An Exercise Intervention for South Asian Mothers with Risk Factors for Diabetes.
OBJECTIVE
South Asians (Indians, Pakistanis, Bangladeshis, Sri Lankans, Nepalis, and Bhutanese) in the United States have a very high prevalence of type 2 diabetes mellitus (DM). This pilot study evaluated a culturally-tailored exercise intervention among South Asian immigrant mothers with DM risk factors.


METHODS
Through an academic-community partnership, South Asian women with risk factors for DM and who had at least one child between 6-14 years were enrolled into this single-arm study. The intervention for the mothers included 16-weeks of twice weekly exercise classes, self-monitoring with activity trackers, goal-setting, and classes on healthy eating. Based on prior community-based participatory research, children were offered exercise classes during the mothers' classes. The primary efficacy outcomes were change in mothers' moderate/vigorous physical activity and body weight pre- and post-intervention (16-weeks). Program adherence, clinical, and psychosocial outcomes were measured. A qualitative process evaluation was conducted to understand participant perspectives.


RESULTS
Participants' (n=30) average age was 40 (SD=5) years., 57% had a high school education or less, and all were overweight/obese.. At baseline, women were not meeting recommended physical activity guidelines. Overall, participants attended 75% of exercise classes. Compared to baseline, participants' weight decreased by 3.2 lbs. (95% CI: -5.5, -1.0) post-intervention. Among women who attended at least 80% of classes (n=17), weight change was -4.8 lbs, (95% CI: -7.7, -1.9). Change in accelerometer-measured physical activity was not significant; however exercise-related confidence increased from baseline (p-value <0.01). Women described multiple physical and psychosocial benefits from the intervention.


CONCLUSIONS
This pilot study suggests that a culturally-tailored exercise intervention that included exercise classes for children was feasible and had physical and psychosocial benefits in South Asian mothers with risk factors for DM.
Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Preventive Medicine, Northwestern University, Chicago, IL.
Namratha R
NR
Kandula
Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.
Swapna
S
Dave
Department of Preventive Medicine, Northwestern University, Chicago, IL.
Peter John
PJ
De Chavez
Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL.
David X
DX
Marquez
Metropolitan Asian Family Services, Chicago, IL.
Himali
H
Bharucha
Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.
Shinu
S
Mammen
Department of Medicine, Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Andrea
A
Dunaif
Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.
Ronald T
RT
Ackermann
Metropolitan Asian Family Services, Chicago, IL.
Santosh
S
Kumar
Department of Preventive Medicine, Northwestern University, Chicago, IL.
Juned
J
Siddique
Physical activity; South Asian; cardiovascular disease; cultural-tailoring; diabetes