ERIC EJ871107: Motivators of and Barriers to Engaging in Physical Activity: Perspectives of Low-Income Culturally Diverse Adolescents and Adults

2009·0.12 MB·English

by  ERIC

Research Article
Motivators of and Barriers to Engaging in Physical Activity:
Perspectives of Low-Income Culturally Diverse
Adolescents and Adults
Marie A. Bragg, Carolyn M. Tucker, Lily B. Kaye, and Frederic Desmond
ABSTRACT
Background: Obesity rates are rising in the United States, especially among low-income and racial/ethnic minority
individuals. Exploring motivators and barriers relative to engaging in physical activity is imperative. Purpose: The
purpose of this study was to identify motivators and barriers relative to engagement in physical activity as reported
by culturally diverse low-income adolescents and adults. Methods: A total of 91 adolescent (11 to 15 years of age)
and adult (18 years of age or older) participants who self-identified as African American, Hispanic, or non-Hispanic
White engaged in age group-, race/ethnicity-, and gender-concordant focus groups. Results: Qualitative data analysis
indicated that the motivators and barriers most commonly identified among the adolescent and adult focus groups
were: social influence; time and priorities; physical environment; fun and enjoyment; inherently physical activities;
weight concerns; fatigue, physical discomfort and current fitness level; and immediate positive feelings. Discussion:
Findings were generally similar across age group, gender and race/ethnicity. Age group-specific, gender-specific and race/
ethnicity-specific motivators and barriers were related to how commonly the motivators and barriers were identified
among each group. Translation to Health Education Practice: Implications for increasing physical activity among
low-income culturally diverse adolescents and adults are discussed.
Bragg MA, Tucker CM, Kaye LB, Desmond F. Motivators of and barriers to physical activity: perspectives of low-income culturally diverse
adolescents and adults. Am J Health Educ. 2009;40(3):146-154. This paper was submitted to the Journal on September 25, 2008, revised
and accepted for publication on January 15, 2009.
BACKGROUND diabetes, hypertension, and cancer.2 Due to lescents.2 Additionally, because individuals
Overweight and obesity among adoles- the increased risk for chronic disease that who are overweight or obese as children also
cents and adults have increased significantly results from being overweight or obese, ef-
in the United States.1 In 2006, over 17% of fective interventions that promote healthy Marie A. Bragg is a research project co-director in
adolescents ages 12 to 19 were considered behaviors and reduce overweight and the Department of Psychology, P.O. Box 112250,
overweight and over one-third of adults were obesity among adults and adolescents are University of Florida, Gainesville, FL 32611;
considered obese.1 Obesity disproportion- especially needed. E-mail: [email protected]. Carolyn M.
ately affects racial/ethnic minority popula- Low-income African American youth Tucker is a distinguished alumni professor in
tions, with African Americans and Hispanics and Hispanic youth are disproportionately the Department of Psychology, P.O. Box 112250,
evidencing higher rates of obesity than affected by several of the health problems University of Florida, Gainesville, FL 32611. Lily
non-Hispanic Whites.1 Healthy People 2010 that can be prevented through engagement B. Kaye is a doctoral candidate in the Depart-
identified overweight and obesity among in health promoting behaviors.1, 3, 4 Thus, ment of Psychology, P.O. Box 112250, Univer-
the country’s 10 leading health indicators, national agencies are calling for interven- sity of Florida, Gainesville, FL 32611. Frederic
as these health problems have been found tions to promote healthy behaviors among Desmond is a visiting assistant professor in the
to be associated with a number of disease all Americans, but especially among low- Department of Psychology, P.O. Box 112250,
conditions including cardiovascular disease, income and minority children and ado- University of Florida, Gainesville, FL 32611.
146 American Journal of Health Education — May/June 2009, Volume 40, No. 3
Marie A. Bragg, Carolyn M. Tucker, Lily B. Kaye, and Frederic Desmond
tend to be overweight or obese as adults, it is females and 20 males). The number of par- 1. A researcher-constructed demographic
particularly important to include youth in ticipants in each focus group ranged from data questionnaire that assessed demographic
research focused on understanding, modify- 4 to 10, with 7 being the median number characteristics such as race/ethnicity, age
ing, and preventing obesity.5 of participants per focus group. Each focus and gender.
