Exercise and physical activity in asylum seekers in Northern England; using the theoretical domains framework to identify barriers and facilitators

Abstract

BackgroundMany asylum seekers have complex mental health needs which can be exacerbated by the challenging circumstances in which they live and difficulties accessing health services. Regular moderate physical activity can improve mental health and would be a useful strategy to achieve this. Evidence suggests there are barriers to engaging black and minority ethnic groups in physical activity, but there is little research around asylum seekers to address the key barriers and facilitators in this group.MethodsA two stage qualitative study used semi-structured interviews underpinned by the Theoretical Domains Framework. The interviews were conducted in voluntary sector groups in four towns/ cities in Northern England. Purposive sampling recruited 36 asylum seekers from 18 different countries. Interviews were audio recorded, transcribed verbatim and subject to framework analysis. Stage two involved a nominal group technique with five key stakeholders including asylum seekers and those that work with them. They followed a four stage process to rank and reach consensus on the key barrier to undertaking physical activity/ exercise that could be addressed locally through a future intervention.ResultsA number of barriers and facilitators were identified including a lack of understanding of the term physical activity and recommended levels but knowledge of the health benefits of physical activity/ exercise and the motivation to increase levels having engaged with activities back home. Living as an asylum seeker was considered a barrier due to the stress, poverty and temporary nature of living in an unfamiliar place. The outcome of the nominal group technique was that a lack of knowledge of facilities in the local area was the prevailing barrier that could be addressed.ConclusionsPublic health practitioners could develop interventions which capitalise on the motivation and knowledge of asylum seekers to encourage an increase in physical activity which may in turn reduce the breadth and depth of mental health needs of this group.

Impact of an 8-Week Exercise and Sport Intervention on Post-Traumatic Stress Disorder Symptoms, Mental Health, and Physical Fitness among Male Refugees Living in a Greek Refugee Camp

“…We are well aware that due to one group pre-test/post-test design and the lack of random assignment, the results of our study must be interpreted with caution. While randomized controlled trials are needed for an advanced evidence base, researchers should be aware that the implementation of such studies will be complicated by multiple knowledge barriers and environmental constraints [52].…”

Physical activity, post-traumatic stress disorder, and exposure to torture among asylum seekers in Sweden: a cross-sectional study

“…More speci cally, previous research has established that people with severe mental ill health are less likely to engage in PA and are more sedentary in comparison to the general population [41,42]. Given the high rates of trauma-related ill health [3,4], disrupted daily life and work routines from home country [4,6], as well as other barriers to engage in PA that are likely to be faced by forced migrant populations, such as economic strain, access to facilities, and lack of motivation when living under extreme stress and uncertainty about the future [25,43,44], it may be concluded that asylum seekers are more readily susceptible to insu cient PA. An increased focus on assessment and promotion of PA is thereby justi ed. Moreover, recent research [45] has demonstrated important health bene ts even at much lower doses than advocated by generic PA guidelines, especially when moving from completely inactive to some activity [46], suggesting that the promotion of any level of PA may be advisable among those currently inactive or at the lower end of the insu cient PA spectrum.…”

Actitud sobre el ejercicio físico y los deportes: Un estudio psicométrico en estudiantes universitarios

“…También se menciona que el ejercicio físico permite a las personas llevar a cabo actividades cotidianas sin fatigarse (Malina & Katzmarzyk, 2006). A diferencia del ejercicio físico, la actividad física como caminar más rápido y aumentar la intensidad del trabajo, puede ayudar a cambiar el estilo de vida (Haith-Cooper, Waskett, Montague, & Horne, 2018). Según el American College of Sports Medicine 2000, los términos ejercicio físico y actividad física sostienen una similitud importante entre ellos.…”

“…Por otra parte, otros autores argumentan que, pese a los beneficios conocidos sobre la actividad física, un 30% de la población mundial no alcanza los niveles de actividad física recomendados (Franco et al, 2015). En cuanto a los efectos de bienestar psicológico y satisfacción con la vida, las personas que realizan actividad física con mayor frecuencia muestran efectos negativos menores en la salud y el bienestar psicológico (Haith-Cooper et al, 2018). Por el contrario, en el presente estudio, quienes realizan ejercicio físico dos veces o menos por semana no mostraron diferencias significativas con respecto al bienestar psicológico y la satisfacción con la vida.…”