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Maricar N, Khan B, David T, Hyrich KL, Barton A. Factors facilitating and hindering South Asian immigrant adults from engaging in exercise and physical activity - a qualitative systematic review. BMC Public Health 2024; 24:1342. [PMID: 38762730 PMCID: PMC11102233 DOI: 10.1186/s12889-024-18288-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/05/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND Exercise and physical activity are key components of management in patients with rheumatic musculoskeletal diseases (RMD), but people of the South Asian communities have a lower level of engagement with these activities compared to their Caucasian counterparts. The aim of this qualitative systematic review was to determine the barriers and facilitators of exercise and physical activity in South Asian communities who have migrated and live in western countries, particularly in those who have RMD. METHODS Qualitative studies, published in English between 1999 and 2021 and including evaluation of barriers and/or facilitators to exercise or physical activity behaviour in people of South Asian adult communities who have migrated and/or lived in western countries were identified from Embase, MEDLINE, CINAHL, PsycINFO, Google Scholar and manual searches. The studies were appraised using the CASP checklist. Inductive thematic synthesis was used to identify common and global themes. RESULTS A total of 32 studies that discussed barriers and facilitators of physical activity in South Asian communities who have migrated and lived in western countries were used for this review but there were no studies identified that focussed specifically on those with RMD. Following appraisal of the reporting of the studies, 30 studies were included in the pooling of the results. The facilitators and barriers to physical activities were broadly categorized into 'extrinsic' and 'intrinsic' factors. Extrinsic factors such as 'opportunity' included environmental factors such as weather and safety; socioeconomic factors such as education, language and literacy, and support in the form of social, psychological and resources. Intrinsic factors included cultural factors, such as life stages and family influence, beliefs and knowledge, which impacted attitudes and skills. CONCLUSIONS This review has synthesised evidence of barriers or facilitators and identified potentially modifiable factors influencing physical activity and exercise engagement, which could form the basis of evidence-based interventions to promote participation in healthy behaviour change. Provision of a safe, comfortable and culturally acceptable environment together with culturally-aligned cognitive strategies to facilitate acquisition of exercise-efficacy skills could help engagement. REGISTRATION The systematic review was registered on PROSPERO, registration no. 289,235.
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Affiliation(s)
- Nasimah Maricar
- Northern Care Alliance NHS Foundation Trust, Salford Royal NHS Foundation Trust, Manchester, UK.
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK.
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK.
| | - Behram Khan
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Trixy David
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Kimme L Hyrich
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Foundation NHS Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Anne Barton
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Foundation NHS Trust, Manchester Academic Health Science Centre, Manchester, UK
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK
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Almas A, Hashmi S, Elahi A, Parkash OM, Sabir S, Iqbal R. Comparison of Physical Activity Measured by Self-Reported Physical Activity and Wearable Device Xiaomi MI2 Band in Preadolescent School Children - A Pilot Cross-Sectional Study. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2024; 17:565-575. [PMID: 38859892 PMCID: PMC11164430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
The purpose of this study is to compare physical activity measured by the wearable device Xiaomi Mi2 Band and self-reported physical activity by YPAQ in preadolescent school children. A pilot cross-sectional study was performed on a subsample (5%=n=60) of preadolescent children within a parallel-group feasibility intervention trial (n=1000). All children aged 9-11 years enrolled in the schools were included in the study and children with any physical disability were excluded. Self-reported physical activity was recorded through the modified version of the Youth Physical Activity Questionnaire (YPAQ) and automatic physical activity was measured by the Xiaomi Mi2 band over 7 days. Data from the Xiaomi Mi2 band was synchronized with its mobile application from where data was transferred to an excel sheet. Data on 7-day total physical activity in minutes and 7-day total step count were recorded by the Xiaomi Mi2 band. Student's t-tests were used to determine whether significant differences were present between self-reported physical activity and by Xiaomi Mi2 band. A Bland-Altman method was also used to assess the degree of agreement between the two methods of measuring physical activity. Mean ± SD age of the children was 9.6 (± 1.0) years and 31 (51.7 %) were boys. The mean ± SD time spent in physical activity reported by YPAQ was 457.5 (± 136) minutes and by the Xiaomi Mi2 band was 594.7 (± 183) minutes. The Bland-Altman plot identified a mean bias between the methods (YPAQ and Xiaomi Mi2 band) of -157.6 (95% CI: 296.3, -611.0) minutes of 7-day physical activity. Physical activity measured by a wearable device, the Xiaomi Mi2 band can give overestimated values of physical activity compared to self-reported physical activity in preadolescent school children. However, when PA is measured through step counts by the Xiaomi Mi2 band converted to minutes, it is comparable to PA measured by YPAQ.
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Affiliation(s)
- Aysha Almas
- Department of Medicine, Aga Khan University, Karachi, PAKISTAN
| | - Shiraz Hashmi
- Department of Surgery, Aga Khan University, Karachi, PAKISTAN
| | - Adil Elahi
- Research Fellow, Aga Khan University, Karachi, PAKISTAN
| | - O M Parkash
- Department of Medicine, Aga Khan University, Karachi, PAKISTAN
| | - Sania Sabir
- Department of Medicine, Aga Khan University, Karachi, PAKISTAN
| | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, PAKISTAN
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Maricar N, Yeowell G, David T, Khan B, Barton A, Hyrich KL, Hartley SE. Barriers and enablers to engagement in exercise and physical activity in non-English speaking South Asian people with chronic musculoskeletal disease. BMC Rheumatol 2024; 8:12. [PMID: 38462630 PMCID: PMC10926668 DOI: 10.1186/s41927-024-00372-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 01/08/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Exercise and physical activity (EPA) are recommended for people with chronic musculoskeletal disease; however, lower levels of engagement with EPA has been consistently reported in people from the South Asian community across a range of diseases. As language can pose a significant barrier in healthcare, this study aimed to understand the enablers and barriers to the acceptance of EPA among non-English speaking South Asian people who attended rheumatology clinics. METHODS 12 non-English speaking individuals from the South Asian community who had chronic musculoskeletal disease with significant pain scores were interviewed via telephone or face-to-face in their spoken languages. The audio recordings of the interviews were translated into English and transcribed verbatim. Data was analysed using thematic analysis implemented in the NVivo 12 Pro software program. RESULTS The mean age was 52 years (9 women and 2 men). One main theme was identified: 'Enablers and barriers to exercise and physical activity'. Enablers to EPA were having knowledge about the benefits of EPA, being given resources in a language that they understood, and supportive environments such as having access to community facilities for those who could not undertake EPA in their houses. Barriers included physical health such as pain and fatigue, lack of time, difficulties with transportation to exercise venues, dislike of group exercises and lack of understanding of what and how to do exercise and be physically active. Participants' beliefs about EPA and whether they impacted their physical health seemed to influence whether they were undertaken or not. There was a perception that their culture shaped their compatriots' beliefs about EPA, and it was not normal practice for people from their country of birth to engage in it. CONCLUSIONS This is the first qualitative study to explore the barriers and enablers to engagement in EPA in non-English speaking South Asian people with chronic musculoskeletal disease. Modifiable factors such as addressing the level of knowledge on the benefits of EPA in the management of chronic joint and muscle pain; aiding the development of the skills required to exercise safely and confidently despite chronic pain and providing information and services in the native language could promote the EPA engagement of non-English speaking South Asian individuals with chronic musculoskeletal disease. The findings may inform improvements within clinical services to promote the benefits, impact and self-efficacy of engagement with EPA as part of chronic musculoskeletal disease management. ETHICS APPROVAL The West Midlands-Edgbaston Research Ethics Committee (reference:20/WM/0305).
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Affiliation(s)
- Nasimah Maricar
- Northern Care Alliance NHS Foundation Trust, Salford Royal NHS Foundation Trust, Manchester, UK.
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK.
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK.
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Trixy David
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Behram Khan
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Anne Barton
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Foundation NHS Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Kimme L Hyrich
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Foundation NHS Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Sandra E Hartley
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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Gage R, Mizdrak A, Richards J, Bauman A, Mcleod M, Jones R, Woodward A, Shaw C. The Epidemiology of Domain-Specific Physical Activity in New Zealand Adults: A Nationally Representative Cross-Sectional Survey. J Phys Act Health 2023; 20:909-920. [PMID: 37290767 DOI: 10.1123/jpah.2022-0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 03/20/2023] [Accepted: 04/22/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Surveillance of domain-specific physical activity (PA) helps to target interventions to promote PA. We examined the sociodemographic correlates of domain-specific PA in New Zealand adults. METHODS A nationally representative sample of 13,887 adults completed the International PA Questionnaire-long form in 2019/20. Three measures of total and domain-specific (leisure, travel, home, and work) PA were calculated: (1) weekly participation, (2) mean weekly metabolic energy equivalent minutes (MET-min), and (3) median weekly MET-min among those who undertook PA. Results were weighted to the New Zealand adult population. RESULTS The average contribution of domain-specific activity to total PA was 37.5% for work activities (participation = 43.6%; median participating MET-min = 2790), 31.9% for home activities (participation = 82.2%; median participating MET-min = 1185), 19.4% for leisure activities (participation = 64.7%; median participating MET-min = 933), and 11.2% for travel activities (participation = 64.0%; median MET-min among participants = 495). Women accumulated more home PA and less work PA than men. Total PA was higher in middle-aged adults, with diverse patterns by age within domains. Māori accumulated less leisure PA than New Zealand Europeans but higher total PA. Asian groups reported lower PA across all domains. Higher area deprivation was negatively associated with leisure PA. Sociodemographic patterns varied by measure. For example, gender was not associated with total PA participation, but men accumulated higher MET-min when taking part in PA than women. CONCLUSIONS Inequalities in PA varied by domain and sociodemographic group. These results should be used to inform interventions to improve PA.
