Physical activity among South Asian women: a systematic, mixed-methods review

Abstract

IntroductionThe objective of this systematic mixed-methods review is to assess what is currently known about the levels of physical activity (PA) and sedentary time (ST) and to contextualize these behaviors among South Asian women with an immigrant background.MethodsA systematic search of the literature was conducted using combinations of the key words PA, ST, South Asian, and immigrant. A mixed-methods approach was used to analyze and synthesize all evidence, both quantitative and qualitative. Twenty-six quantitative and twelve qualitative studies were identified as meeting the inclusion criteria.ResultsStudies quantifying PA and ST among South Asian women showed low levels of PA compared with South Asian men and with white European comparison populations. However making valid comparisons between studies was challenging due to a lack of standardized PA measurement. The majority of studies indicated that South Asian women did not meet recommended amounts of PA for health benefits. Few studies assessed ST. Themes emerging from qualitative studies included cultural and structural barriers to PA, faith and education as facilitators, and a lack of understanding of the recommended amounts of PA and its benefits among South Asian women.ConclusionsQuantitative and qualitative evidence indicate that South Asian women do not perform the recommended level of PA for health benefits. Both types of studies suffer from limitations due to methods of data collection. More research should be dedicated to standardizing objective PA measurement and to understanding how to utilize the resources of the individuals and communities to increase PA levels and overall health of South Asian women.

Physical Activity in First Generation South Asian Women Living in Canada: Barriers and Facilitators to Participation

“…South Asian British Muslim women in Snape and Binks (2008) mentioned that PA participation was seen as neglecting family responsibilities because they would have to leave the house for a period of time which meant they were a "bad" housewife or mother. This was similar to findings in Sriskantharajah and Kai (2007) and a systematic mixed methods review by Babakus and Thompson (2012) where activities are considered "selfish" if they extend past daily house chores. If their doctor had told them to exercise more, instead of buying all the milk on one day they would go the next day to at least get some exercise.…”

“…In this particular group of immigrants, cultural barriers are found to be the biggest restricting factor for participation in PA. Almost all studies (Babakus & Thompson, 2012;Caperchione, Kolt, & Mummery, 2009;Eyler et al, 1998;Jiwani & Rail, 2010;Johnson, 2000;Nanayakkara, 2012;Snape & Binks, 2008;Vahabi et al, 2012;Walseth, 2006;Walseth & Fasting, 2004) pertaining to this group of women reported restrictions for PA because of cultural reasons. In the South Asian culture, women are seen as the primary caregivers of the family (Caperchione et al, 2009;Eyler et al, 1998;Johnson, 2000;Lawton, Ahmad, Hanna, Douglas, & Hallowell, 2006;Nanayakkara, 2012;Snape & Binks, 2008;Vahabi et al, 2012).…”

“…Canadian culture and their South Asian culture in terms of values, norms and responsibilities (Babakus & Thompson, 2012). During the initial stages of settlement, South Asian women reported difficulties in adapting to a new environment because of weather (Ahmad et al, 2005;Martins & Reid, 2007;Samuel, 2009), family responsibilities (George & Ramkissoon, 1998;Martins & Reid, 2007), financial instability (Ahmad et al, 2005;Martins & Reid, 2007), loneliness (Abouguendia & Noels, 2001;George & Ramkissoon, 1998;Martins & Reid, 2007) and lack of English proficiency (Ahmad et al, 2005;George & Ramkissoon, 1998).…”

“…Another common cultural barrier amongst some South Asian women is religion (Babakus & Thompson, 2012;Caperchione et al, 2009;Jiwani & Rail, 2010;Johnson, 2000;Nanayakkara, 2012;Walseth & Fasting, 2004 Muslim women usually take part in prayers which results in stopping all other activities. As well during Ramadan many women fast from morning till sundown which makes it difficult to participate in activities without proper food and energy.…”

‘You started something … then I continued by myself’: a qualitative study of physical activity maintenance

“…Other participants spoke about lack of social support being a barrier to PA, explaining they were less likely to engage in PA if they did not have a companion. Kelly et al (2016) included studies that identified social support as a facilitator (Hooker et al, 2011;Babakus and Thompson, 2012) and those that identified lack of social support as a barrier (Im et al, 2013). Whilst we had too few participants from different ethnic groups to comment on important effects, cultural and ethnic differences can help to explain why some people place more importance on social support, in terms of PA, than others.…”