256800 Determinants of physical activity among refugee Somali women living in Maine

Sunday, October 28, 2012

John T. Devlin, MD , Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME
Emma Duncanson, MD , Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME
William Cook, PhD , Department of Psychiatry, Maine Medical Center, Portland, ME
Bankole Kolawole, MD, MS , Public Health Division, City of Portland, Portland, ME
Asha Suldan, BS , Public Health Division, City of Portland, Portland, ME
Deqa Dhalac, BS , Public Health Division, City of Portland, Portland, ME
Kahsi Threlkeld, PhD , Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME
Nina Alves, BS , Alere Scarborough, Inc., Scarborough, ME
Deqa Ahmed, BS , Public Health Division, City of Portland, Portland, ME
Numerous factors contribute to the vulnerability of refugee Somali women. High rates of obesity and low cardiovascular fitness indicate health disparities have accompanied transition from a traditional lifestyle. Our community-based participatory research (CBPR) team is exploring behavioral determinants of physical activity (PA) in this population, using constructs from the Theory of Planned Behavior and Social Cognitive Theory. Based on findings from focus groups, we initiated culturally-appropriate zumba exercise classes (Only Women) which achieved high rates of participation (> 80% class attendance), as well as improved cardiovascular fitness (baseline: 22.6±3.8; at 12 weeks: 23.9±3.9 ml/kg/min, p < 0.005). We developed a quantitative survey in the Somali language to measure determinants of PA, exploring domains of Attitudes (8 items), Subjective Norms (4), Self-Efficacy (8), Intention (4), and Exercise Stage of Change (1) with regard to PA, using 5-point Likert scales. The reliability (Cronbach's alpha) for survey domains is: Attitudes (0.94), Norms (0.83), Self-efficacy (0.94), and Intention (0.91). Using linear regression with Intention as dependent variable, we found significant correlations with Stage (r=0.73, p<0.001) and Self-Efficacy (r=0.78, p=0.013) but not with Attitudes (r=0.19) or Norms (r=0.21). With self-reported PA levels (zumba class minutes/week) as dependent variable, we found a significant correlation with Intention (beta coefficient=72.9, p=0.016) but not with Attitudes, Norms, or Self-Efficacy. In conclusion, our Somali-language quantitative survey demonstrated high reliability for behavioral determinants of PA, and Intention appears to predict exercise participation in zumba classes. This instrument can be used to evaluate the effectiveness of interventions promoting PA among Somali women.

Learning Areas:
Chronic disease management and prevention
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Describe behavioral determinants of physical activity (PA) among Somali women Evaluate predictive validity of quantitative survey of theory-based determinants

Keywords: Exercise, Refugees

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am principal investigator for a community-based research project, "Determinants of physical activity among Somali refugee women living in Maine", which formed the background for an NIH R21 FOA application, “Community-based Program to Promote Physical Activity among Somali Women". I am P.I. for the translational research project, "Improving Diabetes Care in Cap Haitian, Haiti", funded by the International Diabetes Federation. I have been P.I. on grants from NIH (R01), as well as ADA and JDRF.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.