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Affiliation(s)
- Ryan Gage
- Department of Public Health, University of Otago, Wellington,New Zealand
| | - Anja Mizdrak
- Department of Public Health, University of Otago, Wellington,New Zealand
| | - Justin Richards
- Sport New Zealand, Wellington,New Zealand
- Faculty of Health, Victoria University of Wellington, Wellington,New Zealand
| | - Adrian Bauman
- Sydney School of Public Health, The University of Sydney, Sydney, NSW,Australia
| | - Melissa Mcleod
- Department of Public Health, University of Otago, Wellington,New Zealand
| | - Rhys Jones
- Te Kupenga Hauora Māori, The University of Auckland, Auckland,New Zealand
| | - Alistair Woodward
- Epidemiology and Biostatistics, The University of Auckland, Auckland,New Zealand
| | - Caroline Shaw
- Department of Public Health, University of Otago, Wellington,New Zealand
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Kwon S, Kandula NR, Tandon PS, Shah NS. Physical activity and TV viewing parenting practices for toddlers among South Asian and white families in the UK: born in Bradford 1000 study. BMC Public Health 2023; 23:1590. [PMID: 37605145 PMCID: PMC10463369 DOI: 10.1186/s12889-023-16522-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/14/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Children of South Asian (SA) origin in the UK have lower levels of physical activity (PA), compared to their White counterparts. Parents play an important role in establishing PA habits among young children. The aim of this study was to compare PA and television (TV) viewing parenting practices for young children between SA British (SAB) and White British (WB) parents living in the UK. METHODS We conducted a secondary analysis of the Born in Bradford (BiB) 1000 study, using survey data at child ages 24 and 36 months. The study sample included three groups of mothers (n = 1,149): foreign-born SAB (n = 458), UK-born SAB (n = 276), and WB (n = 455). Mothers completed a survey about parenting practices (i.e., PA supports, PA restrictions, TV viewing restrictions) at child age 24 months and child PA and TV viewing behaviors at child ages 24 and 36 months. Parenting practices were compared among the three groups. Multivariable linear regression analyses compared children's weekly walking frequency and daily TV viewing hours by parenting practices in the three groups. RESULTS The foreign-born SAB group showed the lowest frequencies of PA-supportive parenting practices (verbal encouragement: 3.7 ± 3.1 times/week; logistic support: 1.5 ± 1.8 times/week) and the highest frequencies of PA-restrictive parenting practices (7.8 ± 7.7 times/week) among the three groups (p < 0.01). Children of Foreign-born SAB mothers had the most frequent TV watching during a mealtime (4.0 ± 3.1 times/week) among the three groups (p < 0.01). Less frequent PA-supportive parenting practices and SA ethnicity were associated with lower walking frequency at 24 and 36 months of age among children (p < 0.01). More frequent exposure to TV at mealtimes and SA ethnicity were associated with higher TV viewing time at 24 and 36 months of age among children (p < 0.01). CONCLUSIONS This study demonstrated that SAB parents, particularly those who are foreign-born, apply parenting practices for their young children that are less supportive of PA and more supportive of TV viewing, and their children have lower PA and higher TV viewing time, compared with their WB counterparts.
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Affiliation(s)
- Soyang Kwon
- Department of Pediatrics, Northwestern University, 225 E Chicago Ave. Box 157, Chicago, IL, 60611, USA.
| | - Namratha R Kandula
- Department of Medicine and Preventive Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Pooja S Tandon
- University of Washington & Seattle Children's Hospital, M/S CURE-3, PO Box 5371, Seattle, WA, 98145, USA
| | - Nilay S Shah
- Department of Medicine (Cardiology) and Preventive Medicine, Northwestern University, Chicago, IL, 60611, USA
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Daniel M, Buchholz S, Fogg L. Physical Activity in South Asian Indians: A Systematic Review of Randomized Controlled Trials. West J Nurs Res 2023; 45:363-374. [PMID: 36324264 DOI: 10.1177/01939459221134373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This review systematically examines the characteristics and effectiveness of randomized controlled trials with aerobic physical activity (PA) interventions tailored to South Asian Indians (SAIs). PubMed/MEDLINE, Scopus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, and Google Scholar were searched. The search yielded 1,842 studies; 11 met the criteria. The Center for Evidence-Based Medicine's critical appraisal tool was used to assess the quality of studies. Studies that used supervised structured PA sessions, educational material in SAI languages, motivational strategies, and positive reinforcement for goal setting, reported significant improvement in PA (p < .05; Cohen's d ≤ 0.3 to >0.8). Future PA studies in India featuring SAIs would benefit from clinic-based one-on-one structured aerobic PA interventions. In contrast, SAI immigrants in Western countries would benefit from community-based structured aerobic PA interventions that are offered in groups and culturally adapted.
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Affiliation(s)
- Manju Daniel
- College of Nursing, Rush University, Chicago, IL, USA
| | | | - Louis Fogg
- College of Nursing, Rush University, Chicago, IL, USA
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Stefil M, Bell J, Calvert P, Lip GY. Heightened risks of cardiovascular disease in South Asian populations: causes and consequences. Expert Rev Cardiovasc Ther 2023; 21:281-291. [PMID: 36866613 DOI: 10.1080/14779072.2023.2187780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
INTRODUCTION South Asian individuals comprise almost a quarter of the world's population and have an excess risk of atherosclerotic cardiovascular disease (ASCVD) compared to other ethnicities. In part, this can be explained by higher prevalence, earlier onset, and suboptimal control of traditional cardiovascular risk factors, such as insulin resistance, metabolic syndrome, and dyslipidaemia. However, there remains a significant residual excess risk associated with South Asian ethnicity after controlling for traditional risk factors. AREAS COVERED In this review, we describe the epidemiology of ASCVD in both native and diaspora South Asian populations. We explore how traditional cardiovascular risk factors, novel cardiovascular risk factors, and social determinants of health may contribute to the excess ASCVD risk seen in South Asian populations. EXPERT OPINION There should be increased awareness of the relative importance of South Asian ethnicity and related social determinants of health, as risk factors for ASCVD. Systematic screening processes should be tailored to this population, and modifiable risk factors should be treated aggressively. Further research is required to quantify determinants of the excess ASCVD risk seen in South Asian populations and to develop targeted interventions to address these factors.
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Affiliation(s)
- Maria Stefil
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Jack Bell
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Peter Calvert
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Cardiology, Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Gregory Yh Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Cardiology, Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Safi A, Khawaja I, Collins P, Myers T. A Cross-Sectional Study Exploring the Physical Activity Levels of Afghans and Other South Asian Youth in the UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1087. [PMID: 36673843 PMCID: PMC9858935 DOI: 10.3390/ijerph20021087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/01/2023]
Abstract
Introduction: Participating in regular physical activity (PA) has numerous benefits, such as reducing obesity, chronic degenerative conditions, and depression. Despite many health-related benefits, physical inactivity is increasing in young people worldwide, especially in ethnic minority groups, such as British South Asians (BSAs). The aim of this study was to explore the PA levels of BSAs, specifically focusing on youth from Afghan, Pakistani, Bangladeshi, and Indian groups. Methods: A total of 191 (Afghans N = 44; Bangladeshi N = 39; Indian N = 56, Pakistani N = 52) youth from the West Midlands (UK) participated in this study (mean age 15.4 ± 0.5). The International Physical Activity Questionnaire—Short Form was used to measure PA levels. Data were modelled using a Bayesian approach to determine differences in PA levels. Results: The results indicated that 88.5% Afghans, 80% Bangladeshi, 78.6% Indians and 63% Pakistani reported engaging in <30 min of PA per day. Additionally, boys were more active than girls across all ethnic groups. Discussion: This study highlighted an alarmingly low proportion of young people from each BSA ethnic group meeting the PA guidelines. To the authors’ knowledge, this is the first study to explore and compare PA levels of the young British Afghan population, thus contributing novel findings to the area of BSA PA. Conclusion: Overall, the vast majority of BSA young people failed to meet the recommended PA guidelines of 60 min per day. Future research could utilise objective methods, such as Global Positioning System, pedometers and accelerometery to track and monitor PA levels, and could adopt an ecological approach to explore determinants of PA within each ethnic and gender group.
