Prevalence and Associated Factors of Physical Activity Among Mothers in the Gaza Strip-Palestine
Authors: El Kishawi Rima , Soo Kah Leng , Abed Yehia , Muda Wan Abdul Manan Wan 
Published: July 2019

BackgroundThe high prevalence of obesity was observed in numerous developed and developing countries. A reduce in energy expenditure due to the low physical activity level is a factor contributed to the increase in obesity. Physical inactivity is one of the ten leading risk factors for global death, and associated with the all-cause mortality. Regular physical activity lowers the risk of various types of non-communicable diseases. The prevalence of obesity is high among women in the Gaza Strip. There is a lack of studies on the pattern of physical activity among adults in the Gaza Strip.ObjectiveThe aim of this study was to determine the prevalence of physical activity among mothers aged 18–50 years in the Gaza Strip and its associated factors. Additionally to explore mothers' perception and practice of physical activity.MethodologyA mixed methods design was conducted using quantitative and qualitative methods. A total of 357 mothers were recruited from the Gaza Strip using multistage sampling method from three different geographical areas, namely, Jabalia refugee camp in the north of Gaza Strip, El Remal urban area in Gaza city, and Al Qarara rural area in the south of Gaza Strip. A structured questionnaire was used for face to face interviews with mothers to obtain information on the mothers' sociodemographic, and their nutrition knowledge. The short form of the International Physical Activity Questionnaire (IPAQ) was used to assess the physical activity pattern. In this study, sitting time is used as an independent proxy measure of sedentary behavior. For qualitative component, three focus group discussions (one group in each area) were conducted involving 24 surveyed mothers to explore mothers' perceptions and practices of physical activity. Binary logistic regression analyses were applied to identify the determinants of physical activity and were adjusted in relation to various factors.ResultsThe prevalence of physical inactivity was 21.6%, about 78% of mothers were classified as moderately active, while vigorous activity was not observed. Mean sitting hours was 2.74 ± 1.32 hour/day. Results revealed that, physical activity level decreased among mothers who lived in households with low income (OR: 2.30; 95%CI: 1.20–4.45; p = 0.013), and those with high nutrition knowledge were more likely to be physically inactive (OR: 1.15; 95%CI: 1.0–1.314; p = 0.040), while mothers who had low or medium education level were more active (OR: 0.31; 95%CI: 0.15–0.62; p = 0.001), or (OR: 0.47; 95%CI: 0.23–0.96; p = 0.039). There was no significant association between physical activity levels and the geographical areas. The qualitative results showed that most of the mothers believed home chores were kind of exercises and could substitute for practicing sports. The main constraints to physical activity practice attributed to the sociocultural factors due to the limited availability of exercising facilities for Palestinian women and restrictions on their freedom.ConclusionsResults of this study are important to monitor physical activity levels among mothers in the Gaza Strip. Despite a high level of nutrition knowledge among mothers, physical inactivity prevalence is high. More attention must be given to the policy makers to improve awareness on the importance of the physical activity practice to improve the overall health status of the community. Understanding the cultural attitudes is required as it is relevant in order to implement effective community-based intervention programs to improve physical activity levels among mothers in the Gaza Strip.