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A Physical Activity Intervention to Increase the Level of Physical

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A Physical Activity Intervention to Increase the Level of Physical A Physical Activity Intervention to Increase the Level of Physical Fitness among Boys Aged 14-15 Years in Jeddah City, Saudi Arabia Humood Fahm Albugami A thesis Submitted in fulfilment of the requirements of the degree of Doctor of Philosophy Faculty of Health University of Technology Sydney September 2018 Certificate of original authorship I certify that the work in this thesis has not previously been submitted for a degree nor has it been submitted as part of requirements for a degree except as part of the collaborative doctoral degree and/or fully acknowledged within the text. I also certify that the thesis has been written by me. Any help that I have received in my research work and the preparation of the thesis itself has been acknowledged. In addition, I certify that all information sources and literature used are indicated in the thesis. Signature of Student: Humood Albugami Production Note: Signature removed prior to publication. Date: 29/1/2018 ii Dedication To My Beloved Father who passed away after long years struggling with his illness. I was dreaming to see and share this moment of finishing my PhD and celebrate together. He taught me to never give up and be proud of every step I take toward reaching my goal in this life. I ask Allah to forgive his sins and have mercy upon him as he had mercy upon me when I was child and grant him Paradise. To My beloved Mother for all her prayers and practical help, without her immeasurable love, and her prayers I would not have come this far. To My lovely brothers, especially my old brother Mohammad for his support (both emotional and financial). Thank you for all your advice that enable me to complete this thesis. To my sweet sisters who deserve a heartfelt thank you, for motivation, words of encouragement, and celebrating each achievement along the way. To my Country, the kingdom of Saudi Arabia for their support iii Acknowledgements After sincerely thanking Allah for all blessings and bounties, I would like to express my sincerest gratitude to my thesis supervisors’ team for their contribution, assistance and guidance. Professor David Sibbritt: I am very proud to have you as my supervisor and my exceptional thank you for your quiet, calm nature and brilliant which helped me keep in balance through my acknowledged –searching journey .thank you for the valuable feedback and kind support through all years of struggle .without you I would not have the reason or the willingness to accomplish my studies .words will never express how much your enduring faith in me has kept me going. Professor Patricia M. Davidson: I highly appreciated all your support, invaluable advice and guidance you provided me over the past years .your insight comments and suggestions played a prominent role in improving the quality of my thesis. Thank you for conference presentation support. Dr Phillip Newton: I am grateful to all you’re graciously contributed throughout the thesis process. Thank you for your support and encouragement. iv Abbreviations ADA: Americans with Disabilities Act BHF: British Heart Foundation BMI: Body Mass Index BOD: Burden of Disease CDC: Center for Disease control and prevention CVD: Cardiovascular Disease DBP: Diastolic Blood Pressure HR: Heart Rate Kg: Kilogram KSA: Kingdom of Saudi Arabia MOC: Maximal Oxygen Consumption MVV: Maximum Voluntary Ventilation NASPE: National Association for Sports and Physical Education NHANES: National Health and Nutrition Examination Survey NWO: Normal Weight Obesity PA: Physical Activity PAQ-C: Physical Activity Questionnaire for Older Children PE: Physical Education PF: Physical fitness RCT: Randomized Controlled Trial SD: Standard Deviation SBP: Systolic Blood Pressure 20-mSR: 20 meters Shuttle Run US: United State WC: Waist Circumference WHO: World Health Organization v Table of Contents Certificate of original authorship ........................................................................................................ ii Dedication .............................................................................................................................................iii Acknowledgements .............................................................................................................................. iv Abbreviations ...................................................................................................................................... v Table of Contents ................................................................................................................................. vi List of Figures ....................................................................................................................................... xi List of tables......................................................................................................................................... xii Abstract ............................................................................................................................................... xvi Chapter 1: Introduction ....................................................................................................................... 1 1.1 Background .................................................................................................................................... 1 1.1.1 Definitions of Obesity ................................................................................................................. 1 1.1.2 The Kingdom of Saudi Arabia: Geography and demography .................................................. 8 1.1.3 Research Setting: Jeddah City ................................................................................................... 9 1.1.4 Saudi Arabian culture, society and economy .......................................................................... 10 1.1.5 The Saudi Arabian climate ...................................................................................................... 10 1.1.6 Climate of Jeddah ..................................................................................................................... 11 1.2 Purpose of the Study .................................................................................................................... 12 1.3 Research Questions ..................................................................................................................... 12 vi 1.4 Significance of the Study .............................................................................................................. 13 1.5 Justification for using physical activity intervention ................................................................... 14 Chapter 2: Literature Review ............................................................................................................ 21 2.0 Introduction ................................................................................................................................. 21 2.1 Prevalence of Obesity in Children ............................................................................................... 23 2.2 Causes of Childhood Obesity ....................................................................................................... 28 2.3 Lifestyle choices ........................................................................................................................... 30 2.4 Diet .............................................................................................................................................. 32 2.5 Physical activity ........................................................................................................................... 33 2.6 Physical fitness ............................................................................................................................ 36 2.7 The Cost of Adolescence Obesity ................................................................................................. 40 2.8 Physical Activity Intervention Studies on Childhood Obesity ..................................................... 42 2.9 The School Environment and Physical Activity Promotion ......................................................... 44 2.10 The Education System in Saudi Arabia ...................................................................................... 45 2.11 School Teachers and Physical Activity Promotion among Students ......................................... 47 2.12 School-Based Policies on Physical Activity and Sport in Saudi Arabia .................................... 47 2.13 Physical Activity, Neighborhood and School............................................................................. 48 2.14 Physical Activity Interventions .................................................................................................. 49 2.15 Summary .................................................................................................................................... 57 Chapter 3: Method .............................................................................................................................. 58 3.0 Introduction ................................................................................................................................. 58 3.1 Methodological Protocol: ............................................................................................................ 58 3.2 Mixed Methods Research Design ...............................................................................................
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