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Affiliation(s)
- Ayazullah Safi
- Centre for Nutraceuticals, School of Life Sciences, University of Westminster, London W1W 6UW, UK
| | - Irfan Khawaja
- Department of Sport and Exercise, School of Health Sciences, Birmingham City University, Birmingham B15 3TN, UK
| | - Peter Collins
- Faculty of Education Health and Wellbeing, University of Wolverhampton, Wolverhampton WV1 1LY, UK
| | - Tony Myers
- Department of Social Science, Sport and Business, Newman University, Birmingham B32 3NT, UK
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Patel J, Agarwala A, Bhatt DL. A Message From the Next Generations: I Believe in You-Take Control of Your Health. JACC. ADVANCES 2023; 2:100168. [PMID: 38939025 PMCID: PMC11198238 DOI: 10.1016/j.jacadv.2022.100168] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Affiliation(s)
- Jaideep Patel
- South Asian Cardiovascular Health Initiative (SACHI) for the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Anandita Agarwala
- Center for Cardiovascular Disease Prevention, Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, Texas, USA
| | - Deepak L. Bhatt
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System, New York, NY, USA
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Ahmed A, Tsiami A, Khan HT. Effects of dietary and lifestyle management on type 2 diabetes development among ethnic minority adults living in the UK: A generational shift. Int J Gastron Food Sci 2022. [DOI: 10.1016/j.ijgfs.2022.100634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Kandula NR, Patel KM, Lancki N, Welch S, Bouris A, Marquez DX, Liem R, Rastogi M, Roy R, Bharucha H, Bever J, Kwon S. South Asians Active Together (SAATH): Protocol for a multilevel physical activity intervention trial for South Asian American mother and daughter dyads. Contemp Clin Trials 2022; 120:106892. [PMID: 36007709 DOI: 10.1016/j.cct.2022.106892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 08/11/2022] [Accepted: 08/19/2022] [Indexed: 11/27/2022]
Abstract
South Asian (SA), including Asian Indian and Pakistani Americans, have a high burden of cardiometabolic risk factors and low levels of physical activity (PA). Increasing PA in the U.S. population is a national priority; however, SA American women and girls experience unique barriers to PA that are not addressed by current promotion efforts. To address this gap, our community-based participatory research partnership developed the South Asians Active Together (SAATH) intervention. This study is a two-arm randomized clinical trial to evaluate the effects, mediators, and implementation of the 18-week SAATH intervention. A total of 160 mother-daughter dyads will be randomized in a 1:1 ratio to the SAATH intervention and control groups. The intervention was designed for mother-daughter dyads and targets individual, interpersonal, and family levels through (1) group exercise classes, (2) mother-daughter discussions, and (3) peer group discussions. The intervention targets the environment level through community partner meetings aimed at creating environment changes to enhance PA opportunities for SA women and girls. The control group will receive PA education materials. We hypothesize that dyads who receive the intervention will have significantly greater increases in moderate- and vigorous-intensity PA (MVPA) from baseline to 4 months, compared to the control group. MVPA will be measured at 12 months in intervention participants to examine if changes are sustained. A process evaluation will use the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. This study will fill knowledge gaps about the effectiveness and implementation of culturally adapted, community-based PA interventions for SA women and girls.
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Affiliation(s)
- Namratha R Kandula
- Feinberg School of Medicine, Division of General Internal Medicine, Northwestern University, Chicago, IL, United States; Feinberg School of Medicine, Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
| | - Kajal M Patel
- Feinberg School of Medicine, Division of General Internal Medicine, Northwestern University, Chicago, IL, United States.
| | - Nicola Lancki
- Feinberg School of Medicine, Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
| | - Sarah Welch
- Feinberg School of Medicine, Buehler Center for Health Policy and Economics, Northwestern University, Chicago, IL, United States.
| | - Alida Bouris
- School of Social Service Administration, University of Chicago, Chicago, IL, United States.
| | - David X Marquez
- Department of Kinesiology and Nutrition, Center for Research on Health and Aging, University of Illinois at Chicago, Chicago, IL, United States.
| | - Robert Liem
- Center for Cancer and Blood Disorders, Ann & Robert H. Lurie Children's Hospital of Chicago, Pediatrics, Chicago, IL, United States; Feinberg School of Medicine, Department of Pediatrics, Northwestern University, Chicago, IL, United States.
| | - Mudita Rastogi
- The Family Institute, Northwestern University, Chicago, IL, United States.
| | - Rency Roy
- Feinberg School of Medicine, Division of General Internal Medicine, Northwestern University, Chicago, IL, United States.
| | - Himali Bharucha
- Metropolitan Asian Family Services, Chicago, IL, United States.
| | | | - Soyang Kwon
- Division of Pediatric Surgery, Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.
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Recreational Physical Activity in Urban India: Perceptions and a Pilot Intervention. BEHAVIOUR CHANGE 2022. [DOI: 10.1017/bec.2022.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
The inactive lifestyle of urban Indians has increased their risk of non-communicable diseases (NCDs). A qualitative study was designed to explore barriers and facilitators related to exercise participation among urban Indians. Underpinned by the developmental life course theory, nine focus group discussions (FGDs) were conducted with 29 women and 26 men residing in Mumbai, India. Focus groups were gender and age stratified. Both thematic analysis and content analysis techniques were used to analyse the data. While the lack of time was mentioned as a barrier by all groups, an unstructured schedule was mentioned specifically by women and awareness of physical health benefits emerged as the most popular facilitator for recreational physical activity. Based on the results of the FGDs, a pilot exercise intervention for sedentary women (N = 6) was conducted which consisted of a morning walk six days a week for 10 weeks. Post-intervention, an FGD was conducted to explore participants’ perspectives on their experience in the intervention. The participants reported that the intervention enhanced exercise self-efficacy and well-being. Exercise as relaxation, spousal support, and need for peers to exercise with emerged as primary themes during the follow-up FGD. These findings can inform the development of age and gender-specific as well as culturally appropriate interventions to facilitate active living.
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Mbabazi J, Kanmodi KK, Kunonga E, Tolchard B, Nnyanzi LA. Barriers and Facilitators of Physical Activity. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0042-1753561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract
Background Physical inactivity accounts for 16.6% of deaths in the United Kingdom. This study aims to review the recent (2016–2021) systematic reviews (SRs) on the facilitators and barriers to physical activity (PA) participation among (UK)-based adults.
Methods Using the Participants, Interventions, Comparators, and Outcomes framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy, a SR of SRs of studies on the facilitators and barriers to PA among (UK)-based adults, published between 2016 and December 3, 2021, in the PubMed, SCOPUS, or Cochrane Database of Systematic Reviews, was done.
Results Three SRs (each published in 2016, 2019, and 2021) were included and reviewed in the study. None of the reviewed SR included a study conducted during the coronavirus disease 2019 (COVID-19) pandemic; also, a paucity of primary studies on PA among (UK)-based adult black, Asian, and ethnic minorities populations was recorded. Having a knowledge/appreciation of the benefits of PA, having the opportunity for social interaction/participation and PA-related support, and having a safe environment for PA were the persistently reported facilitators to PA among (UK)-based adults. On the other hand, having language difficulties/language barrier, lack of time, and having underlying health problems were the persistently reported barriers to PA among them. Not all the included SRs received project funding.
Conclusion The outcomes of this study had identified contemporary research gaps regarding the current challenges related to PA among (UK)-based adults. It is a fact that COVID-19 has come to stay in the (UK) and, as a result, it has affected ways of living, especially PA; hence, there is an imminent need for a SR to collate current primary evidence, with regards to the COVID-19 pandemic, on the facilitators and barriers of PA among (UK)-based adults.
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Affiliation(s)
- Johnson Mbabazi
- Health Students Research Network, School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Kehinde Kazeem Kanmodi
- Health Students Research Network, School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Edward Kunonga
- Health Students Research Network, School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Barry Tolchard
- Health Students Research Network, School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Lawrence Achilles Nnyanzi
- Health Students Research Network, School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
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Ellahi B, Aitken A, Dikmen D, Seyhan-Erdoğan B, Makda M, Razaq R. Acceptability, Usability and Weight Loss Outcomes in a Randomized Cross-Over Study of Commercially Available Portion Size Tools in an Overweight South Asian Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137714. [PMID: 35805371 PMCID: PMC9266172 DOI: 10.3390/ijerph19137714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 01/09/2023]
Abstract
South Asian women living in the UK are particularly at high risk of obesity-related complications, such as type 2 diabetes and cardiovascular disease. Exposure to large portion sizes is a risk factor for obesity. Specifically designed tableware helps individuals to manage weight by controlling food portion sizes. Thirty-one (n = 31) overweight or obese South Asian adult women participated in a randomised cross-over trial aimed to assess the efficacy, acceptance, and weight change of two guided/calibrated commercially available portion control tools (Utensil set and Crockery Set) used in free-living conditions. Data on acceptance, perceived changes in portion size, frequency, and meal type was collected using paper questionnaires and 3-day diet diaries. Scores describing acceptance, ease of use, and perceived effectiveness were derived from five-point Likert scales from which binary indicators (high/low) were analysed for significance using multivariate variance analysis for repeated measurements. A reduction in BMI was observed at each point of measurement (p = 0.007). For overall tool use, the crockery set scored higher in all areas of acceptance, ease of use, and perceived efficacy for all comparisons. Self-selected portion sizes increased for salads and decreased for cooking oil and breakfast cereals with both tools. Further research to scale up and evaluate similar weight management interventions for this group is warranted.
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Affiliation(s)
- Basma Ellahi
- Faculty of Health and Social Care, University of Chester, Parkgate Road, Chester CH14BJ, UK; (A.A.); (M.M.); (R.R.)
- Correspondence: ; Tel.: +44-1244-512177; Fax: +44-1244-510000
| | - Amanda Aitken
- Faculty of Health and Social Care, University of Chester, Parkgate Road, Chester CH14BJ, UK; (A.A.); (M.M.); (R.R.)
| | - Derya Dikmen
- Department of Nutrition and Dietetics, Hacettepe University, Ankara 06230, Turkey; (D.D.); (B.S.-E.)
| | - Bilge Seyhan-Erdoğan
- Department of Nutrition and Dietetics, Hacettepe University, Ankara 06230, Turkey; (D.D.); (B.S.-E.)
| | - Munibah Makda
- Faculty of Health and Social Care, University of Chester, Parkgate Road, Chester CH14BJ, UK; (A.A.); (M.M.); (R.R.)
| | - Rifat Razaq
- Faculty of Health and Social Care, University of Chester, Parkgate Road, Chester CH14BJ, UK; (A.A.); (M.M.); (R.R.)
