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Quantitative researchers need a probabilistic sample to generalise their findings, but research constraints often compel them to use non-probabilistic samples. The use of non-probability sampling methods in quantitative studies has therefore become a norm. Interestingly, even studies published in top-quality journals compromise best practices that the use of non-probabilistic samples requires. Based on a thorough review of relevant studies, we developed a typology of non-probability sampling methods used in quantitative health studies. An attempt was made to discuss the limit of inference under each type of non-probability sampling method. Non-probability sampling in quantitative research was also delineated as a way to maximise response rate. This study is expected to guide students and early career epidemiologists to understand how to apply non-probabilistic sampling methods in quantitative approaches and plausibly document or report their chosen methods.

From the year 2003 when the first walkability scale was published to date, person-environment fit models and empirical research, some of which was published in Health Promotion International, have encapsulated healthy communities in ‘neighborhood walkability’. While there is no doubt that neighborhood walkability positively influences health-seeking behaviors and health, recent models suggest that their measurement and conceptualization have not emphasized the role played by psychosocial and personal factors in aging in place. Thus, the development of scales measuring human ecosystem factors has not recognized all critical factors suited for older adults. In this paper, we aim to draw on relevant literature to frame a more holistic construct, hereby referred to as Socially Active Neighborhoods (SAN), that would better support aging in place in older populations. Through a narrative review based on a systematic search of the literature, we define the scope of SAN and delineate some contextual implications for gerontology, health promotion and psychometric testing. SAN, unlike neighborhood walkability in its current measurement and conceptualization, incorporates critical theory-informed psychosocial factors (i.e. safety and disability friendliness of neighborhood infrastructure) that can encourage older adults with physiological and cognitive limitations to maintain physical and social activities as well as health in later life. The SAN is the result of our adaptation of key person-environment models, including the Context Dynamics in Aging (CODA) framework, that recognizes the role of context in healthy aging.

Several studies have compared physical activity (PA) levels between countries, but none of these studies focused on older adults and occupational PA. This study aimed to assess potential inequalities in older adults’ occupational PA across six countries and to ascertain whether having multiple jobs is a factor that interacts with country of residence to modify inequalities. This study adopted a cross-sectional design with a statistical technique screening for potential covariates. Older adults (mean age = 64 years; range = 50–114 years) from six countries (Russia, Mexico, China, India, Ghana, and South Africa) participated in the study. We utilised data from the first wave of the Study on Global AGEing and Adult Health (SAGE). These data were collected from 2007 to 2010. A random sample of 34,114 older adults completed the survey. We analysed the data with a two-way multivariate analysis of variance after screening for the ultimate covariates. There were differences in occupational PA levels (i.e., vigorous and moderate PA) among the six countries. Occupational PA levels were not significantly associated with having multiple jobs. However, having multiple jobs interacted with country of residence to influence vigorous occupational PA. Older adults from most countries who had more than one job reported more vigorous occupational PA. Older adults’ occupational PA differed among the six countries, and having multiple jobs was associated with more vigorous occupational PA. Older adults who keep multiple jobs at a time may be more active than their counterparts who had one job or were unemployed.

Several studies have compared physical activity (PA) levels between countries, but none of these studies focused on older adults and occupational PA. This study aimed to assess potential inequalities in older adults’ occupational PA across six countries and to ascertain whether having multiple jobs is a factor that interacts with country of residence to modify inequalities. This study adopted a cross-sectional design with a statistical technique screening for potential covariates. Older adults (mean age = 64 years; range = 50–114 years) from six countries (Russia, Mexico, China, India, Ghana, and South Africa) participated in the study. We utilised data from the first wave of the Study on Global AGEing and Adult Health (SAGE). These data were collected from 2007 to 2010. A random sample of 34,114 older adults completed the survey. We analysed the data with a two-way multivariate analysis of variance after screening for the ultimate covariates. There were differences in occupational PA levels (i.e., vigorous and moderate PA) among the six countries. Occupational PA levels were not significantly associated with having multiple jobs. However, having multiple jobs interacted with country of residence to influence vigorous occupational PA. Older adults from most countries who had more than one job reported more vigorous occupational PA. Older adults’ occupational PA differed among the six countries, and having multiple jobs was associated with more vigorous occupational PA. Older adults who keep multiple jobs at a time may be more active than their counterparts who had one job or were unemployed.