Engagement in physical activity has been group was age group-, race/ethnicity-, and
2. A researcher-constructed interview
linked to improved health in youth and gender-concordant. For example, a focus
guide, which was orally administered by
adults. Physical activity has been identified group was conducted with only African
trained focus group leaders for the purpose
as one important tool in achieving and American adult males.
of exploring participants’ motivators of and
maintaining weight loss and combating Adolescent focus group participants
barriers to engaging in health promoting
obesity.6,7,8 However, despite the detrimental ranged in age from 11 to 15 years old, with
behaviors, including engaging in physical ac-
impact of inactivity on health, many adoles- a mean age of 13.8 (SD = 1.2). Adolescents
tivities such as walking, moving more rather
cents in the United States do not engage in who were age 16 or older were not recruited to
than less and engaging in moderate-to-intense
recommended levels of physical activity.9,10 be focus group participants due to potential
physical activity. The interview guide was de-
Development of effective interventions dissimilarities (e.g., values, interests, maturity
veloped based on Stewart and Shamdasani’s12
to promote engagement in health promot- level) between such older adolescents and
recommendations regarding conducting
ing behaviors, such as physical activity, their younger counterparts. The racial/ethnic
focus groups, including building rapport in
requires an understanding of the most composition of the adolescent participants
the group before beginning to ask questions,
salient factors that influence such behavior. was 34.1% African American, 43.9% Hispanic
carefully crafting questions so as to maximize
bandura’s Social Cognitive Theory posits and 22.0% non-Hispanic White.
the number and variety of responses, asking
that engagement in health behaviors is Adult focus group participants ranged in
open-ended (rather than close-ended) ques-
influenced by a combination of personal age from 18 to 89 years old, with a mean age of
tions, asking broad questions first and then
determinants (e.g., biological and cogni- 34.0 (SD = 15.4). All participants in the adult
gradually narrowing the focus of subsequent
tive factors) and socio-environmental focus groups were financially independent
questions, and limiting the total number of
influences. Identifying motivators of and and not living with their parents. The racial/
questions to no more than 12.
barriers to engagement in health promoting ethnic composition of the adult participants
behaviors as perceived by adolescents and was 21.2% African American, 38.5% Hispanic Participant Recruitment
adults would enhance the knowledge-base and 44.2% non-Hispanic White. Researchers and five community re-
regarding personal factors that influence One of the requirements for participation search consultants recruited focus group
engagement in physical activity. in this study was having a family income of participants via participant recruitment
less than $40,000. The median annual house- announcements made at schools, churches
PURPOSE hold income range was $20,000-$24,999 and community centers in a small city in
The present research is a component of for both the African American adults and north central Florida. The racial/ethnic
a larger study regarding the health promot- the non-Hispanic White adults. The me- breakdown of this city is 68.4% White,
ing behaviors of culturally diverse children, dian annual household income range for 23.2% black and 6.4% Hispanic.13 Recruit-
adolescents and adults. The specific purpose the Hispanic adults was $25,000-$29,999. ment methods also included publishing
of the present research was to identify moti- Family income data were not obtained for participant recruitment articles in local
vators and barriers relative to engagement in the adolescent focus group participants; newspapers and disseminating and/or
physical activity as reported by low-income however, their parents were informed of the posting participant recruitment flyers
African American, Hispanic and non-His- family income requirement for being a re- at community events and settings (e.g.,
panic White adolescents and adults. search participant. Sixty percent (n = 13) of barbershops and local businesses). Addi-
the Hispanic adult focus group participants, tionally, participants were recruited using
METHODS 60% (n = 12) of the non-Hispanic White the snowball technique; that is, individuals
Participants adult focus group participants, and 90% (n who agreed to be focus group participants
= 10) of the African American adult focus
Participants were adolescents (ages 11 to were asked to disseminate participant re-
group participants reported that their high-
15 years) and adults (older than 18 years) cruitment flyers to other persons that they
est level of education completed was high
who self-identified as African American, knew and to encourage these persons to
school. Participants were from a small city
Hispanic, or non-Hispanic White and who be research participants. The recruitment
in north-central Florida.