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15
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Ali SH, Gupta S, Tariq M, Penikalapati R, Vasquez-Lopez X, Auer S, Hanif C, Parekh N, Merdjanoff AA, DiClemente RJ. Mapping drivers of second-generation South Asian American eating behaviors using a novel integration of qualitative and social network analysis methods. Ecol Food Nutr 2022; 61:503-521. [DOI: 10.1080/03670244.2022.2056166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Shahmir H. Ali
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, USA
| | - Srishti Gupta
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, USA
| | - Maham Tariq
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, USA
| | - Rushitha Penikalapati
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, USA
| | - Xilonen Vasquez-Lopez
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, USA
| | - Sian Auer
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, USA
| | - Channan Hanif
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, USA
| | - Niyati Parekh
- Public Health Nutrition Program, School of Global Public Health, New York University, New York, USA
- Department of Population Health, Grossman School of Medicine, New York University, New York, USA
- Rory Meyers College of Nursing, New York University, New York, USA
| | - Alexis A. Merdjanoff
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, USA
| | - Ralph J. DiClemente
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, USA
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Ahmed S, Uddin R, Ziviani J, Gomersall S, Khan A. Lifestyle behaviours of immigrant and Australian children: Evidence from a nationally representative sample. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 4:112-118. [PMID: 35782282 PMCID: PMC9219330 DOI: 10.1016/j.smhs.2022.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Shahnawaz Ahmed
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Corresponding author. School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD 4072, Australia.
| | - Riaz Uddin
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sjaan Gomersall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Corresponding author. School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia.
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Lansburgh F, Jacques-Aviñó C, Pons-Vigués M, Morgan R, Berenguera A. Time for themselves: Perceptions of physical activity among first and second-generation Pakistani women living in the Raval, Barcelona. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221078738. [PMID: 35168422 PMCID: PMC8855417 DOI: 10.1177/17455057221078738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/14/2021] [Accepted: 01/20/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Pakistani women experience higher-than-average rates of certain chronic diseases, including diseases related to sedentary lifestyles. The aim of this study is to explore how first and second-generation Pakistani women living in the Raval, Barcelona, conceive of physical activity, and their barriers and facilitators around participating in physical activity, with the goal of increasing physical activity in this group. METHODS Qualitative research with an intersectional approach. Nine informal interviews with key community informants were conducted from November 2018 to January 2019 to gain background on the topic, using snowball sampling. Eleven individual interviews were conducted from February to June 2019. Seven were with Pakistani women having lived, or currently living, in the neighborhood of the Raval, Barcelona. Four additional interviews were conducted with non-Pakistani women key community informants who have worked extensively with this community. Thematic content analysis was carried out using ATLAS.ti. RESULTS First-generation Pakistani women generally did not have physical activity present in their daily lives, but by most accounts wished to. Areas that shed light on this included the following: limited economic opportunities and associated living conditions, barriers to social integration, health concepts and access to information, and cultural norms and related gender roles. For the first-generation, gender-related divisions of labor as well as the absence of the concept of self-care were particularly relevant barriers to their participation in physical activity. The experience of immigration-related grief emerged as a transversal theme which overlapped with multiple areas. While both generations expressed a need for the separation of genders during physical activity-as per their cultural interpretation of Islam-the lack of such spaces was highlighted as a principal barrier in physical activity among the second generation. CONCLUSION These findings shed light on distinct elements that exert influence in Pakistani women immigrants' participation in physical activity-among them: social and living conditions, access to public space, and gender-related work distribution and cultural norms-which are in turn influenced by first or second-generation immigration status. Considering the specific needs of both groups when proposing politics and health programs to encourage physical activity is paramount in order to successfully partner with these populations.
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Affiliation(s)
- Flora Lansburgh
- Fundació Institut Universitari per a la
recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona,
Spain
- Universitat Autònoma de Barcelona,
Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona,
Spain
| | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la
recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona,
Spain
- Universitat Autònoma de Barcelona,
Barcelona, Spain
| | - Mariona Pons-Vigués
- Servei Català de la Salut (CatSalut),
Barcelona, Spain
- Universitat de Girona, Girona,
Spain
| | - Rosemary Morgan
- Johns Hopkins Bloomberg School of
Public Health, Baltimore, MD, USA
| | - Anna Berenguera
- Fundació Institut Universitari per a la
recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona,
Spain
- Universitat Autònoma de Barcelona,
Barcelona, Spain
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18
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Visaria A, Nagaraj B, Shah M, Kethidi N, Modak A, Shahani J, Chilakapati R, Raghuwanshi M. Low Amount and Intensity of Leisure-time Physical Activity in Asian Indian Adults. Am J Health Promot 2021; 36:440-449. [PMID: 34911346 DOI: 10.1177/08901171211059807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE We sought to describe leisure-time, aerobic, and muscle strengthening physical activity (PA) patterns in U.S. Asian Indians, in comparison to other races/ethnicities. DESIGN, SETTING, AND SAMPLE We utilized the 2011-2018 National Health Interview Surveys, a set of cross-sectional, nationally representative surveys of the U.S. noninstitutionalized population. Our study population included 257 652 adults who answered PA questions. MEASURES PA was classified per 2008 U.S. guidelines and continuously per estimated metabolic equivalents (METs). Race was classified into White, Black, Asian Indian, Other Asian, and American Indian/Alaskan Native/Multiracial. ANALYSIS We used survey design-adjusted, multivariable logistic regression to determine odds of sufficient and highly active physical activity levels, adjusting for predisposing, enabling, need, and health care service factors as guided by the Anderson Model. We also used linear regression to determine racial differences in average MET-minutes/week. Analysis was additionally stratified by comorbidity status. RESULTS While Asian Indians (N = 3049) demonstrated similar odds of sufficient aerobic PA as Whites (aOR [95% CI]: .97 [.88,1.07]), Asian Indians had 22% lower odds of meeting highly active aerobic PA levels (.78 [.71,0.87]) and 18% lower odds of meeting sufficient muscle strengthening PA levels (.82 [.73,0.91]). This translated to an average 172 (95% CI: 45 300) fewer MET-minutes. Furthermore, this decrease in MET-minutes/week was especially apparent in those without hypertension (β[95% CI]: -164 [-314,-15]) without diabetes (-185 [-319,-52]), and low/normal BMI (-422 [-623,-222]). CONCLUSION Asian Indians, especially those without comorbidities, are less likely to engage in high-intensity physical activity than Whites.
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Affiliation(s)
- Aayush Visaria
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Bharath Nagaraj
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Megh Shah
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Nikhit Kethidi
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Anurag Modak
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA.,Center for Advanced Biotechnology and Medicine, 33244Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Jai Shahani
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Rachana Chilakapati
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Maya Raghuwanshi
- Division of Endocrinology, Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
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19
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Bhatnagar P, Foster C, Shaw A. Barriers and facilitators to physical activity in second-generation British Indian women: A qualitative study. PLoS One 2021; 16:e0259248. [PMID: 34731201 PMCID: PMC8565737 DOI: 10.1371/journal.pone.0259248] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 10/15/2021] [Indexed: 11/18/2022] Open
Abstract
AIM To understand the barriers to and motivations for physical activity among second-generation British Indian women. SUBJECT Approximately 50% of British South Asians are UK-born, and this group is increasing as the second-generation also have children. Previous research into the barriers to and facilitators for physical activity has focused on migrant, first-generation populations. Qualitative research is needed to understand a) how we might further reduce the gap in physical activity levels between White British women and British Indian women and b) the different approaches that may be required for different generations. METHODS Applying a socioecological model to take into account the wider social and physical contexts, we conducted semi-structured interviews with 28 Indian women living in Manchester, England. Interviews with first-generation British Indian women were also included to provide a comparator. Interviews were audio-recorded, transcribed, thematically coded and analysed using a grounded theory approach. RESULTS Ways of socialising, concerns over appearance while being physically active, safety concerns and prioritising educational attainment in adolescence were all described as barriers to physical activity in second-generation British Indian women. Facilitators for physical activity included acknowledging the importance of taking time out for oneself; religious beliefs and religious groups promoting activity; being prompted by family illness; positive messages in both the media and while at school, and having local facilities to use. CONCLUSIONS Barriers to physical activity in second-generation Indian women were very similar to those already reported for White British women. Public health measures aimed at women in the general population may also positively affect second-generation Indian women. First-generation Indian women, second-generation children and Muslim women may respond better to culturally tailored interventions.
