Liangruenrom, Nucharapon (2020) Trends and Correlates of Physical Activity and Sedentary Behaviour in the Thai Population. PhD thesis, Victoria University.

Abstract

To facilitate the development of effective public health programs and policies to increase physical activity (PA) and reduce sedentary behaviour (SB) in Thailand, there is a need for comprehensive epidemiological evidence and a sound assessment of prevalence, trends, and factors associated with these behaviours. This PhD research therefore aimed to: 1) identify gaps in the available literature on PA and SB in Thailand; 2) determine the prevalence of PA and SB among Thai adults using the validated Global Physical Activity Questionnaire (GPAQ); 3) summarise evidence on individual, social, environmental, and policy correlates of PA and SB in the Thai population; 4) develop criteria to classify the International Classification of Activities for Time-Use Statistics (ICATUS) activities into sleep, SB, light-intensity PA, and moderate-to-vigorous PA categories, based on expert assessment; and 5) establish trends in PA and SB and assess how correlates of these behaviours have changed among Thai adults over 15 years. To achieve the first aim, we conducted a systematic scoping review according to the Guidance for Conducting Systematic Scoping Reviews. To achieve the second aim, we conducted a secondary analysis of population-representative data from a Thai national survey. To achieve the third aim, we conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. To achieve the fourth aim, we conducted a Delphi study including 13 content experts. To achieve the fifth aim, trends and sociodemographic correlates of PA and SB in Thailand were examined using Thai national ICATUS-based surveys. Using time-use data from ICATUS allowed for treating PA and SB estimates as integrative parts of a time-use composition, to examine the new holistic 24-hour movement guidelines. Overall, Study 1 found that the interest in research on PA and SB in Thailand has grown in the past two decades. Major research gaps were found for measures and methodology used in previous studies and only limited evidence was found on SB. Findings from Study 2 show low prevalence of PA among Thai adults in 2015 and a declining trend in the prevalence of meeting the PA recommendation since 2004. A range of sociodemographic correlates of PA and SB in the Thai population were identified in Study 3. Study 5 found that more than half of Thai adults engaged in prolonged sitting over a 15-year period. These findings highlight the need of public health programs to promote PA and reduce SB in Thailand. Future interventions and policies to increase PA participation should focus particularly on girls, older women, young adults, urban residents, and those with low education. The interventions to improve self-efficacy for PA and lower perceived barriers for PA should be implemented among all agegroups. Future interventions to reduce SB are also needed among adults, particularly for males, older age groups, obese, and those with higher education. However, more studies are needed to provide a more complete picture of what factors are influencing PA and SB in the population; particularly among children, adolescents, older adults and at social, environmental and policy levels.

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