Understanding how the utilization of walkable neighbourhoods to reduce sedentary behaviour is affected by social and demographic factors is important. Therefore, this study examined the moderating influences of active social networks, sedentary social networks and active social networks lost on the association between neighbourhood walkability and sedentary behaviour. Twelve hundred community-dwelling older adults (≥60 years old) in Accra, Ghana, participated in this study. From these, 863 returned completed questionnaires on their social networks and sedentary behaviours and were incorporated into the analysis using Pearson’s correlation and hierarchical linear regression (HLR) models controlling for confounding variables identified using sensitivity analysis. Low neighbourhood walkability was associated with sedentary behaviour after controlling for confounders (β = –0.09; t = –2.7; p < 0.05). The negative influence of neighbourhood walkability on sedentary behaviour was significantly increased by the number of social network members independently of their activity levels. Low neighbourhood walkability was associated with sedentary behaviour, and older adults ought to constantly replenish or at least retain their social networks and active social networks in particular as they age to reduce sedentary behaviour.

Summary This study examined the moderating influences of active social networks (ASN), sedentary social networks (SSN) and ASN lost on the relationship between neighbourhood walkability and social activity in community-dwelling older adults aged 60 years or more in Accra, Ghana. A total of 863 individuals participated after G*Power 3.1 was utilized to calculate the minimum sample size. We analysed the data with Pearson’s correlation test and hierarchical linear regression models. A sensitivity analysis was conducted to select the ultimate confounding variables. The study found a positive influence of neighbourhood walkability on social activity after the covariate adjustment (β = 0.18; t = 5.2; p = 0.000). The positive influence of neighbourhood walkability on social activity was significantly reduced by ASN lost and SSN. ASN did not have a significant moderating influence on the primary relationship. The study concludes that the positive influence of walkable neighbourhoods on social activity decreases as SSN and ASN lost increase.

Aim The maintenance of physical activity (PA) over the life course is considered a hallmark for ageing well, but individuals who practice PA also often pursue lifestyles (e.g., smoking) that may inhibit the medicinal impact of PA on them. PA is said to protect against cardiovascular diseases (CVDs), but the literature has little to say about the impact of PA on the risk of CVDs when it is associated with lifestyle factors, comorbidities, and personal characteristics. This study aimed to assess the association between PA time and CVDs, with relevant lifestyle factors, comorbidities, and personal characteristics treated as covariates. Subject and methods The study’s population was retired and working older people aged 60 years or more in Accra, Ghana. A total of 686 individuals responded to self-reported questionnaires. Pearson’s chi-square test and binary logistic regression were used to present findings. Results The study found that the risk of having one or more CVDs increases as time spent in moderate and vigorous PA increases, whereas individuals who drank alcohol a few days a week or most days a week are respectively 2 (OR = 2.415; p = 0.037) and 22 (OR = 21.933; p = 0.000) times more likely to have one or more CVDs compared to those who never drank alcohol. Conclusion Health education should not only encourage PA maintenance but should also make individuals aware of the need to avoid unhealthy behaviours to maximize the positive effect of PA on health.

Background This study examined the influence of built environmental factors in the community on active social network size as well as the moderating influence of different dimensions of social activity on this relationship. Methods This study employed the cross-sectional and correlational approaches to construct a scale measuring key community-level built environment factors and test the moderating influence of social activity on the association between these factors and active social network size in older adults. The study population was all 3,211 older adults who were resident in Accra and were part of the database of the Social Security and National Insurance Trust. Participants were 515 older adults in Accra aged 60 years or more who met some inclusion criteria. A self-reported questionnaire, including a new scale measuring the built environment factors, was used to collect data. Principal component analysis with varimax rotation and confirmatory factor analysis were used to validate the measurement scales, whereas Pearson’s correlation test and multiple linear regression analysis were used to test the associations of interest. Results After controlling for relevant demographic variables, built environment factors in the community have no significant influence on active social network size. Volunteering, support for social ties, and group activity positively moderated the influence of built environment factors on active social network size at p Conclusion The study concludes that social activity is essential to the utilization of available built environmental factors by older adults to make active social ties in the community.

