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Background
Globally, insufficient physical activity(PA) has risen to epidemic levels in the past few decades [1]. One in four adults does not meet the World Health Organization (WHO) recommended 150 min of moderate intensity or 75 min of vigorous intensity PA per week [2]. About 33% of Southeast Asians have insufficient PA, and the population-attributable risk for all-cause mortality is 8.5% [3]. It is the fourth leading risk, contributing to 9% of global premature mortality with the increased prevalence of non-communicable diseases (NCDs) [4]. PA is regarded as one of the most effective strategies for NCD prevention and management, improving cardiorespiratory fitness, quality of life, and overall well-being and lowering the risk of all-cause mortality [5, 6, 7, 8, 9, 10, 11, 12–13].
The WHO attributes 66% of all deaths in Nepal to NCDs [14, 15]. The burden of insufficient PA is as high as 44.1% [16, 17, 18, 19–20]. Even though only 7% of people are insufficiently active in national data, a high proportion (43.1%) of people living in semi-urban areas are insufficiently active, with less leisure time PA and high sedentary behavior, despite the benefits of moderate to vigorous PA (MVPA) [13, 17, 18–19, 21]. The actual extent of insufficient PA could be much higher due to potential under-reporting in the subjective assessment utilized in those surveys [22, 23].
Nepal has set a target of achieving a 10% relative reduction in insufficient PA by 2025. However, a country guideline is not yet developed [24, 25]. Lack of knowledge and motivation are identified as major barriers to PA in Nepal, which may be effectively addressed through community-based educational interventions [26, 27–28]. PA intention, which predicts actual physical activity, increases by 9% through educational interventions in semi-urban area of Nepal [26, 27, 29]. Moreover, actual physical activity levels are significantly increased (p= 0.01) through these educational interventions [30]. Community-based PA intervention by trained volunteers is a cost-effective and culturally appropriate approach to reduce insufficient PA and its health consequences [31, 32–33]. Female Community Health Volunteers (FCHVs) are existing grassroots-level human resources in Nepal, providing effective community-based services in reproductive, neonatal, and child health [34]. Their engagement in the detection and community-based management of diabetes, hypertension, cervical cancer, and chronic obstructive pulmonary disease (COPD)...