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Affiliation(s)
- Prachi Bhatnagar
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Alison Shaw
- Institute of Social and Cultural Anthropology, University of Oxford, Oxford, United Kingdom
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20
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Hanif W, Ali SN, Bellary S, Patel V, Farooqi A, Karamat MA, Saeed M, Sivaprasad S, Patel K, Khunti K. Pharmacological management of South Asians with type 2 diabetes: Consensus recommendations from the South Asian Health Foundation. Diabet Med 2021; 38:e14497. [PMID: 33301625 DOI: 10.1111/dme.14497] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/27/2020] [Accepted: 11/30/2020] [Indexed: 12/27/2022]
Abstract
South Asians constitute approximately 1.6 billion people from the Indian subcontinent, comprising Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka; and make up the largest diaspora globally. Compared to the White European population, this group is at a higher risk of developing type 2 diabetes along with cardiovascular, renal and eye complications. Over the recent years, a number of new therapies for type 2 diabetes have become available for which cardiovascular outcome trials (CVOTs) have been published. The recent ADA/EASD consensus guidelines on diabetes, pre-diabetes and cardiovascular diseases' offer a transitional shift in type 2 diabetes management. The new consensus recommendations are based on recent CVOTs, many of which had a representation of South Asian cohorts. In light of this new evidence, there is urgent need for an integrated, evidence-based, cost-effective and individualised approach specific for South Asians. This review takes into consideration the evidence from these CVOTs and provides best practice recommendations for optimal management of South Asian people with type 2 diabetes, alongside the previously published consensus report from South Asian Health Foundation in 2014 [1].
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Affiliation(s)
- Wasim Hanif
- Diabetes & Endocrinology, CSL Diabetes, University Hospitals of Birmingham, South Asian Health Foundation, Birmingham, UK
| | - Sarah N Ali
- Diabetes and Endocrinology, Royal Free London NHS Foundation Trust, Diabetes Working Group, South Asian Health Foundation, Birmingham, UK
| | - Srikanth Bellary
- School of Life and Health Sciences, Aston University, University Hospitals Birmingham, Birmingham, UK
| | - Vinod Patel
- Diabetes and Clinical Skills, Warwick Medical School, University of Warwick, Coventry, UK
- South Asian Health Foundation, Birmingham, UK
| | - Azhar Farooqi
- East Leicester Medical Practice, Leicester City CCG, BME Centre for Health, ARC East Midlands, Leicester, UK
| | - Muhammad Ali Karamat
- Diabetes and Endocrinology, UHB TPD Diabetes and Endocrinology, Health Education, Birmingham, UK
| | - Mujahid Saeed
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham, University of Birmingham, Birmingham, UK
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre and UCL Institute of Ophthalmology, London, UK
| | - Kiran Patel
- South Asian Health Foundation, Birmingham, UK
- University Hospitals Coventry & Warwickshire NHS Trust, Warwick Medical School, University of Warwick, Coventry University, Coventry, UK
| | - Kamlesh Khunti
- South Asian Health Foundation, Birmingham, UK
- Primary Care Diabetes & Vascular Medicine, Diabetes Research Centre and The Centre for Black Minority Health, University of Leicester, Leicester, UK
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Patel T, Umeh K, Poole H, Vaja I, Newson L. Cultural Identity Conflict Informs Engagement with Self-Management Behaviours for South Asian Patients Living with Type-2 Diabetes: A Critical Interpretative Synthesis of Qualitative Research Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2641. [PMID: 33807965 PMCID: PMC7967381 DOI: 10.3390/ijerph18052641] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 02/07/2023]
Abstract
The prevalence of type-2 diabetes (T2D) is increasing, particularly among South Asian (SA) communities. Previous research has highlighted the heterogeneous nature of SA ethnicity and the need to consider culture in SA patients' self-management of T2D. We conducted a critical interpretative synthesis (CIS) which aimed to a) develop a new and comprehensive insight into the psychology which underpins SA patients' T2D self-management behaviours and b) present a conceptual model to inform future T2D interventions. A systematic search of the literature retrieved 19 articles, including 536 participants. These were reviewed using established CIS procedures. Analysis identified seven constructs, from which an overarching synthesizing argument 'Cultural Conflict' was derived. Our findings suggest that patients reconstruct knowledge to manage their psychological, behavioural, and cultural conflicts, impacting decisional conflicts associated with T2D self-management and health professional advice (un)consciously. Those unable to resolve this conflict were more likely to default towards cultural identity, continue to align with cultural preferences rather than health professional guidance, and reduce engagement with self-management. Our synthesis and supporting model promote novel ideas for self-management of T2D care for SA patients. Specifically, health professionals should be trained and supported to explore and mitigate negative health beliefs to enable patients to manage social-cultural influences that impact their self-management behaviours.
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Affiliation(s)
- Tasneem Patel
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK;
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK; (K.U.); (H.P.); (I.V.)
| | - Kanayo Umeh
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK; (K.U.); (H.P.); (I.V.)
| | - Helen Poole
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK; (K.U.); (H.P.); (I.V.)
| | - Ishfaq Vaja
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK; (K.U.); (H.P.); (I.V.)
- NHS Bradford Teaching Hospital, Bradford BD9 6RJ, UK
| | - Lisa Newson
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK; (K.U.); (H.P.); (I.V.)
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22
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Akhter N, Begum K, Nahar P, Cooper G, Vallis D, Kasim A, Bentley GR. Risk factors for non-communicable diseases related to obesity among first- and second-generation Bangladeshi migrants living in north-east or south-east England. Int J Obes (Lond) 2021; 45:1588-1598. [PMID: 33947968 PMCID: PMC8236404 DOI: 10.1038/s41366-021-00822-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 02/18/2021] [Accepted: 04/08/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Obesity is a global burden, which significantly increases the risk of non-communicable diseases (NCDs). More than a quarter of adults in the United Kingdom are obese, but prevalence varies by ethnicity, and South Asians have the largest burden of NCDs. This paper assesses how sex, generation, and region interplay to vary the predisposition to obesity-related (OR) NCDs among UK Bangladeshis. METHODS We used National Institute for Health and Care Excellence suggested grading for combining body mass index and waist circumference to define populations at risk of OR-NCDs. Data from 517 adults of Bangladeshi origin from a cross-sectional study (March 2013 to April 2015) were analysed. Male and female participants from London and north-east England were equally sampled including: (1) adult migrants, who came to the UK aged >16 years; (2) child migrants, who came to the UK aged ≤16 years; and (3) second-generation Bangladeshis (who were born and brought up in the UK). A generalised estimating equation using a binomial distribution and a logit link was used to explore the relationship between the binary outcome of being 'at risk of OR-NCDs' and associated factors. RESULTS Females, married individuals, those living in London, the second-generation, and those of lower self-assessed financial status, with low acculturation status, or who did not walk daily for at least 20 min were more likely to develop OR-NCDs. A striking sex difference was found with more females prone to OR-NCD risk in the north-east than in London. CONCLUSIONS Our study observed important inter- and intra-regional inequality in OR-NCD risk which worsens the health of ethnic minorities and widens inequality.
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Affiliation(s)
- N. Akhter
- grid.8250.f0000 0000 8700 0572Department of Anthropology, Durham University, Durham, UK ,Fuse–UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - K. Begum
- grid.8250.f0000 0000 8700 0572Department of Anthropology, Durham University, Durham, UK ,grid.4868.20000 0001 2171 1133Queen Mary University, London, UK
| | - P. Nahar
- grid.8250.f0000 0000 8700 0572Department of Anthropology, Durham University, Durham, UK ,grid.12082.390000 0004 1936 7590Department of Global Health and Infection, University of Sussex, Brighton, UK
| | - G. Cooper
- grid.8250.f0000 0000 8700 0572Department of Anthropology, Durham University, Durham, UK
| | - D. Vallis
- grid.8250.f0000 0000 8700 0572Department of Anthropology, Durham University, Durham, UK
| | - A. Kasim
- grid.8250.f0000 0000 8700 0572Department of Anthropology, Durham University, Durham, UK ,grid.8250.f0000 0000 8700 0572Durham Research Methods Centre, Durham University, Durham, UK
| | - G. R. Bentley
- grid.8250.f0000 0000 8700 0572Department of Anthropology, Durham University, Durham, UK
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23
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Williams R, Periasamy M. Genetic and Environmental Factors Contributing to Visceral Adiposity in Asian Populations. Endocrinol Metab (Seoul) 2020; 35:681-695. [PMID: 33397033 PMCID: PMC7803598 DOI: 10.3803/enm.2020.772] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 12/12/2020] [Indexed: 12/20/2022] Open
Abstract
Obesity-associated metabolic illnesses are increasing at an alarming rate in Asian countries. A common feature observed in the Asian population is a higher incidence of abdominal obesity-the "skinny-fat" Asian syndrome. In this review, we critically evaluate the relative roles of genetics and environmental factors on fat distribution in Asian populations. While there is an upward trend in obesity among most Asian countries, it appears particularly conspicuous in Malaysia. We propose a novel theory, the Malaysian gene-environment multiplier hypothesis, which explains how ancestral variations in feast-and-famine cycles contribute to inherited genetic predispositions that, when acted on by modern-day stressors-most notably, urbanization, westernization, lifestyle changes, dietary transitions, cultural pressures, and stress-contribute to increased visceral adiposity in Asian populations. At present, the major determinants contributing to visceral adiposity in Asians are far from conclusive, but we seek to highlight critical areas for further research.
