Exercise testing and intervention: translation into a low resource community

Abstract

Ikageng is a low-resource community on the outskirts of Potchefstroom in the North West Province of South Africa. South Africa experiences a burden of disease that includes both diseases of lifestyle due to obesity and sedentary behaviour, and diseases of poverty due to poor sanitation and insufficient public health measures. Exercise interventions are powerful tools to modify diseases of lifestyle, and the effects of these interventions can be readily measured using structured fitness tests, clinical examination procedures, and pencil and paper tests of health and wellbeing. In Ikageng we explored the possible translation of exercise intervention and testing into a low-resource community. We undertook a series of linked studies, commending with the translation of the SF-8 into Tswana, and the test-retest reliability, internal consistency, and face validity testing of this questionnaire in the community. We bench-marked the Tswana SF-8 against the South African English version of the same. We then compared several variations of a graduated step test for the prediction of VO2 peak, comparing the individual test when completed stepping in time to a metronome against a test completed using music to hold time, and the preferred of these individual tests against the step test completed in pairs. Once we had identified the most acceptable forms of these field tests, we conducted pilot testing of these tools during a community based exercise intervention (dancing). We have been able to demonstrate that the Tswana version of the SF-8, and modified step tests, are similarly robust, valid, and as practically useful as their traditional English and laboratory based forms respectively.