participated in one of 12 focus groups. sites/areas that were targeted were those
Specifically, there were 91 focus group Instruments most likely to enable successful use of the
participants, including 41 adolescents (20 The following two instruments were used quota technique, which involved recruit-
females and 21 males) and 50 adults (30 in conducting the focus groups: ing approximately equal numbers of males,
American Journal of Health Education — May/June 2009, Volume 40, No. 3 147
Marie A. Bragg, Carolyn M. Tucker, Lily B. Kaye, and Frederic Desmond
females, adults and adolescents from each would be similar in terms of race/ethnicity, the focus group discussion that could help
of the racial/ethnic groups of interest in the age group and gender; (3) participants could researchers better understand comments
present study. Having fairly equal num- choose to not respond to any question asked made by the focus group participants. All
bers of these groups enabled the planned by the discussion group leaders; (4) before Hispanic focus groups were conducted by
formation of age group-, race/ethnicity-, the discussion group began, each partici- leaders, co-leaders and note-takers that were
and gender-concordant focus groups. For pant would be asked to complete a written fluent in both English and Spanish.
example, a focus group was conducted with demographic questionnaire that would take Researchers who were trained in con-
African American adult males. approximately five minutes to complete; and ducting culturally sensitive focus groups
It is noteworthy that the above men- (5) participants could choose to discontinue trained the focus group leaders, co-leaders
tioned community research consultants in- participation at any point in time with no and note-takers to conduct the focus groups.
cluded retired nurses, retired school teachers adverse consequences. This training involved participating in a two-
and other adults who were active in the com- Potential participants were also informed hour training session which focused on the
munity and had strong relationships with that the group discussion in which they goals and procedures of the focus groups,
low-income culturally diverse adolescents would be involved would include other strategies for facilitating communication
and adults. These active community mem- members of the community. Potential par- among focus group members, and ways of
bers were involved in organizations (e.g., ticipants were informed about the purpose managing focus group dynamics (e.g., re-
the county health promotion committee) of the study, and if they expressed interest minding the group to give everyone a chance
focused on improving the health and well- in it, they were asked to report their age to talk—as a way of encouraging quiet or
being of the residents of the research site and race/ethnicity so they could be given shy group members to talk and as a way of
city and thus found the present research to logistical information regarding the focus reducing the amount of talking by group
be consistent with their community involve- group that was appropriate for their age and members who tend to monopolize a group
ment and interests. Community research race/ethnicity. Potential participants were discussion). At the focus group training ses-
consultants were each offered $200 for informed that the researchers were seeking sion, all focus group leaders, co-leaders, and
approximately 30 hours of work to recruit individuals who identified as African Ameri- note-takers were provided with a training
focus group participants; however, three of can, Hispanic, or non-Hispanic White. manual and the structured interview ques-
these consultants chose not to accept pay- Focus Group Organization tions to study prior to facilitating a focus
ment for their recruitment work. and Leader Training group. On the day of each focus group, the
All recruiters and recruitment materials All focus groups were conducted by lead- roles of these individuals were reviewed
provided potential focus group participants ers, co-leaders and note-takers whose gender with them by the researchers who initially
with information on the purpose and pro- and race/ethnicity matched the gender and trained them. These researchers remained at
cedures of the present research. The stated race/ethnicity of the participants in that the location of each focus group to answer
purpose of the research was to identify mo- group. Focus group leaders for the adult questions from the focus group leaders,
tivators of and barriers to health promoting groups typically were university faculty co-leaders and note-takers, as well as focus
behaviors, including behaviors related to members, while focus group leaders for the group participants, and to help with focus
physical activity. Potential participants were adolescent groups typically were graduate group logistics (e.g., setting up and testing
informed that they would be asked to take students. Focus group co-leaders for the adult the video cameras, and reading Assent Forms
to the adolescent participants).
