Journal of Physical Activity and Health, 2015, 12, 686  -693 http://dx.doi.org/10.1123/jpah.2013-0208 © 2015 Human Kinetics, Inc.

ORIGINAL RESEARCH

Gender-Associated Perceptions of Barriers and Motivators to Physical Activity Participation in South Asian Punjabis Living in Western Canada Cristina M. Caperchione, Shirley Chau, Gordon J. Walker, W. Kerry Mummery, and Cally Jennings Background: Gender is a sociocultural factor known to impact the physical activity (PA) behaviors of South Asians. The purpose of this research was to examine gender-associated perceptions of barriers and motivators for PA in a South Asian population living Canada. Methods: A random sample (N = 204) of South Asian Punjabi adults (18yrs+) completed a computer assisted telephone interview concerning their perceptions to PA participation. Content analysis was used to identify relevant main themes and chi-square analysis was used to calculate gender differences. Results: Results indicated that women more often reported a lack of time due to work and family (χ2 = 7.284, df = 1, P = .007) and a lack of motivation (χ2 = 4.982, df = 1, P = .026), yet men more often reported climate (χ2 = 7.045, df = 1, P = .008) as a barrier. Regarding motivators, men more often reported prevention and reduction of disease (χ2 = 4.451, df = 1, P = .034) and watching others perform (χ2 = 10.827, df = 1, P = .001); however, reducing weight gain (χ2 = 4.806, df = 1, P = .028) and looking like others (χ2 = 4.730, df = 1, P = .029) were reported more often by women. Conclusions: Gender-associated differences concerning PA are present in this population and must be considered in the design and implementation of effective interventions. Keywords: community health promotion, ethnic communities, preventive health, gender differences, migration and acculturation

Migration has seen a significant number of South Asians settling in western countries such as Canada, the United States and the United Kingdom.1–4 Canada currently reports one of the highest immigration rates per capita in the world5 with the South Asian population representing the largest and fastest growing visible minority group, making up 4.1% of the population.3 It is projected that the number of South Asians permanently residing in Canada will increase from 1.3 million in 2006 to between 3.2 and 4.1 million by 2031.6 People of South Asian origin living in their newly adopted countries commonly experience higher rates of chronic diseases such as Cardiovascular Disease (CVD), Coronary Heart Disease (CHD) and diabetes compared with the local population or other migrant populations.7–9 For example, South Asian men in the UK appear to be more prone to coronary heart disease than others, and both men and women of South Asian origin have 30% to 40% higher coronary disease mortality rates than UK born individuals.10 Additionally, when comparing 3 ethnic groups living in Canada, South Asians had the highest prevalence of both CVD (10.7%) and CHD (10.7%) compared with Europeans (5.4% and 4.6%, respectively) and Chinese (2.4% and 1.7%, respectively).11 Recent Canadian evidence suggests that hypertension [OR 1.54 (95% CI)] and diabetes [OR 2.17 (95% CI)] is also more prevalent in people of South Asian background compared with white people.12 Certain risk factors including obesity, hypertension, low high-density lipoprotein cholesterol and insulin resistance contribute to these high rates of CHD and diabetes.13 In addition to these risk factors, evidence in Canada Caperchione ([email protected]) is with the School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada. Chau is with the School of Social Work, University of British Columbia, Kelowna, British Columbia, Canada. Walker, Mummery, and Jennings are with the Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada. 686

also suggests that a higher proportion of people of South Asian origin are not engaging in sufficient physical activity compared with those of white ethnicity.12–14 Regular physical activity can reduce these risk factors, but individuals of South Asian origin report the lowest levels of physical activity compared with their Western counterparts.15,16 To promote physical activity, perceptions specific to this population must be understood. There is a lack of literature on perceptions, particularly associated with barriers and motivators of physical activity for South Asians living in Canada. Research within the South Asian population living in the United Kingdom has identified unique contributing factors associated with cultural differences and barriers such as, modesty in line with religious beliefs, nonparticipation in mixed gender activities and fear of undertaking activities alone.17–19 Given the heavy emphasis placed on culturally labeled gender roles such as the role of ‘homemaker’ and ‘family caregiver’ for females, there may be important gender differences that exist in this population. The need to understand these gender differences in relation to physical activity is highlighted by research indicating that the percentage of females who are inactive is slightly higher compared with their male counterparts.13,14 Given the potential gender differences in this population and the differences in activity levels across gender, the overreaching goal of this research is to examine gender-associated perceptions of barriers and motivators for physical activity in the South Asian Punjabi population living in Western Canada.

