The article by McCoy et al. focused on an intervention program seeking to promote physical activities among African American adults using text messaging (2). According to this article, African American adults are less likely to engage in physical exercises than an average American resident. Most of them rarely find time to visit the gym or engage in outdoor physical exercises for various reasons. It explains why they are the worst affected group when it comes to lifestyle diseases such as obesity, cardiovascular diseases, diabetes, among a host of other related diseases. The study targeted African Americans living in urban centers, specifically in Central Mississippi. The participants in the study were adults aged 21 years old.
Most of them were Christians who attended various churches in the country. In their article, the researchers used two social and behavioral sciences models, the information-behavioral skills model, and the health belief model (McCoy et al. 3). The researchers wanted to determine how the targeted population could be empowered through regular access to information so that their behavior could be influenced by a given pattern. Using the information-behavioral skills model, they argue that constant reminder to the target population of the need to engage in physical exercise may change their behavior. It may make them believe that keeping fit is a way of managing or avoiding related health complications. On the other hand, the health belief model focuses on shaping the beliefs and attitudes of individuals with the aim of predicting their health behavior. In this context, the beliefs and attitudes of the respondents can be shaped by providing relevant information to influence their behavior positively.
According to a report by Al-Eisa et al., Saudi Arabia is one of the countries with the highest rates of obesity in the world (2). It is estimated that 68.3% of the country’s population is either obese or overweight. The studies also show that obesity is currently one of the leading causes of preventable deaths in the country. Livi et al. argue that obesity is a serious problem in major urban centers, especially among the middle-class workers in the country (28). Most of them rarely have time to engage in regular physical activities. These employees work almost on a daily basis with the aim of achieving career growth. When going to work, they use their cars or public transport because they highly value their time. Most of them rarely work or ride bicycles to work. On weekends, many have to be with their family and friends. In their daily or weekly schedule, meaningful physical exercise is not given any priority. Livi et al. state that most of these middle-class urban dwellers in Saudi Arabia have also embraced a poor eating habit that complicates their problem (26). Most of them have moved from traditional healthy meals and now prefer fast foods, most of which are rich in calories. Hamburgers, French fries, fried chicken, pitas, and pizzas have become very popular, especially during lunch-hours when they are away from home.
According to Ahadzadeh et al., the growing incidences of obesity are directly caused by poor dieting practices and limited physical activities (48). Che et al. observe that major cities such as Riyadh, Mecca, and Medina have modern gyms in various neighborhoods that can be used by these people to ensure that they remain physically fit (969). However, the demand for these services is low, leading to limited growth in the number of these facilities. McCoy et al. attribute the low demand for gym services to limited information among the target population (7). Most of these people rarely realize that they are getting obese. They have not come to appreciate the need to maintain regular physical exercise as a way of life. Heydari and Noroozi say that limited public awareness campaign is one of the main reasons why people rarely engage in physical exercises (6985). In many cases, people are informed about the need to engage in regular physical exercise when they visit hospitals because of various health complications. Sometimes it is too late to help them at that stage, especially when they have developed serious health complications. The government and other private entities are yet to take initiatives geared towards promoting physical exercise among urban dwellers in the Kingdom of Saudi Arabia.
The Targeted Population and Setting
In this study, the targeted population is the middle-class urban dwellers. The study specifically targets people with regular jobs, working in offices for five or six days a week. The chosen setting is the major urban centers in the country. The primary setting is the city of Riyadh. However, Mecca and Medina will also form part of the setting in this research. It is important to note that the chosen setting is similar to that in the article by McCoy et al. (1). They both focus on urban centers. The selected population in this study has a number of similarities and differences, which are worth noting. In both cases, the study focuses on the middle working-class members of society. Most of them work for about five or six days a week.
However, the selected populations in the two studies have differences worth noting. The main difference is that in the study by McCoy et al., the focus of the study is primarily on African Americans, just a section of the society in terms of race (3). However, that is not the case in this study. The study looks at all the middle-class urban dwellers in the selected cities working for five or six days a week irrespective of their race. The decision to choose the middle-class members of the society was informed by the fact that they are the worst affected group with the problem of obesity and related sicknesses. They rarely engage in physical exercises, and the researcher believes it is appropriate to promote awareness about the benefits of physical exercise in this community. A study by McCoy et al. shows that obesity is a health problem more prevalent in urban settings than in rural set-ups (3). That is why it was considered the right setting for this research.
Incorporating the Model in Saudi Setting
The chosen model is the health belief model that should be incorporated in the Saudi setting to address the identified problem. In this case, the researcher will use this model to find ways of promoting awareness about the importance of regular physical exercise among middle-class urban dwellers in the Kingdom of Saudi Arabia. The health belief model is based on three main conditions. The first condition is that the person must embrace the feeling that a given negative health condition, which in this case is obesity and related health complications, can be avoided (Heydari and Noroozi 6986). They must have a positive mindset that the problem is avoidable for them to develop the conviction of dealing with the issue.
