Culturally adapted exercise program for postmenopausal women with excess weight gain: A modified international/local Delphi study

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Previous reports suggest that exercise intervention can reduce body weight and body composition profile parameters in obese postmenopausal women (PMW). Although some exercises have been constructed, international and local consensus on exercise programs for weight loss among postmenopausal women with excess weight (overweight and obesity) gain is lacking. We aimed to validate a culturally adapted exercise-based weight loss program for postmenopausal women using the Delphi consensus methodology. The study process consisted of three Delphi rounds among twelve international and twenty-one local experts. Participants were recruited via purposive sampling representing physiotherapists, exercise physiologists, exercise scientists, human kinetics and health education based on their interests and knowledge. A preliminary program was developed based on literature reviews and project findings. In the first Delphi round, open-ended responses were analysed thematically and converted into statements. Experts rated their agreement with these statements on a 5-point Likert scale in the second round. Consensus was defined as at least 60% strong agreement/disagreement. In the final round, participants reviewed the program and achieved an 80% consensus threshold. Thirty-three experts completed all three rounds, reaching consensus across four domains: health assessment, pre-exercise parameters, exercise dosage, and physician referrals. Response rates were high, with a final participation rate of 78% (n = 32).The high response rate established a strong consensus, providing clinicians with evidence-based recommendations to improve health outcomes for postmenopausal women in Ghana, with particular emphasis on the cultural adaptation process, especially the innovative inclusion of Ampe in the intervention.

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