Methods Sample and Design Data were collected from a sample of Punjabi South Asian adults residing in Calgary, Alberta, Canada. Participant eligibility was determined based on the following criteria: a) legal age (18yrs +), b)

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country or region of birth, c) self-identified ethnic or cultural group (eg, Punjabi Canadian, South Asian, South Asian Canadian), and d) fluent in either English or Punjabi. Efforts were made to ensure similar numbers of men and women in the study. Data were collected by means of a Computer-Assisted Telephone Interview (CATI) survey. Data collection took place from May 30, 2011 until June 12, 2011. Land-line telephone numbers were identified through vender-generated lists and telephone directories based on the most common South Asian surnames, a method that has been well established.20 Once contact was made, an eligible respondent from the household was invited to participate in the interview. Participants provided verbal informed consent before completing the survey. Interviewers were fluent in both English and Punjabi and participants could choose their preferred language. If initial contact was unsuccessful, telephone numbers were dialed a minimum of 10 times until removed from the sample. If at any stage a participant refused to participate, their telephone number was removed from the database and they were not recontacted. The survey instrument and data collection protocols received ethics approval from the University of British ColumbiaOkanagan Campus Behavioral Research Ethics Board before conducting the study.

Study Instrument The questionnaire assessed ethnicity status (language, birth country, immigration year, and ethnicity), demographics (gender, age, marital status, income, education and employment), and a series of open-ended questions regarding participants perceptions concerning barriers to, and motivations for, participating in physical activity. Questions were guided by research undertaken by the authors concerning perceptions of physical activity in culturally and linguistically diverse (CALD) communities.21 Examples of the open-ended questions included 1) What are some of the reasons you do not participate in physical activity? and 2) What are some of the reasons/things that would motivate you to participate in physical activity? The questionnaire was translated from English to Punjabi using backward-translation. Before data collection the questionnaire was pretested in both languages (English-language, N = 5; Punjabi-language, N = 7), following the same procedures outlined above. Very minor revisions associated with order and wording of the questions were made by the research team, however no major changes to the context of the questions was needed.

Data Analysis For analysis purposes, all questionnaires undertaken in Punjabi were professionally translated into English before data analysis. Openended responses were entered verbatim into a document without reference to any personal information. A thematic analysis,22 using an inductive approach, was undertaken to identify, code and categorize the data according to predetermined themes. Thematic analysis is a qualitative research method which has been widely used in health promotion research23,24 given its capabilities to identify, analyze, and report themes within large data sets. It organizes and describes a data set in rich detail, highlighting similarities and differences, and generating unanticipated insights. These themes capture something important about the data in relation to the research question/s and represent some meaning within the data set.25 To ensure rigor, 2 members of the research team independently identified and coded the responses into relevant subthemes that were

categorized under each main theme. Both research team members had previous training in analyzing qualitative data and have used similar analysis procedures in previous research.26,27 Once all coding was complete, the subthemes were openly discussed among the 2 research team members to ensure that bias was minimized. Any disagreements or concerns that had arisen during the analysis were presented at this time and further discussion was carried out until consensus was reached and agreement was met. Once agreement of the subthemes was finalized and the all responses were categorized under each of these subthemes, the principal investigator used a 2-tailed, chi-square without Yates correction to calculate gender differences of responses under each subtheme.

Results A total of 372 eligible participants were contacted, with 204 agreeing to participate—a participation rate of 55%. The majority of the interviews were conducted in Punjabi (n = 166). With an average duration of 19.3 minutes (20 minutes for Punjabi; 17.3 minutes for English). The sample (N = 204) consisted of nearly equal Punjabi men (50.5%) and Punjabi women (49.5%), with many being between 35 to 54 years of age (44.6%). Participants were either Canadian citizens (66.7%) or permanent residents (31.4%) and had moved to Canada less than 10 years earlier (37.8%). Many reported their self-identified ethnic or cultural group as Punjabi-Canadian (61.3%). Further details concerning participant characteristics are reported in Table 1. Results (Table 2) are reported under 2 main themes: 1) barriers to physical activity and 2) motivators to physical activity.

