Sabahat Naz

Date of Award

2-2020

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr. Romaina Iqbal

Second Advisor

Dr. Rehana Siddiqui

Third Advisor

Iqbal Azam

Department

Community Health Sciences

Abstract

Background: The burden of obesity increases exponentially, affecting almost one[1]third of the world's adult population. Lifestyle modification is an essential factor for weight reduction and maintenance, but adherence to lifestyle modification is challenging. Peer support is an effective strategy for better compliance and weight loss. Still, limited research explores the role of peers in low-resource communities. Therefore, we assessed the effect of lifestyle modification for weight reduction with peer support among adults in an urban slum of Karachi, Pakistan, using a mix-methods design.
Methodology: The study setting was Azam Basti, an urban slum in Karachi. We enrolled 50 men and women aged 20 to 60 years with body mass index > 23 kg/m2 using a pre-post-test design. We enrolled participants nominated peers, i.e., family members, aged > 20 years and agree to help them with lifestyle modification. We provided online education on lifestyle modification to the participants and their peers. We assessed weight, enerrgy intake using 24-hours dietary recall, and energy expenditure using a general physical activity questionnaire every month from June 2020 to October 2020. We did preliminary analysis for thesis work due to the timelines issue using a generalized estimating equation to determine a change in mean outcomes from baseline to three months.
Results: Of the 50 participants enrolled in the study, 42 were females. The mean age was 36.82 + 1.26 years. While among peers, 31 were females, and the mean age was 35.9 + 12.0. The estimatedaverage weight was 0.9 kg (95% CI: -2.1 to 0.2) lower after providing the intervention compared to the baseline (no intervention) when adjusted for participant’s gender, relation of a peer with participant, household monthly income, energy intake, age, and energy expenditure. The estimated average energy intake was 86.3 kcal/day (95% CI: v -211.4 to 38.7 ) lower after providing the intervention compared to the baseline when adjusted for participant’s gender, age, relation of a peer with participant, and household monthly income. The estimated average energy expenditure was 33.2 kcal/day (95% CI: -18.0 to 84.4) higher after providing the intervention compared to the baseline when adjusted for relation of a peer with the participant, household monthly income, stress, age, and participant’s gender.
Conclusion: The study findings that are limited to three months follow-up tended to reduce weight and energy intake and improves energy expenditure after providing the intervention. However, the findings are insignificant but in the right direction. For better estimates of the intervention effect, this study is ongoing, and the outcomes will be assessed after one year from the baseline.

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1

Last Page

174

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