part in a two-hour audio- and video-taped groups were adult community members,
discussion group during which they would while co-leaders of the adolescent groups Focus Group Implementation
be asked a series of questions about what were adolescents from the community or Each focus group was held at a con-
motivates them to engage in health behav- young undergraduate students. The role of venient community site (i.e., a library or
iors and what prevents them from engaging focus group leaders was to use the structured community center) on a weeknight or a
in those behaviors. Potential participants interview questions to facilitate participants’ weekend day. Upon arrival at the site, adult
were also informed that immediately before identification of their motivators of and bar- participants were given an Informed Con-
the discussion group, they would be served a riers to engaging in physical activity. sent Form to read and sign, while adolescent
meal, and at the end of the discussion group, The co-leaders’ roles were to promote participants were given a Parental Consent
they would be paid ($15 cash for adolescents rapport between the focus group leaders and Form (which required the signature of a
and $20 cash for adults) for their participa- focus group discussion participants, and to parent or guardian) and were read an Assent
tion. It was also stated that: (1) researchers facilitate comfort among the participants. Form. All participants were given the option
would keep all audiotapes, videotapes and Note-takers were undergraduate research as- of having applicable Informed Consent
demographic data questionnaires confi- sistants whose role was to record nonverbal Forms, Parental Consent Forms, or Assent
dential; (2) members in a discussion group behaviors and interactions observed during Forms read to them, and all participants also
148 American Journal of Health Education — May/June 2009, Volume 40, No. 3
Marie A. Bragg, Carolyn M. Tucker, Lily B. Kaye, and Frederic Desmond
could choose to receive written materials an “inductive category development”16 ap- compare codes identified from the respec-
in Spanish. The Informed Consent Form, proach was used, by which coding categories tive transcripts they had coded. Each code
the Parental Consent Form and the As- were derived directly from the data, as op- that had been independently identified by
sent Form included information regarding posed to using a pre-existing theory to con- each coder was discussed by the coding
the purpose of the focus groups, length of struct a coding scheme. To develop an initial team and the coding supervisor. If both
time required for participation, payment coding scheme and increase inter-coder coders categorized a given instance with
amounts and methods, and various research reliability, coders read parts of randomly- the same code, that coded instance was
procedures, including procedures to protect selected transcripts and agreed on categories documented by the coding supervisor as
the confidentiality of information obtained (i.e., “codes”) that described participants’ an agreement. If, however, one of the cod-
from participants. Participants then com- comments regarding specific motivators ers categorized a given instance differently
pleted a demographic data questionnaire. of or barriers to engaging in physical ac- than did the other coder, that instance was
After completing the necessary forms, focus tivity. Each distinct unit of a participant’s recorded by the coding supervisor as a dis-
group participants were served a meal to comment that described or referred to a crepancy, and the discrepancy was discussed
help them relax and to show appreciation particular physical activity motivator or in an effort to resolve the issue (with the cod-
for their participation. The focus group barrier was considered an “instance.” The ing supervisor making all final discrepancy-
leader and co-leader then implemented the length of each coded instance varied from a resolution decisions).
focus group, which began with either an single word to as long as a participant’s entire Inter-coder reliability was calculated by
“ice-breaker” activity (for adolescent focus uninterrupted comment. dividing the total number of coder agree-
groups) or introductions. Each instance was assigned a main code ments across all coded transcripts by the to-
Data Analysis only (e.g., physical environment) or a main tal number of coded instances (i.e., the sum
code as well as a more specific sub-code of total coder agreements and total coder
Qualitative data were collected dur-
ing the focus groups and later quantified (e.g., lack of recreation facilities in one’s discrepancies across all coded transcripts).
for comparative purposes. A digital audio neighborhood was a sub-code of the main The result of this calculation was then mul-
recording of each focus group was tran- code “physical environment”) according tiplied by 100 to convert it to a percentage.
scribed verbatim by a certified transcription to Schilling’s17 recommendations. Every Using this formula, there was an 88% level of
company. Audio-tape recordings of focus coded instance was also labeled as either a agreement among the eight coders involved
groups conducted in Spanish were translated motivator or a barrier. After the initial list in the transcription coding process.
into English and transcribed by bilingual of codes was developed, coders indepen- A total of 50 main codes and 26 sub-codes
transcribers. Focus group transcripts were dently coded each transcript by “constantly were identified through the coding process
analyzed by a team of eight researchers (i.e., comparing” participants’ comments to the across all focus group transcripts. Reported
“coders”) from diverse cultural backgrounds. most current version of the coding list in motivators and barriers were not analyzed
Each transcript was independently coded by order to determine if each instance could based on the number of participants who
each member of a two-person coding team be described using an existing code from the stated each motivator/barrier; instead, they
that included at least one coder whose race/ coding scheme. When coders came across were analyzed based on the frequency with
ethnicity matched the race/ethnicity of the instances that did not fit within the existing which the reported motivators and barriers
participants in the focus group whose data coding scheme, a new code was created and occurred across focus groups. This “com-
were being analyzed. This matching proce- the coding list was appended. On occasion, monness approach” was utilized based on
dure was used to facilitate comprehension a code from the coding list was deemed to the concept that factors reported in more
of word usage and dialect during the tran- be too specific or too broad and was thus than one focus group are likely to be more
scription coding process. To increase the revised (e.g., further specified or combined reliable than factors reported by several
reliability and validity of transcript coding, with another code) to better fit within the persons within a single focus group.