Barriers to Physical Activity Responses concerning barriers to physical activity were further divided into subthemes including psychological-cognitive barriers (eg, attitudes toward PA, self-efficacy), sociocultural barriers (eg, social support, ethnicity), environmental barriers (eg, access to facilities, traffic), and demographic-biological barriers (eg, age, gender, education). These subthemes were guided by the study objectives and previous research concerning the barriers and motivators to physical activity participation.21,28,29 The majority of responses (149 comments) were concentrated under the subtheme psychological-cognitive barriers. Of these comments, the most reported barriers to physical activity participation were a lack of time due to work and family responsibilities (73.1% of comments), a lack of motivation/laziness to be active (18.1% of comments), and not sure how to be active or play sport (3.3%). Chi-square analysis showed a difference in gender concerning 2 of these barriers. Women were more likely to report lack of time due to work and family responsibilities as a barrier to physical activity compared with men (χ2 = 7.284, df = 1, P = .007), where as men were more likely to report lack of motivation/laziness as a barrier to physical activity compared with women (χ2 = 4.982, df = 1, P = .026). Common responses to lack of time for women included I work Monday to Friday and upon coming home I have to do cooking and cleaning. So, practically, I don’t get any time to look after myself and do exercise. Also, I have to babysit small kids too. (female, age category 35–44) Common responses for the men who reported lack of motivation/laziness were associated with other distractions, mainly technologies such as television and computers. For example,

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Table 1  Demographic Characteristics of Participants

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Variable Years lived in Canada (mean, SD)a Language of interview  Punjabi  English Age group  18–24  25–34  35–44  45–54  55–64  ≥65 Marital status   Never married   Married or common-law   Divorced or separated  Widowed Household income  ≤$29,999  $30,000–$59,999  $60,000–$99,999  ≥$100,000  Missing Education   < high school graduation   High school graduation   Some postsecondary   Postsecondary degree or greater Employment  Employed  Unemployed  Retired Immigration status   Canadian citizen   Permanent resident   Work or study permit Country of birth  India  Pakistan  Nepal   Punjab unspecified  Canada Ethnicity  Indian  Pakistani   Punjabi Canadian   East Asian  Indo-Canadian a

688

Total (N = 204) N (%) 16.9 (11.1)

Male (N = 104) N (%) 17.85 (11.81)

Female (N = 101) N (%) 15.98 (10.33)

166 (81.4) 38 (18.6)

82 (79.6) 21 (20.4)

84 (83.2) 17 (16.8)

20 (9.8) 48 (23.5) 54 (26.5) 37 (18.1 28 (13.7) 17 (8.3)

9 (8.7) 17 (16.5) 26 (25.2) 22 (21.4) 15 (14.6) 14 (13.6)

11 (10.9) 31 (30.7) 28 (27.7) 15 (14.9) 13 (12.9) 3 (3.0)

17 (8.3) 178 (87.3) 5 (2.5) 4 (2.0)

10 (9.7) 91 (88.3) 1 (1.0) 1 (1.0)

7 (6.9) 87 (86.1) 4 (4.0) 3 (3.0)

P-valuea .246 .514

.024

.334

.339 24 (11.7) 60 (29.4) 54 (26.5) 31 (15.2) 35 (17.2)

10 (10.5) 28 (29.5) 32 (33.7) 18 (18.9) 7 (7.4)

14 (16.7) 32 (38.1) 22 (26.2) 13 (15.5) 3 (3.6)

27 (13.2) 50 (24.5) 29 (14.2) 98 (48.1)

17 (16.5) 17 (16.5) 14 (13.6) 55 (53.4)

10 (9.9) 33 (32.7) 15 (14.9) 43 (42.6)

148 (72.6) 40 (19.6) 16 (7.8)

79 (77.5) 9 (8.8) 14 (13.7)

69 (69.7) 28 (28.3) 2 (2.0)

136 (66.7) 64 (31.4) 4 (2.0)

73 (70.9) 28 (27.2) 2 (1.9)