To evaluate the associations between walking frequency and social activity as well as the potential moderating role of walkability in these relationships.This study employed a cross-sectional design with a sensitivity analysis and techniques against common methods bias. The study population was community-dwelling older adults aged 60 years or more. A total of 927 older adults participated in the study after G*Power 3.1.9.4 was used to calculate the minimum sample size required for the study. A hierarchical linear regression (HLR) analysis was used to analyse the data.Older adults who walked 'many times' to socialize reported higher social activity than their peers who walked 'sometimes' or less frequently. Older adults who walked 'sometimes', 'many times' and 'always' for economic reasons reported higher social activity than their peers who did not walk at all. Neighborhood walkability positively moderated the association between at least one indicator of walking and social activity.Frequent walking may better contribute to social activity among seniors in more walkable neighborhoods. Community design interventions aimed at enhancing walkability can encourage walking and social activity among seniors.

The available evidence suggests that social networks can contribute to physical activity (PA) enjoyment, which is necessary for the maintenance of PA over the life course. This study assessed the associations of active and sedentary social networks with PA enjoyment and ascertained whether walkability moderates or modifies these associations. A cross-sectional design compliant with STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) was employed. The participants were 996 community-dwelling older Ghanaians aged 50 years or older. A hierarchical linear regression analysis was used to analyse the data. After adjusting for age and income, the study found that the active social network size (β = 0.09; p < 0.05) and sedentary social network size (β = 0.17; p < 0.001) were positively associated with PA enjoyment. These associations were strengthened by walkability. It is concluded that active and sedentary social networks may better support PA enjoyment in more walkable neighbourhoods. Therefore, enabling older adults to retain social networks and live in more walkable neighbourhoods may be an effective way to improve their PA enjoyment.

Background: This study assessed behavioral and demographic correlates of exercise during a COVID-19 lockdown in three cities. A cross-sectional design was employed. An online survey was used to collect data from residents of three Ghanaian cities, namely Accra, Kumasi, and Tamale.Methods: A total of 621 residents participated in the study. Most of the participants had tertiary educational qualifications and were aged 18 to 54 years. A binary logistic regression was used to present findings.Results: The results indicate that unemployed participants were about 13 times more likely to exercise than those who were employed. Individuals aged 25 to 30 years were about 0.7 times less likely to exercise compared with those aged 18 to 24 years. Participants with one or more chronic diseases were about 19 times more likely to exercise compared with those without a chronic condition. Residents who reported a reduction in moderate physical activity time of between 30 to 60 minutes were less likely to exercise compared with those who did not.Conclusion: The study concludes that the behavioral and demographic correlates of exercise during the lockdown are age, chronic disease status, employment, physical activity time lost, smoking, and domestic violence experience.

Summary This study aimed to assess the moderating influence of neighborhood walkability on the association between physical activity (PA) and mental health among older African academics aged 50 years or more in cities with social distancing protocols in response to the Coronavirus disease 2019 (COVID-19). A total of 905 volunteer academics participated in the study. A hierarchical linear regression analysis was employed to conduct sensitivity analyses and test the study hypotheses. After controlling for sex, education and age, there was a positive association between PA and mental health. Neighborhood walkability moderated the relationship between PA and mental health, which suggests that during the pandemic PA was associated with higher mental health scores in more walkable neighborhoods. The study concludes that PA was beneficial to mental health in the social distancing context and was associated with higher mental health in more walkable neighborhoods, particularly in a social distancing context.

The association between subjective age and social activity has been reported in the extant literature, but whether this association is mediated by information technology ability and its domains (i.e., internet use assessment, packaged software use assessment, and innovativeness attitude) has not been examined.To assess the association between subjective age and social activity and to ascertain whether this association is mediated by information technology ability.This study adopted a cross-sectional design characterising sensitivity analyses and common methods bias. The participants were 895 community-dwelling older adults aged 60 years or higher in Accra, Ghana. We measured subjective age, information technology ability, and social activity with previously validated Likert scales, each of which was internally consistent at a Cronbach's α ≥0.7. The data were analysed with partial least squares structural equation modelling (PLS-SEM) and hierarchical linear regression (HLR) analysis.Subjective age was positively associated with social activity, and this association was partially mediated by information technology ability but none of the three domains of information technology ability mediated this relationship. Subjective age was positively associated with information technology ability and its three domains. Information technology ability (but not its domains) was positively associated with social activity.Older subjective age was associated with higher social activity through information technology ability. Social activity and information technology ability levels among older adults depend on subjective age, which has implications for ageing and gerontology as reported in this paper.

