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Abstract

Mortality from non-communicable diseases (NCD) has increased in Vietnam in
recent decades. Relatively little is known about the prevalence of risk factors for
NCD in Vietnam, particularly for rural populations living outside the two major
cities of Ha Noi and Ho Chi Minh City. The measurement of physical inactivity, an
established risk factor for disease in Western populations, has not been attempted.
The principal aim of this thesis was to test the reliability and validity of several
methods of measuring physical activity in the Vietnamese population. A secondary
aim was to investigate the prevalence of physical inactivity and other NCD risk
factors in a population-based sample of rural Vietnam.
A population survey (n=1978) was conducted in 2005 in Can Tho in the Mekong
Delta of southern Vietnam, using the STEPS methodology developed by the World
Health Organisation. Measurements of physical activity were made using the Global
Physical Activity Questionnaire (GPAQ). GPAQ is a modified version of the
International Physical Activity Questionnaire (IPAQ). A sub-sample (n=251) of
participants had multiple measurements of physical activity using GPAQ, IPAQ,
pedometers, and physical activity records (PAR). The key findings were:
1. The prevalence of NCD risk factors in the dominantly rural sample were very
different from those previously reported for big city samples from Ha Noi
and Ho Chi Minh City.
2. Work activity constituted 80% of total moderate and vigorous activity, and
33% of men and 40% of women were classified as inactive.
3. The modifications of IPAQ in the design of GPAQ have improved the
physical activity estimates for those with stable work patterns, but, overall,
both questionnaires had modest reliability and validity in estimating physical
activity.
4. It was feasible to obtain a superior estimate of physical activity using at least
three days of pedometer wear.
5. The use of pedometers was culturally acceptable to the local population. The
involvement of health volunteers was critical, but they require constant
supervision. 6. Tobacco smoking, a potential confounder of the association between physical
activity and NCD risk indicators, was associated with hypertension in a doseresponse
fashion.
7. Physical activity measured by GPAQ was associated with total cholesterol
and, for men, with body composition and blood glucose. Work activity was
the main contributor to these associations.
For Vietnam, the GPAQ modifications of IPAQ have been only partly successful.
Objective measurement by pedometers is feasible and culturally acceptable, and
should be encouraged.

Item Type:	Thesis - PhD
Authors/Creators:	Au, BT
Keywords:	Exercise, Diseases
Copyright Holders:	The Author
Copyright Information:	Copyright 2010 the Author
Additional Information:	Chapter 2 appears to be the equivalent of a post-print of an article finally published as: Pham, L. H.; Thuy, A. B.; Blizzard, L.; Truong, N. B.; Schmidt, M. D.; Granger, R. H.; Dwyer, T., 2009, Prevalence of risk factors for non-communicable diseases in the Mekong Delta, Vietnam: results from a STEPS survey, BMC public health, 9(291), 1-8 published under a Creative Commons license, (http://creativecommons.org/licenses/by/2.0) Chapter 3 appears to be the equivalent of a post-print of an article finally published as: Thuy, A. B.; Blizzard, L.; Schmidt, M.; Luc, P. H.; Magnussen, C.; Dwyer, T., 2010, Reliability and validity of the global physical activity questionnaire in Vietnam, Journal of physical activity and health, 7(3), 410-418 © 2010 Human Kinetics, Inc. "as accepted for publication" Chapter 4 appears to be the equivalent of a post-print of an article finally published as: Thuy, A. B.; Blizzard, L.; Schmidt, M.; Magnussen, C.; Hansen, E.; Dwyer, T., 2011, Using pedometers to estimate ambulatory physical activity in Vietnam, Journal of physical activity and health, 8(1), 52-61 © 2011 Human Kinetics, Inc. "as accepted for publication" Appendix 6A 4 appears to be the equivalent of a non-final version of an article published in final form as: Thuy, A. B.; Blizzard, L.; Schmidt, M.; Luc, P. H.; Granger, R. H.; Dwyer, T., 2010, The association between smoking and hypertension in a population-based sample of Vietnamese men, Journal of Hypertension, 28(2), 245-250 Chapter 7 appears to be the equivalent of a post-print of an article finally published as: Thuy, A. B.; Blizzard, L.; Schmidt, M.; Luc, H. P.; Granger, R. H.; Dwyer, T., 2012, Physical activity and its association with cardiovascular risk factors in Vietnam, Asia-Pacific journal of public health, 24(2), 308-317 © 2012 APJPH
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