63 (62.4) 36 (35.6 2 (2.0)

147 (72.1) 7 (3.4) 1 (0.5) 37 (18.1) 12 (5.9)

73 (70.9) 4 (3.9) 1 (1.0) 19 (18.4) 6 (5.8)

74 (73.3) 3 (3.0) 0 (0.0) 18 (17.8) 6 (5.9)

41 (20.1) 2 (1.0) 125 (61.3) 5 (2.5) 31 (15.2)

17 (16.5) 0 (0.0) 65 (63.1) 3 (2.9) 18 (17.5)

24 (23.8) 2 (2.0) 60 (59.4) 2 (2.0) 13 (12.9)

.038

.000

.424

.885

.357

Difference between males and females measured by t-test or chi-square.

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Table 2  Themes and Subthemes of Participant Comments Themes and subthemes

Comments N (%)

Gender differencesa

Barriers to physical activity   Psychological-cognitive barriers*

N = 149, n = 72 (M), n = 77 (F)

   Lack of time due to work/family

109 (73.1)

.007

   Lack of motivation/laziness

27 (18.1)

.026

   Not sure how to play sport

5 (3.3)

NS

  Demographic-biological barriers*

N = 56, n = 30 (M), n = 26 (F)

  Health concerns

38 (67.8)

NS

   Too tired

8 (14.3)

NS

7 (12.5)

NS

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  Environmental barriers*

N = 31, n = 21 (M), n = 10 (F)

  Climate

22 (70.9)

.008

  Financial constraints

7 (22.5)

NS

  Sociocultural barriers*

N = 18

   Religious and cultural

10 (55.5)

NS

   Lack of support

7 (38.8)

NS

Motivators to physical activity  Health*

N = 143, n = 72 (M), n = 71 (F)

   Prevention/reduction of disease

45 (31.4)

.034

   Reducing weight gain

41 (28.6)

.028

  Overall well-being

29 (20.2)

NS

   Positive mental health

20 (13.9)

NS

  Social support/social interaction*

N = 41, n = 22 (M), n = 19 (F)

   Support from family and friends

21 (51.2)

NS

17 (41.4)

NS

   Undertaking activities with others   Modeling*

N = 32, n = 17 (M), n = 15 (F)

   TV, media outlets, or in person

20 (62.5)

.001

   Wanting to look healthy & fit like others

11 (34.3)

.029

  Body image*

N = 15, n = 7 (M), n = 8 (F)

   Wanting to look good

14 (93.3)

NS

a Indicates results of chi-square analysis examining differences in comments by gender, NS. Abbreviations: M, male; F, female. * Minor discrepancies (under 5%) within percentages and N for all comments are due to a small proportion of participants consistently reporting “No or None” for all barriers and motivators.

I get lazy most of the time. Due to technology like Facebook and computers, and television, if one sits in front of them they will probably remain seated there for a long time and not go out for physical activity. (male, age category 45–54)

I have a pacemaker in my heart and have high blood pressure and get dizziness. (female, age category 65+)

Comments concerning demographic-biological barriers were the next most frequently reported (56 comments). These comments mainly focused on health concerns (67.8%) but included barriers such as being too tired to be active (14.3%) and being too old to participate (12.5%). Chi-square analysis revealed no significant differences between gender and any of the demographic-biological barriers to physical activity participation. Common responses from both women and men who indicated that health concerns prevented them from being active all described poor physical health or fear of injury. For example,

My doctor prescribed me not exercise due to health problems. (male, age category 35–44)

I started exercising, but then I felt pain so I stopped. (female, age category 55–64)

Participants highlighted that being too tired and too old prevented them from being active, sharing comments such as By the end of the day I am too exhausted to do any kind of exercise. (female, age category 25–34) I am old, so I cannot participate in much physical activity. (male, age category 45–54)

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The environmental barriers subtheme yielded 31 comments, reflecting concerns with climate (70.8%) and financial constraints (22.5%). Chi-square analysis revealed a significant difference between gender and climate (χ2 = 7.045, df = 1, P = .008) in which men were more likely than women to perceive weather as a barrier to activity. There were no significant differences between gender and financial constraints. Comments resonating responses from men included The weather is not favorable most of the time, like during the winter and even in the summer time. (male, age category 55–64)