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Affiliation(s)
- Rachel Williams
- Department of Internal Medicine, University of Central Florida (UCF) College of Medicine, Burnett School of Biomedical Sciences, Orlando, FL, USA
| | - Muthu Periasamy
- Department of Internal Medicine, University of Central Florida (UCF) College of Medicine, Burnett School of Biomedical Sciences, Orlando, FL, USA
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The Meaning of Physical Activity: A Qualitative Study on the Perspective of South American Immigrant Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207500. [PMID: 33076326 PMCID: PMC7602638 DOI: 10.3390/ijerph17207500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 12/13/2022]
Abstract
Physical activity facilitates the acquisition of healthy habits from childhood to adulthood. There are differences in the practice of physical activity between immigrant children and native Spanish children. The aim was to describe physical activity in children, from the perspective of South American immigrant parents. A qualitative case study was conducted. Parents were recruited using purposeful sampling. Data were collected from 12 participants by means of unstructured interviews together with researcher notes. A thematic analysis was applied. The following topics were identified: (a) physical activity and health, (b) socialization, (c) the need for movement, (d) gender, (e) barriers, (f) educational burden, (g) community living, and (h) reason for immigrating. Parents described how physical activity is fundamental and has benefits for health, and for the relationship between children. They perceived that physical activity should not be limited by gender. The time dedicated to other school activities, the norms related to community living, and financial limitations were especially relevant as barriers for the performance of physical activity. These results can be used to revise the curriculum in schools, promote equal opportunities for physical activity and support family participation.
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Imtiaz A, ulHaq Z, Afaq S, Khan MN, Gillani B. Prevalence and patterns of physical activity among school aged adolescents in Pakistan: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2020. [DOI: 10.1080/02673843.2020.1831559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Ayesha Imtiaz
- Institute of Public Health & Social Sciences, Khyber Medical University , Peshawar, Pakistan
| | - Zia ulHaq
- Institute of Public Health & Social Sciences, Khyber Medical University , Peshawar, Pakistan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London , London, UK
| | - Saima Afaq
- Institute of Public Health & Social Sciences, Khyber Medical University , Peshawar, Pakistan
- School of Public Health, Imperial College London , London, UK
| | - Muhammad Naseem Khan
- Institute of Public Health & Social Sciences, Khyber Medical University , Peshawar, Pakistan
- Department of Psychological Medicine, University of Liverpool , Liverpool, UK
| | - Basharat Gillani
- Institute of Public Health & Social Sciences, Khyber Medical University , Peshawar, Pakistan
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Physical Activity Among Immigrant Children: A Systematic Review. J Phys Act Health 2020; 17:1047-1058. [PMID: 32858526 DOI: 10.1123/jpah.2019-0272] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 04/22/2020] [Accepted: 06/19/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The health benefits of physical activity (PA) for children are well documented. However, little is known about PA patterns among immigrant children. METHODS The authors reviewed research on PA patterns of immigrant children. The inclusion criteria included peer-reviewed articles published from January 2010 to May 2018 in English, French, or Spanish that included primary-school-aged (6-12 y) children, and data on immigration status. RESULTS A total of 11 articles were included in the analyses. These studies revealed a deficit of PA among immigrant children. Immigration status (immigrant or nonimmigrant) and generation of immigration (first, second, and third), ethnic origin, and gender were associated with PA patterns. In general, PA levels were lower among first-generation immigrant children, children of Hispanic and East Asian origin, and girls. The results suggest that questionnaire measures might be biased or inaccurate among immigrant children, highlighting the need for the integration of mixed methods (objective and subjective measures). CONCLUSIONS A large proportion of children do not meet PA guidelines, and this might be more problematic for immigrant children. Future studies incorporating time since immigration, comparative analyses on gender, sociocultural and socioeconomic characteristics, and mixed methodology could provide a more complete portrait of PA patterns and opportunities for immigrant children.
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Ali SH, Misra S, Parekh N, Murphy B, DiClemente RJ. Preventing type 2 diabetes among South Asian Americans through community-based lifestyle interventions: A systematic review. Prev Med Rep 2020; 20:101182. [PMID: 32844084 PMCID: PMC7441043 DOI: 10.1016/j.pmedr.2020.101182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 07/31/2020] [Accepted: 08/14/2020] [Indexed: 12/13/2022] Open
Abstract
Ethnic South Asian Americans (SAAs) have the highest relative risk of type 2 diabetes mellitus (T2DM) in the United States (US). Culturally tailored lifestyle interventions have the potential to promote South Asian diabetes prevention; however, the extent of their use and evaluation in US settings remains limited. This systematic review characterizes and evaluates outcomes of community-based lifestyle interventions targeted towards T2DM indicators among South Asians living in the US. A PRISMA-informed search of Pubmed, Embase, Cochrane, Web of Science, and clinical trial registry databases using key words pertaining to South Asians migrants and diabetes indicators (glucose and insulin outcomes) was conducted of community-based lifestyle interventions published up until October, 31 2019. Of the eight studies included in the final synthesis, four interventions focused on cultural and linguistic adaptations of past chronic disease prevention curricula using group-based modalities to deliver the intervention. Hemoglobin A1c (A1c) was the most common outcome indicator measured across the interventions. Three of the five studies observed improvements in indicators post-intervention. Based on these findings, this review recommends 1) greater exploration of community-based lifestyle interventions with high quality diabetes indicators (such as fasting blood glucose) in ethnic SAA communities, 2) expanding beyond traditional modalities of group-based lifestyle interventions and exploring the use of technology and interventions integrated with passive, active, and individualized components, and 3) development of research on diabetes prevention among second generation SAAs.
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Affiliation(s)
- Shahmir H. Ali
- Department of Social & Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Supriya Misra
- Department of Social & Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Niyati Parekh
- Public Health Nutrition Program, School of Global Public Health, New York University, New York, NY, United States
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Bridget Murphy
- Public Health Nutrition Program, School of Global Public Health, New York University, New York, NY, United States
| | - Ralph J. DiClemente
- Department of Social & Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
- Corresponding author at: 715 Broadway New York, NY 10003, United States.
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Thanawala MS, Siddique J, Schneider JA, Kanaya AM, Cooper AJ, Dave SS, Lancki N, Kandula NR. Association of Social Networks and Physical Activity in South Asians: The Mediators of Atherosclerosis in South Asians Living in America Cohort Study. J Phys Act Health 2020; 17:149-155. [PMID: 31810059 PMCID: PMC7211545 DOI: 10.1123/jpah.2019-0099] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 09/03/2019] [Accepted: 10/13/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Eliminating racial/ethnic disparities in physical activity remains a challenge in the United States. South Asian immigrants in the United States have particularly low physical activity levels, and evidence suggests that social context may be important. This study examined associations between personal social networks and moderate to vigorous leisure-time physical activity (MVPA) among South Asians in the United States. METHODS We used cross-sectional data (2014-2017) from 689 South Asians (aged 43-85 y) who participated in the Mediators of Atherosclerosis in South Asians Living in America study. Self-reported physical activity and egocentric network data were collected from participants about their network members. Regression models were used to determine associations between social network characteristics and participants' MVPA. RESULTS Participants were on average 59 years old (SD = 9) and reported 1335 metabolic equivalent minutes per week of MVPA (interquartile range = 735, 2212). Having network members who exercised or who were exercise partners associated with increased MVPA in men (β coefficient = 241 MET min/wk [95% confidence interval, 63 to 419] and β = 520 MET min/wk [95% confidence interval, 322 to 718], respectively). For women, the association was only significant if the exercise partner was a spouse. CONCLUSION Physical activity interventions utilizing network members as exercise partners may have potential in South Asians but must consider gender differences.
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Collings PJ, Dogra SA, Costa S, Bingham DD, Barber SE. Objectively-measured sedentary time and physical activity in a bi-ethnic sample of young children: variation by socio-demographic, temporal and perinatal factors. BMC Public Health 2020; 20:109. [PMID: 31992249 PMCID: PMC6986109 DOI: 10.1186/s12889-019-8132-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/30/2019] [Indexed: 12/26/2022] Open
Abstract
Background Evidence suggests that South Asian school-aged children and adults are less active compared to the white British population. It is unknown if this generalises to young children. We aimed to describe variability in levels of physical activity and sedentary time in a bi-ethnic sample of young children from a deprived location. Methods This observational study included 202 South Asian and 140 white British children aged 1.5 to 5y, who provided 3181 valid days of triaxial accelerometry (Actigraph GT3X+). Variability in sedentary time and physical activity levels were analysed by linear multilevel modelling. Logistic multilevel regression was used to identify factors associated with physical inactivity (failing to perform ≥180 min of total physical activity including ≥60 min moderate-to-vigorous physical activity (MVPA) per day). Results There were no significant ethnic differences in the overall levels of behaviours; South Asian and white British children spent half of daily time sedentary, just over 40% in light physical activity, and the remaining 7.5 to 8% of time in MVPA. Sedentary time was lower and physical activity levels were higher in older children, and levels of MVPA and vector magnitude counts per minute (CPM) were higher on weekends compared to weekdays. In South Asian children, sedentary time was lower on weekends. Sedentary time was lower and physical activity levels were higher in spring compared to winter in white British children, and in all seasons compared to winter in South Asian children. South Asian children born at high birth weight performed more MVPA, and in both ethnicities there was some evidence that children with older mothers were more sedentary and less active. Sedentary time was higher and light physical activity was lower in South Asian children in the highest compared to the lowest income families. South Asian girls performed less MVPA, registered fewer vector magnitude CPM, and were 3.5 times more likely to be physically inactive than South Asian boys. Conclusions Sedentary time and physical activity levels vary by socio-demographic, temporal and perinatal characteristics in young children from a deprived location. South Asian girls have the most to gain from efforts to increase physical activity levels. Trial registration The Pre-schoolers in the Playground (PiP) pilot randomized controlled trial is registered with the ISRCTN (ISRCTN54165860; http://www.isrctn.com).