This study developed a scale measuring patients' perceptions regarding physical activity (PA) counseling by physicians. Confirmatory factor analysis and multiple linear regression analysis were used to assess psychometric properties. The first factor extracted was "PA recommendation," which accounted for a variance of 45.1% out of total variance of 76.3% and comprises 5 items. The final scale yielded satisfactory psychometric properties including internal consistency (Cronbach's α = 0.75), convergent validity, discriminant validity, and predictive validity. Nine (9) items that makeup two factors (i.e., PA recommendation and follow-up) are potential measures of patients' perceptions regarding PA counseling by physicians in healthcare.

Research to date suggests that physical activity (PA) among academics is insufficient globally. Academics in many African countries were recently required to resume work while observing social distancing protocols. Physical inactivity (PI) was, therefore, expected to increase in such academics. Interestingly, walkable neighbourhoods are resources that could discourage excessive sitting and PI in this situation. This study, therefore, assessed the moderating role of neighbourhood walkability in the relationship between core job components (i.e. on-site teaching, online teaching, research and student assessment) and PA among academics. The study adopted a cross-sectional design that utilized an online survey hosted by Google Forms to gather data. Participants were volunteer full-time academics in Nigeria, Ghana, Kenya and Tanzania. A total of 1064 surveys were analysed, with a sensitivity analysis utilized to select covariates for the ultimate hierarchical linear regression model. After controlling for the ultimate covariates (e.g. gender, education and income), PA was found to be positively associated with the job component 'research work’ but negatively associated with student assessment. Neighbourhood walkability increased the positive relationship of research work with PA and reduced the negative relationship of student assessment with PA. The non-significant negative relationship between ‘teaching online’ and PA was made positively significant by neighbourhood walkability. We conclude that research as a job component is positively associated with PA, but online teaching is negatively associated with PA among African academics in a post-COVID-19 context.

This study examined the association between core job components (i.e. teaching, research, and student assessment), physical activity (PA), and mental health in a post-COVID-19 context. An online questionnaire administered via Google Forms was used to gather data from 1064 African academics in four countries. A sensitivity analysis was applied to adjust for covariates. Data were analyzed with the hierarchical linear regression analysis. The average age of participants was 44 years. The study found that PA was positively associated with research but negatively associated with student assessment. Mental health was positively associated with onsite teaching but negatively associated with online teaching and research. PA did not predict mental health and mediate the relationship between the job components and mental health. It is concluded that PA may not increase mental health in African academics in a post-COVID-19 situation that required the resumption of work while observing social distancing protocols.

Purpose: Whistleblowing intention (WBI) has been conceptualized and evidenced as a social construct in the literature. As a construct subject to social and environmental factors nevertheless, WBI c...

Purpose This study aims to assess the effect of religiosity on the job satisfaction of nurses in response to the paucity of studies that have investigated this relationship in a health care setting. The authors also tested the moderation impact of materialism on the religiosity–satisfaction nexus. Design/methodology/approach The quantitative (correlational) research technique was applied to test hypotheses of interest. The simple random sampling method was used to select a representative sample of 458 nurses. Confirmatory factor analysis (CFA) was used to examine the factor structures of relevant constructs and to test hypotheses. The study’s ultimate CFA model produced a good fit at 5 per cent significance level [Chi-square (χ2) = 19.121; p = 0.454]. Findings Religiosity was found to make a positive effect on job satisfaction and a negative effect on materialism. Materialism makes a negative effect on job satisfaction. Religiosity and materialism makes a significant negative interaction effect on nurses’ satisfaction after controlling for job income. Practical implications It is therefore concluded that religiosity is a positive behaviour that contributes to the satisfaction of nurses, but materialism must be avoided or at least reduced to maximise this impact. Originality/value In this study, the authors demonstrate that the positive effect of religiousness on job satisfaction can be negatively moderated by materialism so that religiousness makes less impact on satisfaction owing to the negative influence of materialism on job satisfaction.

