Abstract
Populations of South Asian (SA) origin are at high risk of type 2 diabetes (T2D) and related complications. Analysis of T2D prevention interventions for these populations show that limited attention has been given to facilitating increased physical activity (PA) in a culturally appropriate manner. The aim of this feasibility study was to identify whether culturally tailored dance is acceptable to women of SA origin, and whether it may have an effect on PA and PA-related social cognitive determinants. A community-based culturally tailored dance intervention choreographed to Bollywood music was evaluated among 26 women of SA origin in the Netherlands for 10 weeks, 2 times per week. This feasibility study was conducted as a before-after, mixed-methods study, combining data from focus groups, individual interviews, questionnaires and accelerometers. The majority of participants were in the age of 50-59 years and at moderate-to-high T2D risk. There was high attendance (73%), low drop out (12%) and high satisfaction scores for various program components. Key reasons for participation were the cultural appropriateness, in particular the combination of historically and emotionally embedded Indian music and dance, and the non-competitive nature of the intervention. On average, in each of the 19 one-hour sessions, participants spent 30.8 minutes in objectively assessed light intensity PA, 14.1 minutes in moderate intensity PA and 0.3 minutes in vigorous PA, and took 2,100 steps during a session. At follow-up, total moderate-to-vigorous PA increased by 7.8 minutes per day (95%CI: 3.1, 12.5) and daily steps increased by 784 (95%CI: 173, 1394), with a concomitant reduction in light PA of 12 minutes per day (95%CI: -21.9, -2.2). Positive shifts in some PA-behavioral social cognitive determinants and no negative side-effects were observed. Bollywood Dance appears to be a feasible, culturally acceptable and potentially effective approach to increase PA in SA women in the Netherlands. A pilot cluster RCT is needed to confirm these initial findings on effectiveness.
Highlights
Over five million people of South Asian (SA) origin live in Europe [1]
The majority of participants were in the age of 50–59 years and at moderate-to-high type 2 diabetes (T2D) risk
Our analysis of available interventions for T2D prevention in populations of SA origin in Europe has found that there is limited experience of physical activity (PA) interventions adapted for people of South Asian origin [9, 10], and within the studies in South Asians including a PA component, the PA element is often underused by participants [9, 11]
Summary
Over five million people of South Asian (SA) origin live in Europe (e.g. of Bangladeshi, Indian, Pakistani, Sri Lankan ancestry) [1]. Populations of SA origin are at increased risk of type 2 diabetes (T2D) and related complications compared to European-origin populations [2, 3]. PA is one of the major recommendations for the prevention of T2D, low levels of PA have been reported among populations of SA origin [13]. SA women in particular are prone to low PA levels due to perceived barriers, acculturative stressors and cultural priorities regarding health [13]. These factors highlight the need for developing and testing PA interventions that are acceptable to participants and thereby may increase T2D prevention effectiveness [10]
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