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Affiliation(s)
- Paul J Collings
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK. .,Department of Health Sciences, University of York, York, UK.
| | - Sufyan A Dogra
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Silvia Costa
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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Critical Appraisal of Qualitative Studies of Muslim Females' Perceptions of Physical Activity Barriers and Facilitators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245040. [PMID: 31835677 PMCID: PMC6950591 DOI: 10.3390/ijerph16245040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/07/2019] [Accepted: 12/09/2019] [Indexed: 11/25/2022]
Abstract
Muslim women’s perceptions of cultural, religious, and secular determinants of physical activity have been studied for many years, with information typically acquired through focus groups or interviews. Multiple reviews synthesizing the research have been published, however, individual studies have not been scrutinized for their quality/rigor. Therefore, I critically appraised the quality of the body of qualitative research studies that utilized focus groups to identify Muslim women’s perceptions of physical activity barriers and facilitators. I utilized 26 items from the Consolidated Criteria for Reporting Qualitative Research (COREQ) to assess the quality of 56 papers published between 1987 and 2016. Using crosstabulations, I also examined associations between paper quality (low vs. high) and binary categorical variables for impact factor, maximum paper length allowed, publication year, and database the paper was indexed. Overall, papers averaged only 10.5 of 26 COREQ reporting criteria and only two out of 26 items were reported in more than 75% of the papers. Paper quality was not associated with impact factor and length. High quality papers were more likely published more recently (i.e., 2011 or later) and in journals indexed in the PubMed database compared to low quality papers. There is contention among qualitative researchers about standardizing reporting criteria, and while the trend in quality appears to be improving, journal reviewers and editors ought to hold authors to greater accountability in reporting.
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Cainzos-Achirica M, Fedeli U, Sattar N, Agyemang C, Jenum AK, McEvoy JW, Murphy JD, Brotons C, Elosua R, Bilal U, Kanaya AM, Kandula NR, Martinez-Amezcua P, Comin-Colet J, Pinto X. Epidemiology, risk factors, and opportunities for prevention of cardiovascular disease in individuals of South Asian ethnicity living in Europe. Atherosclerosis 2019; 286:105-113. [PMID: 31128454 PMCID: PMC8299475 DOI: 10.1016/j.atherosclerosis.2019.05.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/09/2019] [Accepted: 05/15/2019] [Indexed: 01/22/2023]
Abstract
South Asian (SA) individuals represent a large, growing population in a number of European countries. These individuals, particularly first-generation SA immigrants, are at higher risk of developing type 2 diabetes, atherogenic dyslipidaemia, and coronary heart disease than most other racial/ethnic groups living in Europe. SAs also have an increased risk of stroke compared to European-born individuals. Despite a large body of conclusive evidence, SA-specific cardiovascular health promotion and preventive interventions are currently scarce in most European countries, as well as at the European Union level. In this narrative review, we aim to increase awareness among clinicians and healthcare authorities of the public health importance of cardiovascular disease among SAs living in Europe, as well as the need for tailored interventions targeting this group - particularly, in countries where SA immigration is a recent phenomenon. To this purpose, we review key studies on the epidemiology and risk factors of cardiovascular disease in SAs living in the United Kingdom, Italy, Spain, Denmark, Norway, Sweden, and other European countries. Building on these, we discuss potential opportunities for multi-level, targeted, tailored cardiovascular prevention strategies. Because lifestyle interventions often face important cultural barriers in SAs, particularly for first-generation immigrants; we also discuss features that may help maximise the effectiveness of those interventions. Finally, we evaluate knowledge gaps, currently available risk stratification tools such as QRISK-3, and future directions in this important field.
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Affiliation(s)
- Miguel Cainzos-Achirica
- Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat Del Vallès, Barcelona, Spain.
| | - Ugo Fedeli
- Department of Epidemiology, Azienda Zero, Veneto Region, Italy
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - Charles Agyemang
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Anne K Jenum
- General Practice Research Unit (AFE), Department of General Practice, University of Oslo, Institute of Health and Society, Norway
| | - John W McEvoy
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; National University of Ireland and National Institute for Preventive Cardiology, Galway, Ireland; Division of Cardiology, Department of Medicine, Saolta University Healthcare Group, University College Hospital Galway, Galway, Ireland
| | - Jack D Murphy
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carlos Brotons
- Casernes Primary Care Center, Àmbit D'Atenció Primària Barcelona Ciutat, Barcelona, Spain
| | - Roberto Elosua
- Cardiovascular Epidemiology and Genetics, Mar Institute of Medical Research, Barcelona, Spain; Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Barcelona, Spain; School of Medicine, Universitat de Vic-Central de Catalunya, Vic, Spain
| | - Usama Bilal
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
| | | | - Namratha R Kandula
- Northwestern University, Departments of Medicine and Preventive Medicine, Chicago, IL, USA
| | - Pablo Martinez-Amezcua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Josep Comin-Colet
- Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine, University of Barcelona, Barcelona, Spain
| | - Xavier Pinto
- School of Medicine, University of Barcelona, Barcelona, Spain; Cardiovascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Biomedical Research Network in Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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Ward F, Halliday EC, Barr B, Higgerson J, Holt V. Leisure centre entrance charges and physical activity participation in England. Health Promot Int 2019; 34:379-388. [PMID: 29240917 DOI: 10.1093/heapro/dax095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Reducing or eliminating the cost to the public of using leisure facilities is one tool that local authorities have available to reduce inequalities in physical activity (PA). There is limited evidence about the effect of leisure entrance charges and their impact on participation. This study aimed to ascertain how facility pricing influenced the decisions people made about how to pay and what to pay for and how, in turn, these decisions impacted on participation for different groups. A total of 83 members of the public living in 4 local authorities in the North West of England were involved in focus groups or individual interviews. The results show that cost was a key factor which influenced PA participation in low income neighbourhoods. In practise, however, the majority of service users navigated the range of prices or payment options to find one that was suitable rather than simply reporting whether leisure was affordable or not. Whilst pre-paid options (e.g. direct debit memberships) encouraged participation, entrance charges incurred each time an individual participated had a negative impact on frequency but were a convenient way of paying for occasional use or for people who were unable to afford a pre-paid option. Free access also helped people who could not afford pre-paid membership to exercise regularly as well as incentivizing non-users to try activities. The research concluded that policies that include components of free access and offer more flexible payment options are most likely to contribute to reducing inequalities in PA.
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Affiliation(s)
- F Ward
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK
| | - E C Halliday
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK
| | - B Barr
- Department of Public Health and Policy, University of Liverpool, Liverpool L69 3BX, UK
| | - J Higgerson
- Department of Public Health and Policy, University of Liverpool, Liverpool L69 3BX, UK
| | - V Holt
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK
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Recognition of Barriers to Physical Activity Promotion in Immigrant Children in Spain: A Qualitative Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030431. [PMID: 30717329 PMCID: PMC6388143 DOI: 10.3390/ijerph16030431] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/29/2019] [Accepted: 01/31/2019] [Indexed: 01/12/2023]
Abstract
Physical activity facilitates the acquisition of healthy habits from childhood to adulthood. Differences exist regarding the performance of physical activity among immigrant children compared to native Spanish children. The purpose of the study was to describe the barriers that exist for the promotion of physical activity. A qualitative case-study approach was implemented. Parents of immigrant children, teachers, a school principal, and priests were included, using purposeful sampling. Data were collected from 25 participants, via unstructured and semi-structured interviews, focus groups, and researchers’ field notes. A thematic analysis was performed and ecological levels were identified. Our findings revealed the following barriers to performing physical activity: (a) the meaning of physical activity, (b) gender inequalities, (c) academic burden, (d) lack of social contact, (e) expenses and family economy, (f) lack of infrastructure and natural surroundings, (g) time constraints, (h) fear and insecurity, and (i) the reason for immigrating. These results may be used to revise the school curriculum, promoting equal opportunities for physical activity and encouraging family participation. Additionally, urban design policies should be encouraged to facilitate access to open spaces for recreation within cities.
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Tharmaratnam T, Iskandar MA, Doherty S, D'Urzo KA, Kopalakrishnan S, Tabobondung TC, Gopee-Ramanan P, Sivagurunathan S, Sivananthan N. The Role of Physical Activity Prescription in Cardiovascular Disease Prevention Amongst South Asian Canadians. Front Cardiovasc Med 2018; 5:165. [PMID: 30488037 PMCID: PMC6246639 DOI: 10.3389/fcvm.2018.00165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 10/26/2018] [Indexed: 01/07/2023] Open
Abstract
Unequivocal evidence suggests an increased prevalence of cardiovascular disease (CVD) amongst South Asian Canadians (SACs) compared to other ethnic cohorts, due to a combination of their unique cardiometabolic profile and environmental factors. This unfavorable CVD profile is characterized by an elevated risk of dyslipidemia, high apolipoprotein B/apolipoprotein A1 ratio, hypertension, glucose intolerance, type 2 diabetes mellitus, as well as increased BMI, body fat percentage, abdominal and visceral adiposity. Despite the overwhelming evidence for the effectiveness of physical activity (PA) in circumventing the onset of CVD and in the reduction of CVD risk factors, SACs are among the most physically inactive cohorts in Canada. This relates to a set of common and unique socio-cultural barriers, such as gender, beliefs and perceptions about illness, immigration, unfavorable PA environments, and their high prevalence of debilitating chronic diseases. Several strategies to improve PA participation rates in this high-risk population have been suggested, and include the implementation of culturally sensitive PA interventions, as well as clinician training in PA prescription through workshops that emphasize knowledge translation into clinical practice. Therefore, the purpose of this mini-review is to highlight and discuss: (1) the burden of heart disease in SACs (2) the cardiovascular benefits of PA for SACs; (3) factors affecting PA participation among SACs and how they can be addressed; (4) the impact of culturally sensitive PA prescription on CVD prevention; (5) barriers to culture-specific PA prescription by clinicians, and strategies to improve its use and impact.
