Facilitators and Barriers to Being Physically Active in a Rural Hawaiʻi Community: A Photovoice Perspective

Abstract

A large body of existing literature suggests associations between perceptions of the environment and physical activity status, but very few studies have examined perceptions among Native Hawaiian and Pacific Islander (NHPI) communities. The purpose of this study was to examine perceptions of the active living environment in Hawai‘i in rural communities with a high proportion of NHPI. A total of thirteen adults were purposefully selected to participate in the study, and the Photovoice method was used to capture their perceptions. Three sessions were used to describe the purpose of the study, select and describe photographs, and identify emerging themes. A total of nine overarching themes were identified by participants and placed into three categories. Participants identified facilitators to being physically active, but also identified several barriers in their community such as the lack of available physical and built amenities, social norms, and safety. Participants proposed four action items to improve their active living environment: promote programs that are organized by community members, contact the local university to provide access to physical activity equipment, contact Honolulu City & County officials to voice concerns regarding barriers that prevent physical activity in the community, and working with employers in the community to create policies that promote physical activity at the workplace.

Facilitators and barriers to physical activity for people of Pacific heritage

“…To encourage increased physical activity engagement by Pacific peoples, the approach of 'self' (referring to managing health as an individual) does not match the ideology of 'community' and community-based initiatives in Pacific culture (Heard et al, 2017). The few studies that have explored how to engage Pacific peoples more with physical activity have found that targeted programmes can be effective if they incorporate a cultural component (Albright et al, 2017;Capstick et al, 2009;Hafoka & Carr, 2018;Heard et al, 2017;Look et al, 2012). Including such culture components within physical activities can change perceptions of what physical activity entails (Kolt et al, 2006;LaBreche et al, 2016).…”

“…Including such culture components within physical activities can change perceptions of what physical activity entails (Kolt et al, 2006;LaBreche et al, 2016). Facilitators to physical activity participation have been identified as those that are faith-based (Kolt et al, 2006;Look et al, 2012;Wan et al, 2018), and community-and/or group-based (Albright et al, 2017;Biddle et al, 2011;Kolt et al, 2006;Wan et al, 2018), have a supportive environment (Albright et al, 2017;Hafoka & Carr, 2018;Schluter et al, 2011;Siefken et al, 2014) and focus on social and fun aspects (Albright et al, 2017;Biddle et al, 2011;Siefken et al, 2014Siefken et al, , 2015Wan et al, 2018). Barriers to physical activity acknowledged in extant literature include lack of motivation or self-confidence (Heard et al, 2017;Kolt et al, 2006;Look et al, 2012;Siefken et al, 2014Siefken et al, , 2015Wan et al, 2018), no time or inconvenience (Heard et al, 2017;Schluter et al, 2011;Siefken et al, 2015;Wan et al, 2018), commitments of daily life (Kolt et al, 2006;Schluter et al, 2011;Siefken et al, 2014), concerns for safety (Albright et al, 2017;Hafoka & Carr, 2018;Heard et al, 2017) and lack of support from health care professionals (Kolt et al, 2006;…”

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“…To encourage increased physical activity engagement by Pacific peoples, the approach of 'self' (referring to managing health as an individual) does not match the ideology of 'community' and community-based initiatives in Pacific culture (Heard et al, 2017). The few studies that have explored how to engage Pacific peoples more with physical activity have found that targeted programmes can be effective if they incorporate a cultural component (Albright et al, 2017;Capstick et al, 2009;Hafoka & Carr, 2018;Heard et al, 2017;Look et al, 2012).…”

“…Including such culture components within physical activities can change perceptions of what physical activity entails (Kolt et al, 2006;LaBreche et al, 2016). Facilitators to physical activity participation have been identified as those that are faith-based (Kolt et al, 2006;Look et al, 2012;Wan et al, 2018), and community-and/or group-based (Albright et al, 2017;Biddle et al, 2011;Kolt et al, 2006;Wan et al, 2018), have a supportive environment (Albright et al, 2017;Hafoka & Carr, 2018;Schluter et al, 2011;Siefken et al, 2014) and focus on social and fun aspects (Albright et al, 2017;Biddle et al, 2011;Siefken et al, 2014Siefken et al, , 2015Wan et al, 2018). Barriers to physical activity acknowledged in extant literature include lack of motivation or self-confidence (Heard et al, 2017;Kolt et al, 2006;Look et al, 2012;Siefken et al, 2014Siefken et al, , 2015Wan et al, 2018), no time or inconvenience (Heard et al, 2017;Schluter et al, 2011;Siefken et al, 2015;Wan et al, 2018), commitments of daily life (Kolt et al, 2006;Schluter et al, 2011;Siefken et al, 2014), concerns for safety (Albright et al, 2017;Hafoka & Carr, 2018;Heard et al, 2017) and lack of support from health care professionals …”