coders were rotated so that coding teams did coding scheme. Whenever an existing code Early in the code-frequency tabulation
not always consist of the same two coders. was revised, coders also applied the revision process, it became readily apparent that
A senior researcher (e.g., coding supervi- to any instances in which the code had been the adult focus groups generated a much
sor) with expertise in using the constant used in the respective transcripts they had larger number of distinct motivators and
comparative method closely supervised the previously coded. barriers than did the adolescent groups,
coding process to enhance internal consis- Each transcript was independently and the degree of commonality across fo-
tency of coding between transcripts.14 coded by hand (i.e., no coding software was cus groups regarding identified motivators
Each of the 12 focus group transcripts utilized) by each of the two members of a and barriers was greater among the adult
was coded using content analysis and the coding team, and then each coding team met groups than among the adolescent groups
constant comparative method.15 Specifically, with the coding supervisor to review and (e.g., weight concerns were identified as a
American Journal of Health Education — May/June 2009, Volume 40, No. 3 149
Marie A. Bragg, Carolyn M. Tucker, Lily B. Kaye, and Frederic Desmond
barrier by five of the six adult groups, but diate positive feelings (Table 1). Each of four of six adult groups); (3) spouses and
by only two of the six adolescent groups). these “most common” main codes and any health professionals (each identified in two
Three possible reasons for these differences relevant sub-codes are described in detail in of six adult groups); and (4) family members
are that adults likely tend to be more verbal the following sections. other than a child or spouse (identified in
than adolescents in group situations where Social Influence. The single category of one of six adult groups). Having a dog was
group members do not know each other, motivators of or barriers to engaging in also identified as a motivator of engaging in
adults would almost certainly have had physical activity most often identified by physical activity in two of six adult groups.
more life experiences and a wider range of adolescent and adult focus group partici- Social influence was mentioned as a bar-
life experiences than adolescents, and adults pants was social influence (i.e., the influence rier in three of six adolescent focus groups.
usually are freer to make their own choices of friends, parents, family members, coaches, Specific types of barriers regarding social
than are adolescents. based on these ratio- health professionals, etc.). Social influence influence included family members and
nales, motivators or barriers were classified was most often mentioned as a motivator friends who preferred to engage in sedentary
as “most common” among adolescents if of rather than as a barrier to engaging in activities (e.g., watching television) instead
at least three of the six adolescent groups physical activity (i.e., five of six adolescent of physical activities.
mentioned the motivator or barrier. Moti- focus groups and all six adult focus groups Time and Priorities. In half of the adoles-
vators or barriers were identified as “most identified social influence as a motivator). cent focus groups, and in all of the six adult
common” among adult groups if at least Specific types of motivational social influ- focus groups, a lack of time was mentioned
four of the six adult groups mentioned the ences mentioned in the adolescent groups as a barrier to engaging in physical activity.
motivator or barrier. included: (1) friends (identified in three Similarly, having other priorities (e.g., work,
adolescent groups); (2) parents and peers of school and family) was identified as a barrier
RESULTS the opposite sex (each identified in two ado- to engaging in physical activity in three of
The main codes that were found to be lescent groups); and (3) and non-parental the six adolescent focus groups and in five
descriptive of the most common motiva- family members (e.g., an aunt living in the of the six adult focus groups.
tors of and barriers to engaging in physical household), team members, and coaches Physical Environment. Availability/
activity were: social influence; time and (each identified in one adolescent group). unavailability of resources (e.g., owning a
priorities; physical environment; fun and Specific motivational social influences iden- bicycle, lack of neighborhood recreational
enjoyment; inherently physical activities; tified in the adult focus groups included: (1) facilities); availability of peers in close
weight concerns; fatigue, physical discom- exercise partners (identified in five of six proximity; weather; location (i.e., the lo-
fort and current fitness level; and imme- adult groups); (2) children (identified in cation where one lives/works); and safety
Table 1. Most Common Categories of Identified Motivators and/or Barriers
and the Specific Identifications for Each Age Group x Gender x Race/Ethnicity
Adult Adolescent
Motivator/ Barrier Female Male Female Male
AA H W AA H W AA H W AA H W
Social Influence M M M M M M MB MB M M MB
Physical Environment MB MB MB MB B B MB MB M
Fun and Enjoyment M M M M M M M
Inherently Physical Activities M M M M M M M M M
Weight Concerns M M M M M M M
Time B B B B B B B B B
Priorities B B B B B B B B
Fatigue B B B B
Physical Discomfort B B B B B B B B
Current Fitness Level B B B B B B
Immediate Positive Feelings M M M M M M M
Notes: M = Motivator; b = barrier; AA = African American; H = Hispanic; W = non-Hispanic White
150 American Journal of Health Education — May/June 2009, Volume 40, No. 3
Marie A. Bragg, Carolyn M. Tucker, Lily B. Kaye, and Frederic Desmond
issues (e.g., a dangerous neighborhood) the adolescent focus groups, having weight in the United States, as compared to their
were identified as influential environmental concerns was mentioned as a motivator for native countries, people walk less for trans-
motivators of or barriers to physical activity. being more physically active in only two of portation and there are fewer social events,
Three of the six adolescent focus groups re- six focus groups. particularly events involving dancing—a
ported environmental factors such as safety, Fatigue, Physical Discomfort and Cur- preferred means of physical activity. Par-
availability of resources and availability of rent Fitness Level. In four of the six adult ticipants in this group also reported that
peers as motivators for engaging in physical focus groups, fatigue (either pre-existing having a greater availability of peers of their
activity. Conversely, four of the six adoles- fatigue or fatigue as a result of engaging in own cultural background here in the United
cent groups reported environmental factors physical activity) was identified as a barrier States would be a significant motivator of
such as weather, location, safety and unavail- to being physically active. Similarly, physi- engaging in physical activity.
