Community-Clinic Partnership to Promote Physical Activity in South Asian Women

Project: Research project

Description

Project Summary. South Asians (SAs) make up a quarter of the world’s population and are the second fastest growing racial/ethnic minority group in the U.S. Our data, and others, have found that SAs are some of the least physically active adults in the U.S. and may require special considerations when designing and implementing PA programs. SAs also manifest greater visceral adiposity, insulin resistance, and a significantly higher prevalence of DM, at a lower BMI, compared to other racial/ethnic groups. Regular PA has been shown to decrease visceral adiposity, improve insulin sensitivity, and prevent DM, even in the absence of weight loss; thus, PA may be especially important to prevent or delay the onset of DM in SA populations. Facilitating and promoting PA interventions for this growing population could lead to a substantial impact on their DM risk. Yet there is almost no research on how best to deliver PA interventions in SA populations. Our prior community-based participatory research, conducted in communities with a high proportion of recent immigrants who have limited English proficiency and limited access to health care, found that SA women, in particular, are not being reached by current PA interventions. SA women reported little PA and even had difficulty defining exercise. Although 75% of the women were sedentary and overweight/obese, they did not recognize these as risk factors for DM. Lack of knowledge about benefits of PA, cultural and linguistic isolation, concerns about modesty, and rigid gender roles were strongly influencing SA women’s PA. Despite these barriers, SA women were willing to participate in exercise if it could be done in single-sex classes, with their children, and in a trusted community setting. In partnership with the Chicago SA community, we adapted and applied evidence-based behavior change principles in a culturally-salient PA intervention that explicitly addresses the socio-cultural and ecological drivers of underserved SA women’s PA. The intervention includes community-based exercise classes that incorporate culturally-salient activities (e.g., SA folk dance) for women and their children because the community identified these as key strategies to engaging SA women in PA. During the proposed 2 year-study, we will work with community partners to pilot-test the culturally-salient PA intervention in a community-based setting, via a 2-arm randomized design, and examine the intervention’s feasibility (recruitment, retention, and adherence) and initial efficacy on HbA1c in SA women who are at high risk for developing DM. Secondary outcomes include fasting plasma glucose; biomarkers associated with insulin resistance; components of the metabolic syndrome; physical activity; and psychosocial processes. We will also conduct a process evaluation to understand participants’ perceptions of the PA intervention. Regular PA is an evidence-based DM prevention strategy. Translating this evidence across diverse communities has proved a major challenge. The results of this study will provide essential data for planning a future, large-scale efficacy trial to promote PA and reduce DM risk among SAs, via community and family-level interventions.
StatusFinished
Effective start/end date9/8/149/7/15

Funding

  • National Institute of Diabetes, Digestive and Kidney Diseases (1R56DK099680-01A1)

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Exercise
Insulin Resistance
Adiposity
Ethnic Groups
Population
Community-Based Participatory Research
Dancing
Minority Groups
Health Services Accessibility
Translating
Linguistics
Weight Loss
Fasting
Biomarkers
Glucose