interventions promoting activity in high-income populations. Little is known about LTPA in sub-Saharan Africa (SSA), and with expected declines in physical activity due to rapid urbanisation and lifestyle changes we aimed to assess the sociodemographic differences in the prevalence of LTPA in the adult populations of this region to identify potential barriers for equitable participation. Methods A two-step individual participant data meta-analysis was conducted using data collected in SSA through 10 population health surveys that included the Global Physical Activity Questionnaire. For each sociodemographic characteristic, the pooled adjusted prevalence and risk ratios (RRs) for participation in LTPA were calculated using the random effects method. Between-study heterogeneity was explored through meta-regression analyses and tests for interaction. Results Across the 10 populations ( N  = 26,022), 18.9% (95%CI: 14.3, 24.1; I 2  = 99.0%) of adults (≥ 18 years) participated in LTPA. Men were more likely to participate in LTPA compared with women (RR for women: 0.43; 95%CI: 0.32, 0.60; P  < 0.001; I 2  = 97.5%), while age was inversely associated with participation. Higher levels of education were associated with increased LTPA participation (RR: 1.30; 95%CI: 1.09, 1.55; P  = 0.004; I 2  = 98.1%), with those living in rural areas or self-employed less likely to participate in LTPA. These associations remained after adjusting for time spent physically active at work or through active travel. Conclusions In these populations, participation in LTPA was low, and strongly associated with sex, age, education, self-employment and urban residence. Identifying the potential barriers that reduce participation in these groups is necessary to enable equitable access to the health and social benefits associated with LTPA.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Active travel / Adult / Africa South of the Sahara / Age / Aged / Aged, 80 and over / Analysis / Biostatistics / Confidence intervals / Data analysis / Education / Environmental Health / Epidemiology / Estimates / Ethics / Exercise / Exercise - psychology / Female / Global physical activity questionnaire / Health Promotion - statistics & numerical data / Health surveys / Heterogeneity / Humans / Leisure Activities - psychology / Leisure-time physical activity / Male / Medicine / Medicine & Public Health / Men / Meta-analysis / Methods / Middle Aged / Occupational physical activity / Odds Ratio / Participation / Physical activity / Physical fitness / Population / Population health / Populations / Public Health / Regression analysis / Research Article / Rural areas / Self employment / Social determinants of health / Sociodemographics / Socioeconomic Factors / Studies / Sub-Saharan Africa / Surveys / Surveys and Questionnaires / Urbanization / Vaccine / Values / Women / Young Adult