ability of resources as barriers to engaging in cal discomfort (as a result of engaging in Similarly, participants in the Hispanic
physical activity. Among the adults, four of physical activity) was reported as a barrier adult male focus group reported that having
the six focus groups reported environmental to engaging in physical activity in five of less time available for exercising and having
factors such as safety, location, weather and the six adult groups and in three of the six fewer social activities that involve being
availability/unavailability of resources as adolescent groups. Current physical fitness physically active (e.g., playing soccer) here in
motivators of and/or barriers to engaging level was reported as a barrier (e.g., not the United States are barriers to being physi-
in physical activity. being physically fit enough to engage in cally active. Additionally, participants in the
Fun and Enjoyment. Participants indi- certain types of exercise) among half of the Hispanic adult male group mentioned that
cated that if an activity is perceived as being adolescent groups and among half of the not wanting to exercise because of having
fun and enjoyable, the activity served as a adult groups. eaten too much is a culture-related barrier
motivator of engaging in physical activity. Immediate Positive Feelings. Some par- to engaging in physical activity (these par-
Specifically, three of the six adolescent focus ticipants reported immediate positive feel- ticipants also suggested that over-indulgence
groups and four of the six adult focus groups ings as a motivator for engaging in physical in food is culturally-accepted within the
mentioned fun and enjoyment as a motiva- activity. Specifically, feeling “better” and/or Latino culture). Finally, only one adolescent
tor. Nearly half of the adolescent groups energetic after exercising was identified by group (the Hispanic adolescent male group)
specifically identified that listening to music both adolescents and adults as a motivator. identified that here in the United States,
while being physically active is a motivator Three of the six adolescent focus groups and they live farther away from friends, spend
of engaging in physical activity. four of the six adult focus groups reported less time outdoors, and have greater access
Inherently Physical Activities. Four of the immediate positive feelings as a motivator to technology—all of which are barriers to
six adolescent focus groups and five of the six of engaging in physical activity. being physically active.