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Sometimes due to weather conditions, especially in winter, I don’t go for walks. (male, age category 45–54). Sociocultural barriers were reported the least by participants (18 comments), with the majority of comments focusing on religious and cultural aspects (55.5%) followed by lack of social support (38.8%). In terms of religious and cultural aspects the participants highlighted that much of their spare time was committed to their religious faith, attending church functions and volunteering at community cultural events. Chi-square analysis revealed no significant differences between gender and sociocultural barriers to physical activity participation. Comments from both women and men focused primarily on not having someone to participate with. For example, Often I don’t have company to go walking with so I don’t go. (female, age category 25–34) I don’t have anybody to go with me for a walk or to the gym. (male, age category 65+)

Motivators to Physical Activity Based on participant responses, comments pertaining to motivators to physical activity participation were divided into subthemes, including Health, Social Support/Social Interaction, Modeling, and Body Image. These subthemes were guided by the study objectives and previous research concerning the barriers and motivators to physical activity participation.21,28,29 The majority of comments (143) related to the Health subtheme focused on prevention and reduction of disease (31.4%), preventing and reducing weight gain (28.6%), overall well-being (20.2%), and increasing positive mental health (13.9%). Chisquare analysis showed a significant difference between gender and prevention and reduction of disease (χ2 = 4.451, df = 1, P = .034), indicating that men were more likely than women to report this as a motivator to physical activity. A significant difference was also found between gender and weight gain (χ2 = 4.806, df = 1, P = .028), suggesting that women were more likely to report preventing and reducing weight gain as a motivator to physical activity. There were no significant differences between gender and overall well being or gender and increasing positive mental health. An example of the responses from men that reflected the prevention and reduction of disease as motivator included . . . to stay away from diseases, I got a heart attack once and since then I have been exercising everyday. (male, age category 55–64) Examples of responses from women who were more likely to report preventing and reducing weight gain included

Whenever I see myself gaining weight I go to do exercise. (female, age category 25–34) I do physical activity to keep my weight under control. (female, age category 45–54) The second most reported motivator was Social Support/Social Interaction (41 comments), in which participants indicated that they were motivated to be physically active if they were supported by their family and friends to undertake activity or sport (51.2%) and had the opportunity to socialize with others (41.4%). Chi-square analysis revealed no significant differences between gender and the social support/interaction as motivators to physical activity participation. Participant response from both women and men included When a family member or friend who does exercise tells me that it is good for me, then I realize that I could do it. (female, age category 18–24) My father does physical activity and I do physical activity, so my kid takes part in games and stuff. I think it is an important way to motivate others and our future generations. (male, age category 40–54) Modeling (32 comments), in terms of seeing others perform physical activity on TV, other media outlets, or in person (62.5%) and wanting to look healthy and fit like others (34.3%), was the next most popular motivator for physical activity. Chi-square analysis revealed a significant difference between gender and modeling, indicating that men were more likely than women to be motivated by watching others perform physical activities (χ2 = 10.827, df = 1, P = .001), yet women were more likely than men to report that they are motivated by seeing others looking healthy and fit and wanting to look like that (χ2 = 4.730, df = 1, P = .029). Specific comments highlighting these forms of modeling included When we watch TV or some other programs such as yoga programs on TV or when we read newspaper articles about exercise, that motivates us to do exercise. (male, age category 55–64) Whenever I see a friend who is doing exercise and losing weight, I want that too. (female, age category 18–24) Lastly, some participants’ perceived body image as motivator to being physically active (15 comments), with the majority of comments (93.3%) concentrated on ‘looking good.’ Chi-square analysis revealed no statistically significant differences between gender and body image as a motivator to physical activity participation. Comments from both women and men equally reflected this: I want to look good and my clothes to fit better. (female, age category 35–44) I like to look more muscular and manly. (male, age category 18–24) There were a small proportion of participants who consistently reported that they did not have any perceived barriers to physical activity participation or were not motivated to be physically active. This small percentage is represented by the minor discrepancies found when calculating the total percentages under each subtheme. For instance, when reviewing the total comments for body image (N = 15, 93.3%), the remaining 6.7% reflected a comment of “not motivated to be physically active.”

