Stage of physical activity change and correlates among hypertensive out patients at a tertiary hospital In Jos, Nigeria

Abstract

Objective: Trans-theoretical model stage-specific exercise prescription is vital to achieving sustained physical activity and reducing morbidity and mortality in hypertensives. This study aimed to determine the stage of change of physical activity of hypertensives, in order to improve the practice of prescribing exercise.

Methods: A cross sectional study of 414 consenting, adult hypertensives was carried out. Sociodemographic, behavioral and clinical parameters of the participants were obtained, and their stage of change was determined using the Physician based Assessment and Counselling for Exercise tool (PACE).  Correlations between the stage of change category and  sociodemographic/clinical parameters were also determined.

Results: The participants were mostly female (52.9%), married (84.5%), with  tertiary education (52.9%), urban dwellers (86%) with a mean age of 51±8 years. Most (75.1%) were 2 overweight/obese with a mean BMI of 28.2±5.0 Kg/m , were non –smokers (98.3%) and non-diabetics (92.3%). The median PACE score was 4.0 (1.0-8.0) and most were Contemplators (79.5%) followed by Actives (16.4%) and Pre-contemplators (4.1%). Multivariate analysis revealed that unemployed and retired hypertensives were twice more likely to be in active stage (AOR 2.2, 95% CI 1.04-4.56). Educational level, marital status, age, sex, place of dwelling, smoking status, BMI category, family history of diabetes, arthritis and heart disease, were not significant predictors of stage of change.

Conclusion: Most hypertensives in the outpatient setting are in inactive stages of change (83.6%), but the unemployed are more likely to be in active stage.  Physicians managing hypertensives should offer more cognitive-based change counselling, and exercise prescriptions that consider employment status.

Key words: Stage of change; hypertensives; motivation; behavior change; physical activity, PACE