Perception and knowledge of black Africans on physical activity and non-communicable diseases

Abstract

The burden of non-communicable diseases (NCDs) is high in South Africa. Behavioural conducts and lifestyle factors, unhealthy diets and physical inactivity are the major contributors to the development of NCDs among South Africans. Physical activity (PA) is a modifiable risk factor that is also low in cost for preventing and managing NCDs. PA for health outcomes remains low among black South Africans. Regular engagement in PA is influenced by the knowledge and perception that a person has about the influence of PA as a healthy lifestyle. No studies that investigate perceptions and knowledge of NCDs and PA among black South Africans could be found in literature. The main purpose of this study was to explore and determine the knowledge and perceptions of NCDs and PA among black South Africans. A total of 93 black South Africans from the Northern Cape and North West provinces voluntarily participated in the study. The participants consisted of groups of employed and unemployed men and women residing in an urban community, men working in unskilled labour conditions residing in rural areas and unemployed women residing in a deep rural area. The recruitment procedures included flyers, local radio announcements, participants recruited from previous researchers, mass communication, and word of mouth. A mixed method approach was performed that consisted of quantitative and qualitative methods. Quantitative methods were employed to determine the point prevalence of NCD risk factors among 93 participants. Of these participants, 54 participated in a survey to determine knowledge of NCDs and PA. Participants from deep rural areas were excluded from the survey owing to a high incidence of illiteracy. A qualitative exploration of perceptions of NCDs and PA was performed. The quantitative procedures included a survey for heart disease knowledge and PA knowledge questionnaires. This was followed by NCD risk factor profile measurements; weight, height, waist and hip circumference, resting blood pressure, peripheral blood measurements for glucose and total cholesterol and objective PA measurements using combined accelerometry and heart rate (Actiheart®) for seven consecutive days. Qualitatively, focus group discussions (FGDs) were conducted to explore perceptions of the PA and NCDs using an open-ended semi-structured questionnaire. SPSS version 22 was used in all quantitative statistical analyses. Descriptive statistics reporting means and standard deviations and frequencies were performed to determine knowledge of NCD risk factors and PA, and to determine the point prevalence of NCD risk factors. Partial correlation analyses were performed to determine the relationship between knowledge of heart disease, knowledge of PA and current PA and risk factors of heart disease. Statistical significance was set at p <0.05. Qualitative data was analysed. FGDs were audio recorded and transcribed for analysis. The Noticing, Thinking and Coding approach was used to analyse data using Atlas. ti7. Black South Africans have high risk profiles for NCDs. The highest prevalence was for systolic blood pressure (71%), physical inactivity (68%) and markers of overweight and obesity with 67%. NCD knowledge was 59 ± 8 % and the total sample mean for PA was 84 ± 16%. The results of this study found a significant relationship between NCD knowledge and activity levels among males (r = 0.38; p =0.03). Among women PA knowledge positively associated with PA, though not statistically significant (r = 0.29; p = 0.42). The knowledge of NCDs and NCD risk factors results from the qualitative exploration of this study showed that black South Africans have limited knowledge about NCDs and negative perceptions about NCDs. They have an undistinguished knowledge of PA and are unable to apply the PA knowledge for disease prevention or management. It is therefore concluded that among black South Africans there is limited knowledge and misconception about PA. Black South Africans also lack knowledge on NCDs and have negative perceptions about NCD. An improved understanding of the perceptions of the population about physical activity and disease outcomes should be assessed in future studies in order to ensure the adoption of physical activity for the management of risk factors for NCDs.