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Attitudes towards Physical Activity among South Asian Men with Coronary Heart Disease - Research Proposal Example

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This study shows the relationship between physical activity and coronary heart disease as individuals with a higher rate of heart disease have been found to have lifestyle patterns marked by sedentary habits and poor physical exercise. …
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Attitudes towards Physical Activity among South Asian Men with Coronary Heart Disease
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Attitudes towards Physical Activity among South Asian men with Coronary Heart Disease Research Proposal This study shows the relationship between physical activity and coronary heart disease as individuals with a higher rate of heart disease have been found to have lifestyle patterns marked by sedentary habits and poor physical exercise. This study investigates the attitudes of South Asian men towards lifestyle and exercise habits and the relationship between physical activity in such men and instances of heart diseases. 30 South Asian men within 30-60 years are selected to participate in interviews showing their attitudes towards physical activity and heart disease. Results involve qualitative analysis of the responses given by such individuals. Background The study shows the relationship between physical activity and Coronary heart disease and more specifically not just the habits of physical activity but even attitudes towards it that could lead to increased or decreased levels of physical activity. Levels of physical activity have been tied to coronary heart disease and decreased levels of activity for that matter can increase the levels and rates of heart disease. According to the Department of Health, 'coronary heart disease (CHD) is a preventable disease that kills more than 110,000 people in England every year. More than 1.4 million people suffer from angina and 275,000 people have a heart attack annually. CHD is the biggest killer in the country. The Government is committed to reducing the death rate from coronary heart disease and stroke and related diseases in people under 75 by at least 40% (to 83.8 deaths per 100,000 population) by 2010'. The Department of health has also emphaised the relationship between coronary heart disease, exercise habits and physical activity and has highlighted key lifestyle factors that are related to CHD that include smoking, poor diet and lack of exercise. The Department of Health indicated that 10 million people tend to smoke and 20% of CHD related deaths in men and 17% of CHD cases in women are attributable to smoking. CHD is highest among obese people and obesity is seen in more than 20% of men and women. The Department of Health stresses that regular physical activity reduces the risk obesity and also cardiovascular disease mortality in general and of coronary heart disease mortality in particular. Physically inactive people have about double the risk of CHD (DH, 2006). Lack of physical exercise could increase obesity and heart disease although excessive and sudden strenuous exercise can also lead to major conditions such as heart attacks. The research questions posed here show the relationship between coronary heart disease and attitudes towards physical activity especially among South Asian men. Review of Relevant Literature Suggesting how CHD care, treatment and prevalence would show the differences in health care acorss the country, the Department of Health specifies that 'CHD exemplifies inequalities in health as unskilled working men are three times more likely to die prematurely of CHD than men in professional or managerial occupations. This shows that strenuous manual physical jobs are more likely to be the cause of heart disease than non manual workers. Angina, heart attack and stroke would be very common amongst individuals working in manual social classes. The ethnic variations in coronary heart disease are also highlighted and people in the Indian sub-continent, have a death rate from heart disease 38% higher for men and 43% higher for women than rates for the country as a whole. In a study by Bedi et al (2006), coronary heart disease is considered the leading cause of mortality and mortality worldwide and this is especially true for South Asians who seem to have a high prevalence of such disease compared with other ethnicities (Bedi et al, 2006). One theory suggests that Asians may have a genetic disposition towards heart disease although environmental, nutritional and lifestyle factors of South Asians could be responsible for a higher prevalence of heart disease. Conditions such as metabolic syndrome, diabetes, insulin resistance, obesity, increased thrombotic tendency, decreased levels of physical activity, low birth weights, dietary indiscretions and sedentary lifestyle amongst South Asians are high risk factors for coronary disease. Bedi et al suggest dietary modifications, increased physical activity and educational programs on genetic disposition to reduce risks of the disease and to spread awareness. Schnohr et al (2006) investigated the