Barriers and Facilitators to Healthy Eating and Physical Activity in Overweight Mexican-Origin Smokers

BACKGROUND: Smoking, poor diet, and physical inactivity account for over 60% of cancer-related deaths in the U.S. These risk factors cluster and may have multiplicative effects on health. Interventions addressing multiple risk behaviors are needed, particularly in understudied populations. This study qualitatively investigated barriers and facilitators to healthy eating and physical activity (PA) in overweight Mexican-origin smokers to inform the adaptation of an evidence-based smoking cessation intervention to also address diet and PA.

METHODS: Five focus groups (three female, two male) were conducted in Spanish with overweight Mexican-origin smokers. Data were transcribed and analyzed using Atlas.ti. A team of coders reviewed the transcripts to identify salient themes.

RESULTS: Relevant themes revealed similarities and differences by gender.  Barriers to healthy eating in men revolved around preferences for unhealthy foods. Women described a lack of time and energy for healthy meal preparation and the strong influence of husbands and children, who did not always support a healthy diet. Strategies for healthy shopping, cooking, and meal preparation were important facilitators for women. For PA, there was little expectation for PA outside of routine activities. Both men and women identified work and family commitments as leaving little time for PA.  Women also expressed fear of injury, yet emphasized how enjoyable activities with family/friends facilitated being active.

CONCLUSIONS: Findings highlight the need for intervention strategies to be mindful of behavioral contexts, build off of healthy eating strategies, address ways to incorporate PA into one’s routine, and make PA fun and able to involve family/friends.