Physical activity promotion of ethnic populations in deprived communities : from determinants to intervention

Despite the clear health benefits of being physically active (DH, 2006), people from ethnic backgrounds show low levels of physical activity (PA) (HSE, 2006) and are recognised as a hard to reach group. Furthermore research approaches need to discover a process by which BRM groups can be reached in both planning and evaluation phases of programme development. Influencing physical activity behaviors among BRM population requires investigation from an individual level and socio ecological perspective. According to the socio-ecological model Sallis et al. (1997) the effective promotion of physical activity is based on an understanding of the interaction between the physical and social environment (Hesketh et al., 2005). From a social environment perspective social relationships and social support are key aspects that encourage positive health behaviours and health status (Springer et al., 2006). Furthermore family support and parental influence play a significant role in the development of children's health behaviours (Trost et al., 2003). Understanding the impact of a different culture on physical activity behaviour among the BRM populations is important in order to design the interventions which would result in behaviour change. Study 1 aimed to work closely with BRM, neighbourhood managers and community researchers to identify perceived constraints to PA and to develop a framework for a comprehensive intervention to promote PA, advised by and based in the BRM communities. Local women were consulted and a bespoke survey based on socio-ecological model was constructed which effectively engaged 213 hard to reach individuals from BRM population. Major findings of this survey indicate that participation in PA was influenced by a number of intrapersonal (attitude), interpersonal (time), social (language barrier) and environmental (facilities, resource and information) factors. A qualitative approach, utilising individual interviews based on socio-ecological model was adopted for Study 2 and sought to explore the physical activity determinants among 4 BRM families and whether BRM individuals' beliefs and attitudes towards and knowledge about physical activity have changed since living in the UK. The role of family support and parental role modelling in promoting physical activity in the family unit was also examined. Findings revealed that the determinants of PA were not influenced by immigration to the UK, they were more related to age, life style, increased knowledge about PA. Parents influenced their children's physical activity levels by encouraging them verbally and supporting them. Boys received more support to engage in physical activities compared to girls. Study 3 whilst not aimed entirely at a BRM population sought to apply the RE-AIM framework (Glasgow et al., 1999) to evaluate the multi-component community based intervention which aimed to tackle health inequality through increased participation in physical activity and engagement in the community in a deprived disadvantaged population. The intervention the "Work-Out Project" was designed to address the barriers identified in studies 1 and 2 in the context of the socio-ecological model and was tailor made to the needs of disadvantaged individuals including the BRM groups. Findings from the evaluation indicated that the formulation and development of the Work-Out project was linguistically and culturally appropriate as this intervention used local "fitness activators" to support the participants and resulted in increased physical activity. Conclusion: This research demonstrated the significance of cultural and community partnership in advocating and empowering communities to collect robust evidence for health promotion and the development of needs-based over product-led based services. LJMU RD10 Decl (1992N1) LIVERPOOL JOHN MOORES UNIVERSITY Candidate's declaration form (This form must be typed) Note: This form must be submitted to the University with the candidate's thesis. Name of candidate: Masoumeh Minou School: Sport and Exercise Sciences Degree for which thesis is submitted: Degree of Doctor of Philosophy 1. Statement of related studies undertaken in connection with the programme of research (see Regulations G4.1 and 4.4) Study 1: Identifying physical activity determinants in BRM women living in deprived areas in Liverpool. The Kensington Women Get Lively Project Study 2: Identifying physical activity determinants in the BRM families who have migrated to the UK. Parental influence on children's physical activity behaviorA qualitative study Study 3: Evaluation of a community based intervention. The Work-Out Project 2. Concurrent registration for two or more academic awards (see Regulation G4.7) either *I declare that while registered as a candidate for the University's research degree, I have not been a registered candidate or enrolled student for another award of the LJMU or other academic or professional institution 3" Material submitted for another award either *I declare that no material contained in the thesis has been used in any other submission for an academic award Signed . (Candidate) . Date . 2e May 2011