The second condition is that the patient or targeted individual must have a positive expectation towards the recommended action and its ability to address the problem (Ahadzadeh et al. 49). For such a person to act in a given desirable manner, he or she must believe that the action will help in avoiding the negative health condition. In this case, the middle-class urban dwellers must believe that when they engage in exercise on a regular basis, they can overcome the problem of obesity and other related health problems. The third condition is that the targeted individual should have confidence in his or her ability to take recommended health action and achieve the desired health outcome (Heydari and Noroozi 6986). Taking regular exercise requires strong will power. The targeted individuals must believe that they can engage in regular physical exercise and that through consistency, they can fight obesity and related health problems.
The intervention strategy that will be used to address the problem of growing cases of obesity would be the promotion of awareness about physical exercise and its relevance in fighting obesity. The existing studies show that the number of gyms in major cities in Saudi Arabia has been on the rise, but the demand is still low. The strategy is to inform members of the public about dangers of obesity; ways to determine whether one is of normal weight, overweight, or obese, and how to deal with the problem. The campaign will then emphasize how regular physical exercise can help in managing obesity. Going to the gym regularly is one of the best ways of maintaining physical exercise. However, the awareness campaign will inform the targeted group that there are other ways of remaining physically active.
Walking to work instead of using buses, regular roadwork, attending dancing sessions among others can also be used to manage one’s body weight. The primary goal of this strategy will be to change the social behavior of middle-class urban dwellers in Saudi Arabia. Al-Eisa et al. say that most of these people in the target group rarely find time to engage in meaningful physical exercise (4). They do not consider it a priority. What they fail to understand is that their way of life may make them acquire life-shortening illnesses that may be very costly to manage. Taking some time to engage in physical exercise may not threaten their career. To the contrary, it will give them the physical strength they need to overcome various challenges in the workplace. It will eliminate opportunistic diseases that may threaten their career, especially when they are incapacitated. They must reconsider their current lifestyle and embrace a new behavior where they have to remain physically active.
The intervention plan proposed by McCoy et al. is effective in the setting where it was developed. However, in the local Saudi context, a number of changes will be needed to the original plan in line with the local forces. The original plan was developed in the United States. Livi et al. note that the ratio of gyms to the number of people in the United States is one of the highest in the world (31). People have come to appreciate the importance of gym and the increasing demand has increased the number of these facilities in places such as Mississippi where the study was based. However, that is not the case in most of the urban centers in Saudi Arabia. The facilities are scattered and cannot meet the full demand of the locals if more people are convinced to go to the gym on a regular basis. It means that it will be necessary to make adjustments in the initial plans. In this case, the proposed plan will promote other related activities that involve physical activities. Although these people will be encouraged to go to the gym, those who cannot conveniently access such facilities will be encouraged to use alternative means. Regular roadwork, dancing sessions, and walking to work are other alternatives that will be championed. The program will encourage the target group to choose an alternative they consider most appropriate based on their work and personal schedule, needs, and reliability.
The original program is silent when it comes to the issue of gender. That is expected because, in the United States, men and women can easily mingle in social forums and having one large training hall is not an issue. However, that may not be the case in Saudi Arabia, especially given the physical nature of the activities involved. In this plan, emphasis will be placed on the need to have separate training halls for men and women, in line with the Islamic culture that is valued by the majority of the Saudis. The trainers in the female gyms should be women, and that in the male gym should be men. This requirement will make both men and women feel comfortable going to the gym regularly.
Ahadzadeh, Sadat, et al. “Integrating Health Belief Model and Technology Acceptance Model: An Investigation of Health-Related Internet Use.” Journal of Medical Internet Research, vol. 17, no. 2, 2015, pp. 45-52.
Al-Eisa, Einas, et al. “Effect of Motivation by (Instagram) on Adherence to Physical Activity among Female College Students.” BioMed Research International, vol. 6, no. 1, 2016, pp. 1-5.
Che, Shaw-Ree, et al. “Using the Health Belief Model to Illustrate Factors that Influence Risk Assessment during Pregnancy and Implications for Prenatal Education about Endocrine Disruptors.” Policy Futures in Education, vol. 12, no. 7, 2014, pp. 961-972.
Heydari, Esmat, and Azita Noroozi. “Comparison of Two Different Educational Methods for Teachers’ Mammography Based on the Health Belief Model.” Asian Pacific Journal of Cancer Prevention, vol.16, no. 16, 2015, pp. 6981-6986.
Livi, Stefano, et al. “Health Beliefs Affect the Correct Replacement of Daily Disposable Contact Lenses: Predicting Compliance with the Health Belief Model and the Theory of Planned Behavior.” Contact Lens and Anterior Eye, vol. 40, no. 1, 2017, pp. 25-32.
McCoy, Pamela, et al. “Text Messaging: An Intervention to Increase Physical Activity among African American Participants in a Faith-Based, Competitive Weight Loss Program.” International Journal of Environmental Research and Public Health, vol. 14, no. 326, 2017, pp. 1-12.