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Affiliation(s)
| | - Mina A. Iskandar
- School of Medicine, Royal College of Surgeons in Ireland, Adliya, Bahrain
| | - Sally Doherty
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- School of Medicine, Royal College of Surgeons in Ireland, Adliya, Bahrain
| | - Katrina A. D'Urzo
- School of Kinesiology and Health Studies, Queens University, Kingston, ON, Canada
| | | | - Tyler Cameron Tabobondung
- Department of Family Medicine, Michael G. DeGroote School of Medicine, Brantford General Hospital, McMaster University, Hamilton, ON, Canada
| | - Prasaanthan Gopee-Ramanan
- Department of Diagnostic Radiology, Hamilton Health Sciences Centre, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Seyon Sivagurunathan
- Department of Family Medicine, Stonechurch Family Health Clinic, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Nirunthan Sivananthan
- Department of Pharmacology & Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Associations of social and economic and pregnancy exposures with blood pressure in UK White British and Pakistani children age 4/5. Sci Rep 2018; 8:8966. [PMID: 29895845 PMCID: PMC5997744 DOI: 10.1038/s41598-018-27316-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/19/2018] [Indexed: 12/22/2022] Open
Abstract
South Asians have higher rates of coronary heart disease (CHD) than White European individuals. Blood pressure (BP) is one of the most important risk factors for CHD and ethnic differences in BP have been identified in childhood. Early life exposures could explain some of these differences. We examined associations of family social and economic and maternal pregnancy exposures and BP at age 4/5 in 1644 White British and 1824 Pakistani mother-offspring pairs from the Born in Bradford study. We found that systolic BP was similar but diastolic BP was higher, in Pakistani compared to White British children (adjusted mean differences were −0.170 mmHg 95% CI −0.884, 0.543 for systolic BP; 1.328 mmHg 95% CI 0.592, 2.064 for diastolic BP). Social and economic exposures were not associated with BP in either ethnic group. Maternal BMI was positively associated with BP in both groups but this association was mediated by child BMI. Only gestational hypertension was associated with child systolic and diastolic BP and this was only identified in Pakistani mother-offspring pairs. These findings suggest that Pakistani populations may have a different BP trajectory compared to White British groups and that this is already evident at age 4/5 years.
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Abstract
PURPOSE OF REVIEW We comment on the high prevalence of cardiovascular disease (CVD) in South Asians (SA). The effect of various risk factors, for example biochemical, genetic, lifestyle, socioeconomic factors and psychosocial stress on CVD risk is discussed. RECENT FINDINGS 'Prediabetes' is common in SA, but its relationship with coronary artery disease (CAD) is not significant unlike for the white population. At the same time, 'prediabetes' in SA is associated with an increased risk for cerebrovascular disease (CeVD). The differentiating factor could be the high lipids in Europeans and their relationship to CAD. Likewise, higher diastolic blood pressure in SA may explain the risk of CeVD. Small, dense, low-density lipoprotein (LDL), low high-density lipoprotein-cholesterol (HDL-C) concentration and high triglycerides may contribute to atherosclerosis. Thrombotic factors such as increased levels of plasminogen activator inhibitor, fibrinogen, lipoprotein (a) and homocysteine have been shown to be associated with increased CVD. Impaired cerebrovascular autoregulation and sympathovagal activity, increased arterial stiffness and endothelial dysfunction may increase CVD risk further. In addition, environmental and dietary factors may exaggerate the unfavourable cardiovascular profile through genetic factors. SUMMARY The implications of the findings suggest comprehensive screening of SA for CVD. Cultural differences should be considered while designing prevention strategies specifically targeting barriers for uptake of preventive service.
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Gumber A, Gumber L. Improving prevention, monitoring and management of diabetes among ethnic minorities: contextualizing the six G's approach. BMC Res Notes 2017; 10:774. [PMID: 29282119 PMCID: PMC5745639 DOI: 10.1186/s13104-017-3104-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 12/19/2017] [Indexed: 12/22/2022] Open
Abstract
Objective People from Black, Asian and Minority Ethnic (BAME) groups are known to have an increased risk of developing diabetes and face greater barriers to accessing healthcare resources compared to their ‘white British’ counterparts. The extent of these barriers varies by demographics and different socioeconomic circumstances that people find themselves in. The purpose of this paper is to present and discuss a new framework to understand, disentangle and tackle these barriers so that improvements in the effectiveness of diabetes interventions for BAME communities can be achieved. Results The main mediators of lifestyle behavioural change are gender, generation, geography, genes, God/religion, and gaps in knowledge and economic resources. Dietary and cultural practices of these individuals significantly vary according to gender, generation, geographical origin and religion. Recognition of these factors is essential in increasing knowledge of healthy eating, engagement in physical activity and utilisation of healthcare services. Use of the six G’s framework alongside a community centred approach is crucial in developing and implementing culturally sensitive interventions for diabetes prevention and management in BAME communities. This could improve their health outcomes and overall wellbeing.
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Affiliation(s)
- Anil Gumber
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK.
| | - Leher Gumber
- Brighton and Sussex Medical School, Brighton, UK
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Such E, Salway S, Copeland R, Haake S, Domone S, Mann S. A formative review of physical activity interventions for minority ethnic populations in England. J Public Health (Oxf) 2017; 39:e265-e274. [PMID: 27899479 DOI: 10.1093/pubmed/fdw126] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Physical activity (PA) levels are lower among some UK Black and minority ethnic (BME) groups than the majority White British population and a variety of tailored interventions have emerged. This study documents the characteristics and logic of local adaptations, a vital first step in evaluating such innovations. Methods An English PA data set was examined to identify and characterize PA programmes focussed on BME populations. Three case studies were conducted, employing documentary analysis and qualitative interviews. Netto et al.'s principles of adapting health promotion interventions for BME populations guided the analysis. Results Out of 861 PA interventions, 57 focussed on BME populations. These were typically aimed to engage the most inactive groups, improve both health and social outcomes and were largely publically/charitably funded. Tailored approaches matched Netto et al.'s five principles: using community resources for publicity, identifying and addressing barriers, developing sensitive communication strategies, working with values and accommodating cultural identification. Another common principle was identified: building community capacity for sustainability. Conclusions PA interventions tailored to the needs of BME groups reflect their largely disadvantaged position in society and focus on inactivity. The six principles could be used as a framework for developing, designing and evaluating tailored interventions for BME populations.
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Affiliation(s)
- E Such
- ScHARR, University of Sheffield, Sheffield S1 4DA, UK
| | - S Salway
- ScHARR, University of Sheffield, Sheffield S1 4DA, UK
| | - R Copeland
- Centre for Sport and Exercise Scienceand National Centre for Sport and Exercise Medicine, Sheffield Hallam University, SheffieldS10 2BP, UK
| | - S Haake
- Advanced Wellbeing Research Centre, Sheffield Hallam University, SheffieldS10 2BP, UK
| | - S Domone
- ukactive Research Institute, London WC1R 4HE, UK
| | - S Mann
- ukactive Research Institute, London WC1R 4HE, UK
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A Mixed-Methods Examination of Physical Activity and Sedentary Time in Overweight and Obese South Asian Men Living in the United Kingdom. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040348. [PMID: 28346386 PMCID: PMC5409549 DOI: 10.3390/ijerph14040348] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/15/2017] [Accepted: 03/22/2017] [Indexed: 01/21/2023]
Abstract
South Asian men living in the UK have higher rates of central obesity and Type 2 Diabetes Mellitus (T2DM) compared with their white British counterparts. Physical activity (PA) and sedentary time (ST) are important risk factors for the development of T2DM. The purpose of this study was to objectively measure PA, ST, and to explore the factors influencing these behaviours in this high-risk population. A mixed-methods cross-sectional research design was employed, including the quantification of PA and ST using the self-report International Physical Activity Questionnaire (IPAQ)-long form and accelerometry in overweight and obese UK South Asian men (n = 54), followed by semi-structured interviews in a purposive sub-sample to explore the factors influencing PA and ST (n = 31). Accelerometer-derived moderate-to-vigorous PA (MVPA) and ST were 298.9 ± 186.6 min/week and 551.4 ± 95.0 min/day, respectively. IPAQ-derived MVPA was significantly lower than accelerometer-derived MVPA (p < 0.001). IPAQ-derived ST was significantly higher than accelerometer-derived ST (p < 0.001). Lack of time and family commitments were identified as the main barriers to being more physically active, with group exercise identified as an important facilitator to being more active. A cultural norm of focusing on promoting education over sport participation during childhood was identified as an important factor influencing long-term PA behaviours. Work commitments and predominantly sedentary jobs were identified as the main barriers to reducing ST. Healthcare professionals and researchers need to consider the socio-cultural factors which affect PA engagement in overweight and obese South Asian men living in the UK, to ensure that advice and future interventions are tailored to address the needs of this population.
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