relationship between long term physical activity and reasons of deaths. Their results indicated that Adjusted relative risks for coronary heart disease were, for moderate physical activity 0.71 (0.51, 0.99) and for high 0.56 (0.38, 0.82). Considering the benefits of physical exercise, Schnohr et al suggested that men with high physical activity survived 6.8 years longer, and men with moderate physical activity 4.9 years longer than sedentary men. Their results indicated that long-term moderate or high physical activity was in both sexes associated with significantly lower mortality from coronary heart disease (Schnohr et al, 2006). Research Questions The research questions identified for this study would be 1. The exact relationship between physical activity and coronary heart disease 2. Does decreased physical activity essentially lead to increased risks of heart disease 3. What are the links between obesity, heart disease and physical exercise 4. What would be considered as low or high physical activity and how would this relate to heart conditions and disease 5. Are there any ethnic differences in manifestation of heart disease 6. Are there any ethnic differences in attitudes towards physical activity 7. What are the attitudes of South Asian men towards physical activity and how do these relate to heart disease manifestations in this section of the population Methodology-Qualitative The methodology that would be used in the study relate to qualitative techniques although certain quantitative methods could also be used to draw a balance of the two approaches. The methodology show how books, journals, websites, and interviews could be used to draw out findings on obese or physical inactive men and conditions of heart disease. The Department of Health has identified that lack of physical exercise leads to higher rates of heart disease and this study focuses on research findings that deal with not just the relationship between physical activity and instances of heart disease but also attitudes towards physical exercise that can lead to habits of exercise and conditions of heart disease. The more specific focus is on study of heart disease and physical activity in South Asian men. For the methods, interviews on focus groups of South Asian men aged 3-60 years are conducted and they are asked questions on their exercise habits, eating patterns, heart disease conditions if any and their attitudes towards physical activity, with regard to exercise, work load and schedule, personal lifestyle etc. The interview questions are based on a semi structured pattern as such a framework allows for a two way open communication and information is given and received at both ends. Thus South Asian men who are interviewed to note their attitudes towards work, physical exercise and general physical activity are given information on how physical activity can help in reducing heart disease and what are the relationship between obesity, exercise patterns and coronary diseases. They are provided information on the links between heart disease and physical activity and recommendation of health organisations to engage in more physical activity although their own attitudes on exercise, physical activity patterns and the effects of these on heart disease are investigated through the study, through questions given during the interviews. The focus group here is thus a small sample of 30 individuals, precisely South Asian men between 30-60 years who are from upper socioeconomic class and have sedentary non manual jobs and lowered physical exercise levels. Their awareness of higher levels of physical exercise was also tested with the interview questions and information provided. The interview questions were structured and responses obtained were analysed qualitatively to understand subjective viewpoints and decipher individual attitudes towards exercise, physical activity and its relationship with coronary heart disease conditions. Interview (Semi structured) The interviews conducted with South Asian men would be primarily semi structured which means both the interviewer and interviewee would have an open two way communication on the conditions of physical and heart disease and attitudes towards physical activity. The focus groups used for the study would be a sample of 30-60 year old South Asian men and 30 men are chosen in the study, selected from hospitals and clinical units who attended clinics for heart problems or chest related symptoms. Tightening of chest, shortness of breath and such symptoms would indicate the initial stages of heart problems in many cases and could also be considered. However, the preference for the sample would be at least 30 men suffering from heart disease and advised for increased physical exercise. The men who visit such clinics for their condition and treatment would be interviewed on their exercise habits and physical activity patterns, general lifestyle, work patterns and also health conditions including conditions of heart disease if any. Data Analysis- The data analysis would be done by using taped recordings of interview questions given to the 30 participants. For the process, 30 South Asian men are identified in the clinics of London and are asked