title: Physical activity and nutrition among immigrant and refugee women: a community-based participatory research approach.
abstract: BACKGROUND
  Immigrant and refugee populations arrive to the U.S. healthier than the general population, but the longer they reside, the more they approximate the cardiovascular risk profiles of the country. Among women, these declines are partly mediated by less physical activity and lower dietary quality upon immigration. Given the complex forces that influence these behaviors, a community-based participatory research (CBPR) approach is appropriate. Therefore, a socioculturally responsive physical activity and nutrition program was created with and for immigrant and refugee women in Rochester, Minnesota, through a CBPR approach.
  
  
  METHODS
  Focus groups informed program content and revealed principles for designing the sessions. A 6-week program with two, 90-minute classes per week was conducted among 45 women (Hispanic, Somali, Cambodian, and non-immigrant African American). Average attendance was 22.5 women per class; 34 women completed the evaluation.
  
  
  RESULTS
  Evaluation revealed high acceptability (average overall score of 4.85 out of 5 on the Physical Activity Class Satisfaction Questionnaire). After the intervention, participants were more likely to exercise regularly (p ≤ .001). They reported higher health-related quality of life (p ≤ .001) and self-efficacy for diet (p = .36) and exercise (p = .10). Likewise, there were trends for weight loss (87 vs 83.4 kg; p = .65), decreased waist circumference (99.6 vs 95.5 cm; p = .35), and lower blood pressure (125/80 vs 122/76 mm/Hg; p = .27).
  
  
  CONCLUSIONS
  A CBPR approach to design and implement a socioculturally responsive fitness program was highly acceptable to immigrant and refugee women and demonstrated promising outcomes. Further testing of physical activity and nutrition interventions that arise organically from target communities are needed.
authors.affiliation: Division of Primary Care Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Wieland.mark@mayo.edu
authors.forename: Mark L
authors.initials: ML
authors.lastname: Wieland
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Weis
authors.forename: Tiffany
authors.initials: T
authors.lastname: Palmer
authors.forename: Miriam
authors.initials: M
authors.lastname: Goodson
authors.forename: Sheena
authors.initials: S
authors.lastname: Loth
authors.forename: Fatuma
authors.initials: F
authors.lastname: Omer
authors.forename: Adeline
authors.initials: A
authors.lastname: Abbenyi
authors.forename: Karen
authors.initials: K
authors.lastname: Krucker
authors.forename: Kim
authors.initials: K
authors.lastname: Edens
authors.forename: Irene G
authors.initials: IG
authors.lastname: Sia
mesh_terms: D055812:Community-Based Participatory Research; D054242:Emigrants and Immigrants; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D017144:Focus Groups; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008910:Minnesota; D009043:Motor Activity; D009752:Nutritional Status; D016730:Program Development; D015397:Program Evaluation; D012036:Refugees; D011795:Surveys and Questionnaires