1. PHYSICAL ACTIVITY PREVALENCE AND BARRIERS TO PHYSICAL ACTIVITY AMONG YEREVAN ADULT POPULATION (2007) Liana Hakobyan, MD, MPH CRRC Publication Research Fellowship June, 3 2008

11. Dependent Variable: physical activity level Mode of Measurement Scale 1=Health Enhancing Physical activity level Any of the following two criteria: - Vigorous-intensity activity on at least 3 days and accumulating at least 1500 MET-minutes/ week OR - 7 or more days of any combination of walking, moderate-intensity or vigorous-intensity activities achieving a minimum of at least 3000 MET-minutes/week. 0= Inactive/Minimally active - No activity is reported OR - Some activity is reported but not enough to meet category 1 Dichotomous 1=Health Enhancing Physical activity level 0=Inactive/ Minimally active

12. Independent Variables Variable Mode of Measurement Scale 1. Gender Dichotomous 1=Female, 0=Male 2. Age What was your age on your last birthday? Continuous 3. Educational level What is your level of education? Ordinal 1= Incomplete / complete secondary 2= College 3= U niversity/ Postgraduate

13. Independent Variables (cont.) Variable Mode of Measurement Scale 4. Income level ( proxy - monthly household expenditures) On average how much money does your household spend monthly? Ordinal 1= Below 35, 000 AMD 2= 35,000 to 70,000 3= 70, 001 to 130 , 000 4=130 , 001 to 200 , 000 5 = More than 200 001 5. Occupation Are you occupied? Dichotomous 1=Yes, 0=No 6. Marital status What is your marital status? Nominal 1 = Single 2= Married 3= Divorced 4=Widowed

16. # Quarter Community (Hamaynk) # of people aged 18-65 year-old living in Hamanynk # of people aged 18-65 year-old according to sample size 1 Malatia-Sebastia 93,041 61 2 Nor-Nork 90,848 61 3 Shengavit 87,646 56 4 Arabkir 84,330 51 5 Kentron 82,651 51 6 Erebuni 75,326 46 7 Achapnyak 67,517 41 8 Kanaker-Zeytun 49,567 31 9 Avan 31,403 26 10 Davidashen 26,026 20 11 Nork-Marash 7,078 10 12 Nubarashen 5,783 6 Total 701,216 460

22. Calculation of Metabolic Equivalents TYPE OF ACTIVITY MET AMOUNT Walking 3.3 Moderate intensity activity 4.0 Vigorous intensity activity 8.0 Total MET-min/week = (Walk METs x min x days) + ( Mod METs x min x days) + (Vig METs x min x days) * To calculate the weekly physical activity (MET-hours), we multiplied the number of hours, dedicated to each activity by the specific MET score of each activity. Ainnsworth et al. (1993)

26. Results: 1. Response to the survey Number Percent Persons Interviewed (Completed interviews) 369 80% Persons Interviewed (Partial interviews) 0 0 Persons Refused 61 13 Non-reached* * people of unknown eligibility who theoretically could be reached during the period of the survey 30 7 Total 460 100

27. Results: 2. Distribution of Sample Characteristics Characteristics Category % of sample representatives Age Mean ± standard deviation 39 yrs-old ± 14 Gender Male : female 24 : 76 Education Secondary 19 College 32 University / postgrad 48 Occupation Unoccupied : occupied 62 : 38 Expenditures per month (as a proxy for income), AMD < 70,000 8 70,001-130,000 17 130,001-200,000 22 >200,001 17 Marital status Single 24 Married 69 Divorced 3 Widowed 3

28. Results: 2. Distribution of Sample Characteristics (cont.) Characteristics Category % of sample representatives Health status Excellent 6 Very good 5 Good 36 Moderate 48 Poor 4 Weight Too skinny 4 Normal 68 Slightly overweight 23 Overweight 4 Smoking status Smoking : not smoking 20 : 79 # of cigarettes Mean ± st. deviation (range) 20 ± 16 (2-99) # of people in the household Mean ± st. deviation (range) 4 ± 2 (1-13)

29. Results: 3. Physical Activity Level Category of physical activity Sample population Inactive / Minim ally active 53% HEPA active (Health Enhancing Physical Activity level) 47%

31. Results: 4. ORs for Logistic Regression of association between PA & socio-demographic indicators B. Model with all demographic variables Independent Variable OR 95% CI p value 1 Age 0.982 0.959-1.006 0.142 2 Gender 0.683 0.341-1.368 0.282 3 Education 0.941 0.484-1.828 0.857 4 Income level 1.719 0.819-3.608 0.152 5 Occupation* 4.078 2.140-7.769 0.000 6 Marital status 2.278 0.967-5.364 0.06