to participate in 30 minute interviews in which they are given 10 questions to answer and express their attitudes and opinions on their own lifestyle and exercise patterns and what they thought was the relationship between physical activity and heart disease. The responses from the 30 participants are then interpreted and analysed and responses of each individual are studied to understand differences or similarities in their attitudes towards physical exercise patterns. Ethical Approval The ethical aspects of the study include questions that may affect sentiments on ethnicity and culture such as food habits, exercise patterns or even work schedules that differ in preferences from one ethnic group to another. For example questions on how food habits could lead to heart disease if exercise patterns are not followed regularly can have racial implications and will have to be dealt with properly. Confidentiality of information regarding participant details, their job patterns and other personal details should be maintained throughout the study and all participants of the interview should be assured of confidentiality and privacy of the information obtained with regards to personal details as well as attitudes and opinions expressed. Results and Conclusion The results would be obtained after analysis of the data, in this case qualitative and subjective study of individual responses which would provide deeper insights on attitudes of the South Asian men towards physical activity and exercise patterns. Important questions on whether attitudes are related to ethnicity would be examined and even the reasons for which cardiac diseases are very high among South Asians could be investigated. The possible reason of high sedentary work patterns or lowered activity and exercise among South Asian men or even high fat food habits and obesity could be analysed in some detail and conclusions are drawn from the findings of the study. It is expected that South Asian men may have negative or neutral attitudes towards exercise or increased physical activity and this may be the cause of very high rates of obesity and heart disease among this category of the population. Bibliography Bedi US, Singh S, Syed A, Aryafar H, Arora R. 2006 Coronary artery disease in South Asians: an emerging risk group. Cardiol Rev. Mar-Apr;14(2):74-80. Erbs S, Linke A, Hambrecht R. 2006 Effects of exercise training on mortality in patients with coronary heart disease. Coron Artery Dis. May;17(3):219-25. Fischbacher CM, Hunt S, Alexander L. 2004 How physically active are South Asians in the United Kingdom A literature review. J Public Health (Oxf). Sep;26(3):250-8. Fransson E, de Faire U, Ahlbom A, Reuterwall C, Hallqvist J, Alfredsson L. 2006 The effect of leisure-time physical activity on the risk of acute myocardial infarction depending on body mass index: a population-based case-control study. BMC Public Health. Dec 7;6:296. Klieman L, Hyde S, Berra K. 2006 Cardiovascular disease risk reduction in older adults. J Cardiovasc Nurs. Sep-Oct;21(5 Suppl 1):S27-39. McKeigue PM, Shah B, Marmot MG. 1991 Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet. Feb 16;337(8738):382-6. Mukamal KJ, Ding EL, Djousse L. 2006 Alcohol consumption, physical activity, and chronic disease risk factors: a population-based cross-sectional survey. BMC Public Health. May 3;6:118. Ponchia A, Biasin R, Tempesta T, Thiene M, Volta SD. 2006 Cardiovascular risk during physical activity in the mountains. J Cardiovasc Med (Hagerstown). Feb;7(2):129-35. Reddy KK, Rao AP, Reddy TP. 2002 Socioeconomic status and the prevalence of coronary heart disease risk factors. Asia Pac J Clin Nutr.;11(2):98-103. Rao GH, White JG. 1993 Coronary artery disease: an overview of risk factors. Indian Heart J. May-Jun;45(3):143-53. Reid RD, Morrin LI, Pipe AL, Dafoe WA, Higginson LA, Wielgosz AT, McDonald PW, Plotnikoff RC, Courneya KS, Oldridge NB, Beaton LJ, Papadakis S, Slovinec D'Angelo ME, Tulloch HE, Blanchard CM. 2006 Determinants of physical activity after hospitalization for coronary artery disease: the Tracking Exercise After Cardiac Hospitalization (TEACH) Study. Eur J Cardiovasc Prev Rehabil. Aug;13(4):529-37. Rothenbacher D, Koenig W, Brenner H. 2006 Lifetime physical activity patterns and risk of coronary heart disease. Heart. Sep;92(9):1319-20. Epub 2006 Jul 19. Schnohr P, Lange P, Scharling H, Jensen JS. 2006 Long-term physical activity in leisure time and mortality from coronary heart disease, stroke, respiratory diseases, and cancer. The Copenhagen City Heart Study. Eur J Cardiovasc Prev Rehabil. Apr;13(2):173-9. Scrutinio D, Bellotto F, Lagioia R, Passantino A. 2005 Physical activity for coronary heart disease: cardioprotective mechanisms and effects on prognosis. Monaldi Arch Chest Dis. Jun;64(2):77-87. Sriskantharajah J, Kai J. 2006 Promoting physical activity among South Asian women with coronary heart disease and diabetes: what might help Fam Pract. Dec 18; Venkatramana P, Reddy PC. 2002 Association of overall and abdominal obesity with coronary heart disease risk factors: comparison between urban and rural Indian men. Asia Pac J Clin Nutr.;11(1):66-71. Read More
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