Perspectives on physical activity participation in middle-aged U.S. South Asian women at risk for type 2 diabetes mellitus: A qualitative study

OBJECTIVE: Increasing evidence supports the benefits of physical activity (PA) in lowering the risk of type 2 diabetes mellitus (T2DM) among middle-aged women. Despite the increased risk for T2DM at a younger age, South Asian (SA) women in the United States (U.S.) have lower PA than men and have been studied to a lesser extent. This study explored the culturally bound attitudes, behaviors, beliefs, and barriers related to PA among middle-aged SA women at risk for T2DM. DESIGN: A descriptive qualitative study involving focus group discussions (FGDs) with SA women (N=25) at risk for T2DM was conducted. Participants were recruited from SA religious/faith communities and professional organizations in Houston, Texas, using purposive and snowball sampling. FGDs were audio-recorded and transcribed. Data were analyzed using Braun and Clarke's reflexive thematic analysis in MAXQDA. RESULTS: Most participants were married, college-educated, employed, and first-generation immigrants. Two overarching themes-barriers to PA and facilitators/motivators of PA-emerged, comprising six subthemes. Barriers included balancing roles and responsibilities and cultural attitudes and norms, while facilitators/motivators included support systems, personal drives, role models, and exercise as enjoyable. CONCLUSION: Cultural attitudes and gender norms strongly influence PA behavior among SA women in the U.S. Collectivism expressed through bonding, accountability, enjoyment, and mutual encouragement is a key strength among SA women that shapes their PA experiences. Culturally appropriate intervention strategies may include offering peer-based, socially supported PA programs and targeted education to increase SA women's awareness of PA benefits across life stages.