Inhibitors and enablers of physical activity in multiethnic hypertensive patients: qualitative study

Abstract

Regular physical activity (PA) can reduce blood pressure, but hypertensive patients in ethnic minority populations are often inactive. The objective of this qualitative study was to explore inhibitors and enablers of PA from the perspective of hypertensive Ghanaian, African-Surinamese and White-Dutch patients in Amsterdam, The Netherlands. In-depth individual interviews with 46 patients were analysed for thematic content, using Maxqda software. All three groups mentioned their hypertension, the presence of other health conditions, lack of priority, lack of social support, limited financial resources or access to PA facilities as inhibitors for maintaining or increasing their level of PA. Common enablers included health-related incentives, support from physicians or family and having physically demanding work. Specific inhibitors only mentioned by Ghanaians and Surinamese included inexperience with recommended 'Western' activities (cycling), little access to their habitual forms of PA, cultural preferences for large body sizes, unfamiliarity with the host country and the pressure of social demands from the Dutch society and their own communities. Specific enablers for Ghanaians and Surinamese included access to community or church-based support groups. These patient-identified inhibitors and enablers can be a useful framework for promoting PA in hypertensive patients, particularly from immigrant groups. Physicians may build their advice on the identified enablers and tackle the inhibitors.