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Discussion Results from this study outlined specific barriers and motivators to physical activity participation for South Asian Punjabis living in Western Canada. Noteworthy, is the gender-associated differences that where highlighted among these barriers and motivators. Women more often reported a lack of time due to work and family, yet men were more likely to report a lack of motivation and climate as barriers. In terms of motivators, men were more likely to report prevention/reduction of disease and watching others, while women more often reported reducing weight gain and looking like others. These gender-associated differences are discussed below. Lack of time due to work and family responsibilities was the overarching barrier for participants. This barrier is not unique to the South Asian population, and is often reported by the majority of the general population.28 However, many of these participants also indicated that being active with family and friends was a motivator to physical activity. South Asian communities are often described as having very strong ties to family and close friends in their local communities, especially as immigrants to a new country,30 thus developing programs and initiatives which are family and community oriented could address both this barrier and motivator, providing participants with the opportunity to be active while spending valued family time together. In terms of gender differences, South Asian women were more likely than South Asian men to report lack of time due to family responsibilities as a barrier to physical activity. This is not surprising within the South Asian culture as South Asian women are often regarded as primary care givers, responsible for childcare and domestic duties.31 Interestingly, South Asian men perceived a lack of motivation/laziness to be a barrier to physical activity more than their female counterparts. Many of the men indicated that they worked very long hours in laborious jobs and had little motivation to be active once their shift had ended. This opens up an opportunity to place greater emphasis on occupational activity for these men, developing strategies to assist these men in being more active while at work. Developing friendly competitive challenges with work colleagues and sport oriented group activities during lunch breaks or immediately after work have been previously suggested by men,32,33 and thus may be an approach that could be culturally adapted for South Asian men. Responses concerning motivators to physical activity provided further insight regarding the physical activity behaviors of South Asian adults in Canada. In particular, having good health was the most reported motivator to physical activity and is strongly supported by the research literature regardless of gender, ethnicity, or age.29,34 When further broken down with respect to participant responses, South Asian men were significantly more likely than South Asian women to report the prevention of disease as a main motivating factor for being active. Evidence has consistently indicated that South Asian men are at greater risk of diabetes and heart disease, well above the general population and other ethnic groups.7,35 This risk is even greater when South Asian men migrate to the Western world and acculturate36 to new traditions and customs, which often includes a decrease in physical activity and an increase in poor dietary habits.37,38 As more attention is drawn to the increased risk of disease for men of South Asian origin in particular, these men may be more sensitive to public health messages and better understand the negative consequences associated with these poor health behaviors, thus motivating them to change this trend in an attempt to prevent and reduce disease and premature mortality. Consistent with the Health Belief Model39 these men begin to

perceive their poor health behaviors to be at a level of severity that warrants behavior change to prevent and reduce death and disease. They are further motivated to change their lifestyle behaviors as these messages (cues to action) make them aware of the health benefits associated with doing so.40,41 However, this is somewhat speculative and thus requires further investigation, particularly examining how men perceive these messages and the context in which they are delivered. South Asian women reported the prevention or reduction of weight more often than men as a main motivating factor to engaging in physical activity. Although this is not a surprise in terms of gender, what is interesting is that this seems to also be impacted by acculturation theory, in which an individual or cultural group’s experiences begin to change as a result of being in contact with another culture.36,42 For instance, in the South Asian culture being of a larger size is culturally acceptable, indicating good health, wealth and status.43,44 However, as these women acculturate to their Canadian surroundings they to begin to be exploited by media messages (predominately in the Western world) concerning body and societal pressures to be thin, thus, it could be that South Asian women are now more mindful of these numerous messages and have become more conscious of how they look. In an attempt to help these women further understand all of the benefits of being at a healthy weight, it would be beneficial to frame these messages in a way that links both prevention of disease and losing weight to look good or to fit into a certain size45 as a motivational component. Further consideration needs to be taken in how these messages are designed, making sure that all messages are culturally tailored and sensitive to religious traditions and gender concerns.23,46,47 Gender differences also existed with respect to modeling in which men more often reported an interest in undertaking an activity because they saw someone else doing it on TV or in other media. In contrast, women reported that they would like to participate in physical activity to enhance appearance. They wanted to look slim and get similar results to those seen on TV or other media. Further supporting the previous finding concerning body weight, media continue to focus on body image, using models not reflective of the average women to portray these messages. For instance, health and fitness magazines or TV fitness programs often use fit and slim women to demonstrate activities, stressing that ‘you too could have long lean legs just like [insert models name] by doing these 4 simple exercises.’ Rarely would you see a woman of average size (or larger) or a woman of South Asian ethnicity, highlighting the need to undertake these activities to decrease their risk of heart disease rather than having long lean legs. Similar to health promotion messages highlighting disease prevention/reduction in a culturally sensitive and appropriate manner, individuals used to portray this message also need to be culturally appropriate and relate to the target population. For instance, the use of culturally appropriate models, in this case, models of South Asian decent, might make the message more salient to women from the South Asian community. The fact that men were more motivated than women to become active by watching others perform the actual activity or sport lends further support to the notion of tailoring this approach with respect to gender, and diversity. Clear and simple messages that emphasize the connection between the activity or sport and the prevention and reduction of disease for men would be most advantageous. For example, the use of high profile South Asian sportsmen engaging in a culturally-specific activity (eg, cricket, yoga, field hockey, kabaddi), while highlighting the health benefits associated with the activity, may generate greater participation interest.

