Determinants of physical activity among refugee Somali women living in Maine

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.