A Comparative Study on Health Risks, Lifestyle Behaviors, Health Perceptions, and Health Seeking Patterns between Older and Younger Filipinos in the Rural Areas.

Background: Worldwide trends in health risks, lifestyle behaviors, health perceptions, and health-seeking patterns suggest alarming disparities among individuals from low- and middle-income countries. Such international comparisons are particularly troubling for older individuals (≥ 60 years). Objectives: This study aims to compare health risks, lifestyle behaviors, health perceptions, and health-seeking patterns between younger (<60) and older (≥60) Filipinos from rural communities in the Philippines. Methods: A comparative cross-sectional study was employed with 863 younger and 427 older Filipinos. Data were analyzed using frequencies, chi-squares, and T-tests. Results: Older participants were more likely to be single/widowed, ≤ high school education and had higher rates of hypertension, high cholesterol, diabetes, and depression. They reported poorer health status and went to the village health center when sick. Furthermore, they were less likely to drink alcohol and see a physician. Conclusion: There were significant differences in modifiable health risks and lifestyle behaviors and differences in health perceptions between younger and older cohorts of Filipinos living in rural areas in the Philippines. Our findings suggest the need to design separate health promotion interventions that target older and younger Filipinos' unique needs from rural communities.

Facilitators and Challenges to Exergaming: Perspectives of Patients With Heart Failure.

BACKGROUND: Few investigators have explored challenges and facilitators to exergaming, essential factors to exergaming adherence, among patients with heart failure. OBJECTIVES: In this qualitative study, we explored facilitators and challenges using a home-based exergame platform, the Nintendo Wii Sports, in patients with heart failure. METHODS: Semistructured face-to-face interviews were conducted in 13 participants given a diagnosis of heart failure (age range, 34-69 years). Participants were asked about their experiences with exergaming. Transcribed interviews were analyzed with content analysis. RESULTS: The following 4 facilitators were identified: (1) enjoyment and competition motivated gaming, (2) accessibility at home gave freedom and lowered participants' barriers to exercise, (3) physical benefits when decreasing sedentary lifestyle, and (4) psychosocial benefits on stress, mood, and family interactions. Challenges included (1) diminished engagement over time due to boredom playing similar games and (2) frustrations due to game difficulty and lack of improvement. CONCLUSION: Exergaming can increase individuals' physical activity because of easy accessibility and the fun and motivating factors the games offer. Participants initially found exergaming enjoyable and challenging. However, engagement diminished over time because of boredom from playing the same games for a period of time. Participants' preferences and capacities, participants' past experiences, and social support must be considered to avoid boredom and frustrations. Future studies are warranted to determine adherence to exergaming among patients with heart failure and, ultimately, increased overall well-being and healthcare delivery in this patient population.

Health determinants and risk factors for coronary artery disease among older Filipinos in rural communities.

AIMS: Lifestyle modifications and healthy behavioural regimens are critical in preventing coronary artery disease (CAD) and other important health conditions. Little is known about the risk for CAD and health behaviour among older adults (>60 years) living in rural areas in the Philippines. Compare risk profiles and health behaviours of Filipinos at low- vs. moderate-to-high-risk for CAD and examine the association between demographic variables, risk profiles, and health behaviours. METHODS AND RESULTS: A comparative, cross-sectional study was conducted using a convenient sample of 427 Filipinos (≥60 years old). Data on sociodemographic characteristics, risk profiles, and health behaviours (e.g. diet, physical activity, smoking status, and alcohol use) were collected. Ten-year CAD risk was estimated using the non-laboratory-based Framingham algorithm. Of the 427 participants [mean age was 69.2 ± 6.7 years, primarily women (65%), married (52.8%)], 319 (75%) were at low risk, and 108 (25%) were at moderate-to-high-risk for CAD. Filipinos at moderate to high risk were more likely to have cardiometabolic diseases (e.g. hypertension, hyperlipidaemia, diabetes, and obesity, all P's < 0.001). Health behaviours did not differ between the two groups except for the consumption of ≥5 servings of fruit, higher in the low-risk group. CONCLUSION: Data showed highly consistent and convergent evidence among older Filipinos living in rural areas at high risk for CAD and other health conditions. These findings underscore the need for culturally sensitive guidance to improve CAD outcomes for moderate to high-risk older adults living in rural areas, including education and counselling on risk and risk-reducing strategies.

Are Health Behaviors and Risk Factors for Altherosclerotic Cardiovascular Disease Interrelated Among Older Filipinos in Underserved Communities?

Introduction: Moving individuals toward ideal cardiovascular health through adoption of healthy lifestyle behaviors is critically important for prevention of atherosclerotic cardiovascular disease (ASCVD) and other important health conditions. However, associations between health behaviors and risks for ASCVD is poorly understood among older adults (≥ 60 years) living in rural areas in the Philippines. Likewise, their access to healthcare and health-seeking practices are unknown. Purpose: To 1) compare risk profiles of Filipinos at low- vs. moderate to high-risk for ASCVD; and 2)examine the relationships befiveen demographic variables, risk profiles, and health behaviors. Methods: A convenient sample of 427 Filipinos (≥ 60 years old) were recruited to participate in this comparative, cross-sectional study. Data on sociodemographic characteristics, risk profiles, and health behaviors (e.g., dietary patterns, physical activity, smoking status,and alcohol use)were collected. Results: Of the 427 participants (mean age was 69.2± 6.7 years, primarily women [65%], married [52.8%]), 319 (75%) were at low-risk and 108 (25%) were at moderate to high-risk for ASCVD. Those at moderate to high-risk were more likely to have cardiometabolic diseases(e.g., hypertension, hyperlipidemia, diabetes, and obesity, all p's < .001).Health behaviors did not differ between the two groups except for consumption of≥ 5 servings of fruit which was higher in the low-risk group. Conclusion: Findings showed that there is highly consistent and convergent evidence that older Filipinos living in rural areas are at high risk for ASCVD and other health conditions. Much of this is attributable to the suboptimal implementation of prevention strategies, uncontrolled ASCVD risk factors, and poor access to effective and equitable healthcare services commonly observed in low-income countries. Clinicians, researchers, policy makers, and other stakeholders need to address these issues to improve primary and secondary prevention and disease management in this population.