Tailoring evidence-based physical activity strategies in minority communities: One size does not fit all

Minorities and underserved populations suffer disproportionately from obesity and obesity-related diseases, and they are less likely than Whites to meet recommendations for physical activity. Research has identified strategies proven to increase physical activity, including community-wide campaigns, individual behavioral change programs, social support in community settings, efforts to create/enhance access to places for physical activity, and point-of-decision prompts. To explore minority response to and recommendations for modifying these strategies, the National Cancer Institute (NCI) funded proposals by minority investigators working with low-income Hispanic women in Texas, Hmong parents and their children in California, low-income African Americans in the Mississippi Delta, and Native Hawaiian junior college students in Hawaii. Sites followed a social marketing framework to guide focus group and key informant interviews. Common themes emerged. All groups wanted physical activity programs that were oriented toward families and existing social structures. Places for physical activity must be safe, convenient, and low-cost and must accommodate family and work schedules. Partner/buddy systems were important to Latina women and African American adults, while Native Hawaiians and Hmong desired programs based in cultural traditions and values. Campaigns in mainstream media were not seen as effective. Barriers were not culturally specific, but common among underserved individuals (e.g., lack of time, transportation, access, neighborhood safety, or economic resources). Participants felt that cultural leaders could help encourage physical activity and advocate to reduce environmental barriers. Findings confirm the value of engaging target groups in the review and discussion of mainstream interventions to identify ways to adapt them to fit.