Purpose The purpose of this paper is to provide an empirical basis for considering in-service training, tenure prolongation and continuing education as methods for enhancing nursing performance. Design/methodology/approach A self-reported questionnaire was used to collect data from 532 nurses, who were selected using the simple random sampling method from ten hospitals in Accra North, Ghana. Confirmatory factor analysis (CFA) was used to test the study’s hypotheses. Findings The resulting model is of good fit at 5 per cent significance level (χ2=1.492, p=0.222), with in-service training found to be the ultimate method for enhancing nursing performance. The fitted CFA model also shows that in-service training is positively associated with education and tenure at 1 per cent significance level (p Originality/value Apart from its contribution to the literature, this study applies validated primary data to empirically identify key methods for enhancing nursing performance.

Purpose: This study attempted to conceptualize confounding and guide healthcare management researchers to identify and adjust for potential confounders from the point of view of their theoretical f...

Background\ud The social support provided or given to others play a key role in healthy ageing. Empirical and anecdotal evidence suggests that walkable neighbourhoods can positively influence social support given. Higher health self-consciousness may strengthen the positive association between walkability and social support provided.\ud \ud Aim\ud This study investigated whether the association between walkability and social support provided is moderated by health self-consciousness.\ud \ud Methods\ud A cross-sectional design with sensitivity analysis and recommended procedures against common methods bias was employed. The study's population was community-dwelling older adults living in Accra, Ghana. Data from 923 participants were analysed using the hierarchical linear regression analysis.\ud \ud Findings\ud The study found a positive association between walkability and social support provided after adjusting for the ultimate confounding variables. Health self-consciousness positively moderated the association between walkability and social support provided.\ud \ud Conclusion\ud The study concludes that social support provided in older adults may be higher in more walkable neighbourhoods. Health self-consciousness can enhance the contribution of walkability to social support provided. Our results reinforce the importance of campaigns aimed at improving walkability of neighbourhoods.

This study constructed a scale for measuring nurses' physical activity (PA) counseling in healthcare from the points of view of regular patients. Confirmatory factor analysis produced a two-factor solution with 7 items. The first factor extracted was "follow-up", which accounted for a variance of 44.5% out of a total variance of 64.8% and comprises 4 items. The second factor, "PA recommendation", accounted for a variance of 20.3% and comprises 3 items. The final scale had a good internal consistency (Cronbach's

BACKGROUND AND OBJECTIVES Many scales have been developed to measure health care quality over the years, but no scale available today incorporates all important indicators of sanitation and hygiene in health care. This study therefore assessed the psychometric properties of an adapted scale, hereby called ADAPTED SERVQUAL, in an attempt to provide a scale that includes relevant indicators of hospital hygiene and sanitation. METHODS The setting of the study was low- and medium-capacity hospitals in the Greater Accra Region of Ghana. Patients in wards and outpatient departments in the hospitals participated in the study. We used relevant statistical tools to estimate the psychometric properties of ADAPTED SERVQUAL. To understand the relative importance of the new scale, we compared and related it to a recent scale, HEALTHQUAL. RESULTS Principal component analysis yielded 6 factors: "tangibles," "reliability," "responsiveness," "assurance," "empathy," and "sanitation and hygiene," which explained 84% of the total variance. ADAPTED SERVQUAL has a good internal consistency (Cronbach α = 0.96). Confirmatory factor analysis confirmed the 6-factor solution and produced satisfactory discriminant validity and convergent validity indicators. The adapted scale was highly correlated with all dimensions of HEALTHQUAL, including continuous quality improvement (r ≥0.75, P < .001). In multiple linear regression, the 5 domains of HEALTHQUAL explained 59% of the variance in ADAPTED SERVQUAL (P < .001). CONCLUSIONS The study concluded that 8 items that make up a single factor (ie, sanitation and hygiene) and contribute most of the total variance satisfactorily fit into the SERVQUAL scale as additional indicators of health care quality.

This study examined built environmental and socio-demographic variables as correlates of sedentary behaviour in a population of older adults, and attempted to introduce the idea of measuring sedentary behaviour with two domains, namely ‘partial sedentary behaviour’ and ‘absolute sedentary behaviour’. The study’s population was community-dwelling older adults aged 60 years or more in Accra, Ghana. A self-reported questionnaire was used to gather data from 504 older people. Multiple linear regression analysis was used to present findings, with all nominal categorical variables incorporated in this analysis dummy-coded. The overall (third) regression model accounted for a variance of 55.9% and a significant F-test [F (25,454) = 22.99; p