adult focus groups identified that activities Culture. Only three of six adult groups
that are inherently physical (e.g., team sports, and one of six adolescent groups reported DISCUSSION
doing a chore/job that involves being active) cultural factors as a barrier to engaging in The major purpose of this research was
motivate them to engage in such activities. In physical activity; thus, culture was not actu- to identify motivators of and barriers to
the adolescent groups, walking as a means of ally one of the most commonly reported engaging in physical activity among African
transportation was identified as a motivator main codes. However, these findings are American, Hispanic, and non-Hispanic
for being physically active, but this was the reported here due to the emphasis of the White adolescents and adults from low-
case only among the male and female African present research on cultural diversity. Half income families. Due to the large number
American adolescent groups. In the adult of the adult focus groups reported cultural of discrete motivators and barriers identi-
groups, walking as a means of transportation factors as a barrier to engaging in physical fied by focus group participants, only the
and having a physically-demanding job were activity. Specifically, in the African American most commonly mentioned motivators
most commonly mentioned as motivators of adult female group, one race-related barrier and barriers are reported here. In general,
being physically active. regarding exercising was implied by the com- the findings of this research indicate that
Weight Concerns. In five of the six adult ment that “you don’t associate exercise and the most commonly identified category of
focus groups, having concerns regarding being health-conscious with black people.” physical activity motivators and barriers
one’s weight was identified as a motivator Additionally, the Hispanic adult female involved social influence factors, and the
for engaging in physical activity. Particularly group discussed culture-related barriers in majority of the most commonly identified
noteworthy is that the African American terms of their lifestyle in the United States motivators of and barriers to engaging in
adult female group was the only adult group in comparison to their lifestyle in their physical activity identified among the ado-
in which having weight concerns was not country of origin. Participants from the lescent focus groups and among the adult
mentioned as a motivator or barrier. Among Hispanic adult female group suggested that focus groups were very similar. If these
American Journal of Health Education — May/June 2009, Volume 40, No. 3 151
Marie A. Bragg, Carolyn M. Tucker, Lily B. Kaye, and Frederic Desmond
findings are validated in future research Hispanic adult female participants specifi- and (4) the researchers created a welcom-
with low-income African American, His- cally referred to a lack of Hispanic peers as a ing social environment for the focus group
panic, and non-Hispanic White adolescents barrier to engaging in physical activity. Such participants by providing them with food
and adults, support would be provided for findings suggest that interventions designed and social interaction with the focus group
developing and testing both family-focused to target Hispanic families/individuals, or leaders and researchers before conducting
and peer-focused interventions that ad- interventions that occur in areas in which each focus group. Given the difficulties of
dress the many common motivators of and a large percentage of the population is His- community-based research, such practices
barriers to physical activity that may exist panic, may benefit from including informa- appeared to have aided in increasing par-
in low-income families similar to those in tion on strategies to overcome some of the ticipants’ comfort and desire to participate.
the present research. Such peer-focused perceived United States cultural barriers to Additionally, the qualitative data analysis
interventions should ideally complement engaging in physical activity. Furthermore, procedures were conducted in a culturally
such family-focused interventions, given because it appears that Hispanic adults may sensitive manner. For example, the research-
the strong influence of peers in general, but be more motivated to be active when they are ers who engaged in the analysis of each focus
particularly during adolescence. connected with other Hispanic adults, inter- group transcript included at least one coder
One interesting specific finding is that ventions designed to increase physical activ- of the same race/ethnicity as the participants
concern over one’s weight was identified as ity among these individuals may be more whose data were being coded. This strategy
a motivator of physical activity in every adult effective when a culturally relevant social ensured that the racial/ethnic makeup of
focus group except the African American component is included (e.g., dancing events the coding team was as diverse as that of the
female group. This finding is consistent with or walking groups organized by and targeted study’s participants, and additionally, may
earlier research indicating that compared to for Hispanic adults and their families) and have promoted better comprehension of
non-Hispanic White, Hispanic, Asian and when these interventions occur within the any culture-specific language or culturally-
Native American females, African American Hispanic community (e.g., at a Hispanic influenced practice.
females reported the highest levels of body church). The present research is unique in It is interesting to note that there were
satisfaction, even though as a group, the regard to its inclusion of three major racial/ minimal differences in reported motivators
African American females had the highest ethnic groups as well as its inclusion of ado- and barriers in association with gender or
prevalence of obesity.11 It has been asserted lescents and adults of each gender. It is also race/ethnicity. This finding could be inter-
that part of traditional African American unique because of its focus on identifying preted in a number of ways. One interpreta-
culture includes having a different con- motivators of and barriers to engaging in tion is that there are, in fact, only minimal
ceptualization of what is “overweight” or physical activity that are common across differences in motivators of and barriers to
“being too fat” than the perceptions held age groups (adolescents and adults) and/or physical activity in association with gender
by health care professionals, the majority race/ethnicity (African American, Hispanic or race/ethnicity. Alternatively, low socioeco-
of non-Hispanic Whites, and other ethnic and non-Hispanic White). nomic status may serve as an equalizer across
groups; and honoring and adhering to cul- It is also worth mentioning that this re- racial/ethnic groups; that is, the motivators
tural traditions (e.g., eating ethnic “soul” search sought to conduct the focus groups of and barriers to engaging in physical activ-
foods that are high in fat and/or sodium in a culturally sensitive manner so as to ity among adolescents and adults that are
and associating beauty with large body sizes) optimize conditions for comfortably disclos- associated with socioeconomic status may
that are antagonistic to weight-loss recom- ing motivators of and barriers to physical mask race/ethnicity- and gender-related dif-
mendations made by health care providers activity among focus group participants. ferences in these motivators and barriers.