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Strengths, Limitations, and Recommendations

Acknowledgments

Existing research has provided a general overview of barriers and motivators to physical activity participation for this population,23,24,48 resulting in some intervention research concerning these barriers and motivators.49 However, to our knowledge no research has specifically addressed the gender differences associated with barriers and motivators to physical activity participation for South Asians. Given the traditional religious and cultural differences between South Asian men and women (ie, gender appropriateness of activity, facility, etc), the results of this research provides much needed preliminary data to assist with tailoring interventions to meet specific gender limitations and variations. Furthermore, the use of open-ended questions allowed a large sample of participants (N = 204) to freely express their own perceptions and opinions concerning barriers and motivators to engaging in physical activity, providing a wealth of rich data. A shortcoming for this is the small percentage of explained variance in responses, thus making it difficult to draw true conclusions. In addition, given that the sample only consisted of South Asian Punjabis, generalizations cannot be made across the whole South Asian population beyond the city of Calgary. A further limitation of this study was that it did not assess physical activity levels, thus making it difficult to distinguish any further differences in terms of barriers and motivators for those considered physically active (meeting recommended physical activity guidelines of 150 min/wk) versus those who are not considered physically active. Future research should include an objective measure of physical activity to further examine these differences as barriers and motivators for South Asians may vary for those who are active and those who are not. Additional followup studies should include other South Asian communities (not limited to Punjabi) that commonly reside in other areas of Canada, including Toronto, Vancouver, Ottawa, Edmonton, and Montreal.5 Additionally, differences between 1st and 2nd generation South Asians should be explored, paying special attention to the impact of migration patterns, acculturation theory and assimilation on health behavior change.

This research was supported by an Internal Research Grant from the University of British Columbia, Okanagan, and Internal Research Funds from the University of Alberta, Edmonton.

Conclusions Little is known about the preventive health behaviors of the South Asian population in Canada, and even less regarding gender associations of physical activity behaviors. Specific to the barriers and motivators associated with physical activity participation, our findings outlined specific gender differences for the South Asian population in Canada. Specifically, women more often reported a lack of time due to work and family, whereas men were more likely to report lack of motivation and climate as barriers. In terms of motivators, men were more likely to report prevention and reduction of disease and watching others perform physical activity, yet women more often reported reducing weight gain and looking like others. This research provides an important first step toward the design, development and implementation of effective interventions, highlighting the importance of considering gender specific variations associated with physical activity participation for South Asians in Canada. In particular, promoting different contexts of physical activity (eg, occupational PA) and tailoring public health messages dependent on the needs and interests of South Asian men and women may help address these gender differences and develop best practice approaches for this population.

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JPAH Vol. 12, No. 5, 2015

Gender-Associated Perceptions of Barriers and Motivators to Physical Activity Participation in South Asian Punjabis Living in Western Canada.

Gender is a sociocultural factor known to impact the physical activity (PA) behaviors of South Asians. The purpose of this research was to examine gen...
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