32. Results: 4. ORs for Logistic Regression of association between PA & socio-demographic indicators C. Model with all variables excluding income Independent Variable OR 95% CI p value 1 Age* 0.979 0.960-0.997 0.026 2 Gender 0.716 0.415-1.234 0.229 3 Education 0.995 0.565-1.614 0.864 4 Occupation* 3.324 2.007-5.505 0.000 5 Marital status* 3.369 1.781-6.372 0.000

33. Results: 5. Knowledge on benefits of physical activity “Physical activity is beneficial for health” Strongly agree 87% Agree 10% Uncertain 2% Disagree 1%

34. Results: 6. 1. Knowledge on the d iseases to be prevented by PA Disease (Nosology) Spontaneous answer Answer after interviewer clarification YES YES Don’t know NO # (%) # (%) # (%) # (%) Cardiovascular diseases 90 (24%) 265 (72%) 60 (16%) 24 (7%) Hypertension 46 (13%) 219 (59%) 90 (24%) 39 (11%) Diabetes 8 (2%) 133 (36%) 143 (39%) 73 (20%) Obesity 37 (10%) 294 (80%) 44 (12%) 10 (3%) Colon cancer 2 (1%) 95 (26%) 198 (54%) 55 (15%) Breast cancer 2 (1%) 77 (21%) 204 (55%) 68 (18%)

35. Results: 6. 2. Knowledge on the d iseases to be prevented by PA Disease (Nosology) Spontaneous answer Answer after interviewer clarification YES YES Don’t know NO # (%) # (%) # (%) # (%) Stress 27 (7%) 220 (60%) 87 (24%) 42 (11%) Pneumonia 3 (1%) 80 (22%) 156 (42%) 113 (31%) Tuberculosis 0 37 (10%) 177 (48%) 134 (36%) HIV/AIDS 0 17 (5%) 140 (38%) 192 (52%)

36. Results: 6. 3. Knowledge on the d iseases to be prevented by PA Disease (Nosology) Spontaneous answer Answer after interviewer clarification YES YES Don’t know NO # (%) # (%) # (%) # (%) Osteoporosis 2 (1%) 2 (1%) Arthritis 2 (1%) 29 (8%) Vertebral diseases 6 (2%) Influenza 4 (1%) Metabolic syndrome 2 (1%) Thymus diseases 2 (1%) Muscles diseases 2 (1%) Rheumatic diseases 2 (1%) Bronchitis 1

39. Results: 9. Source of I nformation about P hysical A ctivity: current and desirable SOURSE Heard about physical activity Want to know about physical activity # (%) # (%) 1 TV 257 70 200 54 2 Radio 76 21 108 29 3 Medical literature 56 15 34 9 4 Physician, medical office 22 6 27 7 5 Newspapers, magazines 57 15 48 13 6 Internet 15 4 25 7 7 Relatives, friends, neighbors 37 10 40 11 8 Workplace 8 2 13 4 9 Brochures 5 1 4 1 10 School, college 4 1 - -

40. Results 10. Subjective Perception vs. Objective Level of PA: cross-tabulation Category of activity Inactive/min active HEPA active Total Satisfaction status No 101 57 158 Yes 93 (48%) 118 (33%) 211 (57%) Total 194 175 369 Pearson Chi-square 15.4 P value . 000

42. Results: 12. Reported Barriers to Physical Activity Barriers # of people (%) Lack of time because of working/studying 111 30 Lack of time because of family responsibilities 106 29 Lack of energy/tiredness 17 5 Lack of money/high cost of sport gyms 30 8 Feeling of shame - - Fear to be injured 2 1 Overweight, obesity 2 1 Lack of companionship 4 2 No person to take care for children 7 2 Poor health status 39 11 Bad mood/depression 9 3 Lack of safe places - - I do not like to be active - - Lack of strong will 21 6 Sitting occupation 2 1 Old age 5 2 Being unemployed 8 4

43. Results: 13. Motivating F actors to P hysical A ctivity # FACTOR Spontaneous Answer Answer after Interviewer Clarification # (%) # (%) 1 Family member/wife, husband exercising with me 17 5 89 24 2 Friend exercising with me 10 3 86 23 3 Family member/wife, husband encouraging me 9 2 80 22 4 Friend encouraging me 8 2 76 21 5 Employer paying for sport club/gym 11 3 75 20 6 Gym in the workplace 5 2 42 11

44. Results: 13. Motivating F actors to P hysical A ctivity # FACTOR Spontaneous Answer Answer after Interviewer Clarification # (%) # (%) 7 Flexible working hours 5 1 49 13 8 Advice from a doctor 17 5 123 33 9 Sport club/gym close to home 2 1 37 10 10 Sport club membership 2 1 29 8 11 Person to take care of children 5 1 28 8 12 Availability of inexpensive sport facilities 12 4 13 Availability of green places 2 1

45. Results: 14. Suggestions: “ what should be done in your area to motivate people to practice more activity ” Suggestions # of persons answered Create good places (parks) 3 Educate people 4 Establish non-expensive sport facilities 2 Organize meetings with famous sportsmen and sport events 2