Abstract
BackgroundAboriginal and Torres Strait Islander women experience higher rates of obesity, chronic disease, and are less active than non-Indigenous Australian women. Lifestyle programs designed to increase physical activity and encourage healthy eating are needed to ameliorate this disparity. The aim of this study was to identify participants’ perceived barriers and enablers to attend group exercise classes as part of a 12-week fitness program.MethodsTo understand the factors that influence attendance, a mixed method process evaluation was undertaken in which a quantitative measure of attendance in the group exercise classes was used to identify cases for further qualitative investigation. Aboriginal and/or Torres Strait Islander women aged 18 to 64 years were recruited to a research trial of a fitness program. The 12-week program included two 60-minute group exercise classes per week, and four nutrition education workshops. Semi-structured interviews were conducted at program completion. Participants were stratified by attendance, and interviews from the highest and lowest 25 percentiles analysed. Rigour was strengthened through use of multiple data analysts, member checking and prolonged engagement in the field.ResultsAnalyses of the post-program interviews revealed that participants enrolled in the program primarily for the perceived health benefits and all (with one exception) found the program met their needs and expectations. The atmosphere of classes was positive and comfortable and they reported developing good relationships with their fellow participants and program staff. Low attendees described more barriers to attendance, such as illness and competing work and family obligations, and were more likely to report logistical issues, such as inconvenient venue or class times.ConclusionsAttendance to the ‘Aboriginal and Torres Strait Islander Women’s Fitness Program’ was primarily influenced by the participant’s personal health, logistics and competing obligations. Low attendees reported more barriers during the 12-week period and identified fewer enabling factors than high attendees.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12610000224022
Highlights
Aboriginal and Torres Strait Islander women experience higher rates of obesity, chronic disease, and are less active than non-Indigenous Australian women
There is conclusive evidence that regular physical activity is an effective primary and secondary preventive measure against chronic diseases such as type 2 diabetes mellitus (T2DM) [3], and clinical trials have shown that the combination of physical activity and nutritional advice can reduce weight [4], blood pressure [5,6], incidence of T2DM [7], and improve glycemic control in diabetics and reduce other diabetes related complications [8,9]
Low attendees were more likely to be employed (7 low attendees compared to 5 high attendees), were less likely to have dependants under the age of 18 (4 low attendees compared to 2 high attendees), and on average lived 2.6 km further from where classes were held
Summary
Aboriginal and Torres Strait Islander women experience higher rates of obesity, chronic disease, and are less active than non-Indigenous Australian women. Compared to non-Indigenous Australian women, Aboriginal and Torres Strait Islander women are more likely to be obese, have lower levels of physical activity and higher rates of type 2 diabetes mellitus (T2DM) [1]. Point to the poor overall quality of evaluation research [15,25]. These studies, for example, are often not accompanied by process evaluations. Process evaluations are important for providing insight into how programs are implemented and whether difficulties are encountered in the field [15]
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