Perceptions, experiences and barriers to lifestyle modifications in first-generation Middle Eastern immigrants to Sweden: a qualitative study

Abstract

ObjectiveThe prevalence of type 2 diabetes (T2D) among Iraqi immigrants to Sweden is high and partly related to sedentary physical activity and calorie dense food. The aim of the present study was to explore perceptions, experiences and barriers concerning lifestyle modifications (LSM) in Iraqi immigrants to Sweden at risk for T2D.DesignA qualitative thematic analysis was conducted on data collected from gender-specific focus group interviews which took place during a culturally adapted randomised controlled intervention study addressing motivation to lifestyle change, self-empowerment, behavioural modifications and sociocultural barriers to LSM. Seven focus groups were held, with an interval of 1–4 weeks between January and May of 2015; each session lasted approximately 1.5 hours.SettingThe city of Malmö, Sweden.ParticipantsOut of 27 women and 23 men assigned to the intervention group, 19 women and 14 men who attended at least one focus group session were included in the study.ResultsParticipants expressed awareness of the content of healthy lifestyle practices. They also expressed numerous social and cultural barriers to LSM connected to irregular meals, overeating, food and drinking preferences and family expectations. Overeating was described as a consequence of social and cultural norms and expectations and of poor mental well-being. Facilitators for reaching successful LSM were connected to family involvement and support.ConclusionOur study reports that facilitators for LSM are connected to presence of family support. Preventive actions addressing family involvement may benefit Middle Eastern immigrants at high risk for T2D to consider healthier lifestyles practices. Identification of sociocultural barriers and facilitators for LSM are crucial for successful health promotion in minority populations at risk for T2D.Trial registrationTrial registration number: NCT01420198 for the MEDIM-study; Pre-results.

A systematic review of qualitative studies exploring the factors influencing the physical activity levels of Arab migrants

“…Aged 20–59 years. Focus groups Thematic analysis Olaya-Contreras et al (2019) [ 35 ] Sweden To explore perceptions, experiences and barriers concerning lifestyle modifications in Iraqi immigrants to Sweden at risk for Type 2 Diabetes. Yes 33 Iraqi immigrants (19 women, 14 men).…”

“…Five studies were conducted in Australia [ 29 , 30 , 36 , 41 , 43 ], three in the US [ 33 , 38 , 42 ], three in the Netherlands [ 34 , 37 , 44 ], three in Sweden [ 32 , 35 , 40 ], and one in Canada [ 39 ]. The target population of the 15 studies included Arab migrant groups from the Middle East and North Africa, with a total of five studies exclusively focusing on Arab migrant samples [ 29 , 33 , 35 , 38 , 42 ]. A total of six studies focused on physical activity as the primary behaviour of interest [ 29 , 30 , 32 , 38 , 40 , 43 ], while the remaining studies focused on physical activity in addition to other lifestyle behaviours (e.g., physical activity and diet).…”

“…The sample sizes of Arabs in the included studies ranged from 11 [ 32 ] to 45 [ 43 ]. A total of seven studies included both men and women [ 29 , 33 , 35 , 37 , 39 , 41 , 44 ], seven studies focused exclusively on women [ 30 , 32 , 34 , 36 , 40 , 42 , 43 ], and one study focused on men [ 38 ].…”

“…Ten studies employed focus groups for data collection [ 29 , 30 , 32 – 35 , 37 , 40 , 41 , 44 ], two studies used interviews [ 36 , 38 ], and three studies used a combination of both focus groups and interviews [ 39 , 42 , 43 ]. The interviews and focus group duration ranged from 30 [ 38 ] to 180 min [ 44 ].…”

Cardiovascular risk assessment in South and Middle-East Asians living in the Western countries

“… 58 Those participants succeeding in changing lifestyles experienced positive support from their family relatives in their efforts. 60 In addition, the study showed beneficial effects on mental health. 61 …”