The design and impact of culturally-safe community-based physical activity promotion for immigrant women: descriptive review

Abstract

Background Immigrant women have low rates of physical activity (PA), placing them at risk for chronic diseases. Some research suggests that strategies targeting this group must be culturally-safe and community-based. This study aimed to identify the design (i.e. characteristics) and impact of culturally-safe community-based PA promotion for immigrant women. Methods We conducted a descriptive review by searching MEDLINE, EMBASE, SPORTDiscus, CINAHL, SCOPUS, Cochrane Library and Joanna Briggs Institute Database of Systematic Reviews from inception to June 9, 2021 for English language studies that assessed community-based PA promotion strategies targeting adult immigrants and involved at least 50% women. We compiled findings in a preliminary context-mechanisms-outcomes conceptual framework. Results We included 13 studies published from 2004 to 2020. Three included women-only; the remainder included a median of 63% women (range 50 to 98%). Studies included immigrants from Brazil, Dominican, Columbian, Haiti, Mexico, China, Vietnam, Bangladesh, India, Pakistan, Somalia, Sudan and Turkey. All but one study (89%) significantly improved one or more outcomes: PA knowledge, PA participation and anthropometric measures (e.g. weight, BMI, blood pressure). Most (89%) strategies were multi-faceted: in-person group educational sessions reinforced by take-home educational material and/or follow-up reminder phone calls. Single strategies (e.g. mailed educational material, group educational session) also achieved beneficial outcomes. We identified 17 culturally-safe characteristics of PA promotion strategies: language of choice, based in community settings or organizations, led by lay health workers, reflected ethno-cultural linguistic expressions and PA norms, and recognized and offered solutions to barriers of PA. Findings were captured in a preliminary theory of how contextual factors (gender, intersectionality) and mechanism (culturally-safe PA promotion) may influence PA-related outcomes (PA knowledge, self-efficacy and participation; anthropometric measures, quality of life). Conclusions This study revealed the characteristics of PA promotion strategies that significantly improved PA-related outcomes among immigrants. Given that few studies focused solely on immigrant women or reported sub-analyses, the conceptual framework generated by this study can be used in future research to more definitively establish the design and impact of culturally-safe, community-based PA promotion for immigrant women.

Barriers and facilitators to older adult participation in intergenerational physical activity program: a systematic review

“…Ethnic minorities, particularly elderly women, are more affected by this, while the cultural emphasis on family in Latino communities encourages intergenerational PA participation [ 32 ]. A descriptive review [ 74 ], also noted the low participation of ethnic minority older women in PA and the need to identify culturally safe community-based PA. Additionally, language is a factor that needs to be considered. Organizing intergenerational sports activities in the participants' primary language can enhance their sense of self-efficacy in participating in these activities.…”

Acceptability of Intergenerational Physical Activity Programming: A Mixed Methods Study of Latino Aging Adults in Nebraska

“…These findings complement those from Piedra et al (2018) and the ¡Caminemos! Program as well as the conceptual framework for culturally-safe physical activity (Gagliardi et al, 2022) in that culturally relevant and age-appropriate programming is critical. Our results are also consistent with a recently published systematic review highlighting the essential nature of tailoring physical activity interventions for culturally and linguistically diverse populations in the U.S.…”

“…The authors noted that cultural adaptations may be necessary based on consultation with the community, such as adjusting to the common language spoken by participants, ensuring cultural and linguistic concordance of program personnel with participants, and providing culturally relevant intervention materials and content (El Masri et al, 2022). Physical activity programs should aim to acknowledge and integrate factors that may affect participation such as cultural values, language preferences, social norms, and cultural concordance of program facilitators (Gagliardi et al, 2022; Joseph et al, 2017; Marquez et al, 2020). Previous research has demonstrated that a culturally tailored aerobic dance program (e.g., using bilingual community staff to implement all aspects of the study in Spanish, adapting for lower formal education levels, and addressing cultural myths) increased physical activity among Latinas facing cultural, social, and environmental barriers to routine physical activity (Hovell et al, 2008).…”

Cancer Screening Program Delivered by Community Health Workers for Chinese Married Immigrant Women in Korea

“…It is necessary to follow-up for a longer period in the future and conduct a study to deliver interventions to various married immigrants using CHWs. In addition, since there are cases of using CHWs in other health promotion areas such as diabetes management [ 38 ] and physical activity promotion [ 39 ], we propose a study that provides interventions for immigrants living in Korea.…”