in the United States.18 Specifically, the present focus group research The findings from the present research
Another noteworthy specific finding was designed such that: (1) the gender and must be viewed with caution given that the
is that Hispanic groups of all ages, but race/ethnicity of the focus group leaders, participants involved in the present research
especially adults, described living in the co-leaders and note-takers were the same as may not be representative of African Ameri-
United States (in comparison to living in that of the participants in the focus group can, Hispanic and/or non-Hispanic White
their respective countries of origin) as a they conducted, (2) focus group participants adolescents and adults with low family
barrier to engaging in physical activity. For who preferred to speak and read in Spanish incomes. Furthermore, the adolescent focus
example, they suggested that people in the were provided all materials in Spanish and group participants were much less verbal
United States, as compared to people in participated in focus group where the leaders than the adult focus group participants, and
their respective native countries, rely less on and other participants spoke Spanish, (3) the thus the responses of the adolescent partici-
walking, have less leisure time, and engage focus group sessions were conducted in a pants may be less inclusive than those of the
in fewer social events that involve physical community setting that was at a convenient adult participants. Additionally, given the
activity (e.g., dancing, soccer). Additionally, location for the focus group participants, non-representativeness of the participant
152 American Journal of Health Education — May/June 2009, Volume 40, No. 3
Marie A. Bragg, Carolyn M. Tucker, Lily B. Kaye, and Frederic Desmond
sample and group differences relative to fac- category of physical activity motivators and 2. U.S. Department of Health and Human
tors such as age, it is impossible to conclude barriers has to do with social influence (e.g., Services, Healthy People 2010: Understanding
that there are or are not race/ethnicity or from friends, parents, spouses and children), and Improving Health, 2nd ed. U.S. Government
gender differences in the physical activity it seems apparent that interventions to Printing Office, Washington D.C.; 2000.
motivators and barriers identified in the promote increased physical activity among 3. Strauss R, Pollack H. Epidemic increase in
present study. Finally, due to the nature culturally diverse youth and adults should be childhood overweight, 1986–1998. JAMA. 2001;
of the data collection process (i.e., focus family-focused and peer-focused and need 286:2845-2848.
groups), there is no way to determine why to address social influence motivators and 4. Wang S, brownell K. Obesity: Causes and
each specific focus group identified certain barriers. Nevertheless, although the most consequences. From Anderson N, eds. Encyclope-
motivators or barriers but did not mention common motivators and barriers identi- dia of Health & behavior. Thousand Oaks, CA:
others. For example, it is possible that the fied in the present study were similar across Sage Publications; 2004:627-629.
focus group questions that were asked or gender groups, age groups and racial/ethnic 5. Freedman, DS, Scrinivasan SR, Valdez RA,
the communication style of the focus group groups, further research is necessary to as- Williamson DF, berenson GS. Secular increases
leaders did not elicit certain motivators of sess whether or not interventions should be in relative weight and adiposity among children
and barriers to engaging in physical activity. tailored to any of these specific groups. relative weight and adiposity among children
Had participants been given an extensive Finally, since motivation is an important over two decades: The bogalusa Heart Study.
list of potential barriers to and motivators aspect in maintaining a routine of physical Pediatrics. 1997; 99:420-426.
of physical activity and asked to rate the activity over time, providing health educators 6. berkey CS, Rockett HR, Gillman MW, et
degree to which each item applied to them, with knowledge regarding the motivators of al. One-year changes in activity and in inactivity
observed group differences could have been and barriers to physical activity among low- among 10 to 15 year old boys and girls: Relation-
reported. Nevertheless, the overall sample income culturally diverse adolescents and ship to change in body mass index. Pediatrics.
size and diversity in this qualitative focus adults will likely increase the probability of 2003; 111:836-843.
group research are impressive relative to successfully assisting these individuals with 7. barlow S. Expert committee recommenda-
similar studies focusing on the influences of establishing healthy lifestyles. A focus on tions regarding the prevention, assessment, and
health promoting behaviors such as physi- increasing the motivators of and decreasing treatment of child and adolescent overweight
cal activity. the barriers to physical activity, particularly and obesity: Summary report. Pediatrics. 2007;
among racial/ethnic minorities with low 120:S164-S192.
TRANSLATION TO HEALTH incomes, will likely play a major role in 8. Hovell M, Mulvihill M, buono M, et al.
EDUCATION PRACTICE preventing and overcoming the mentally, Culturally tailored aerobic exercise intervention
The combination of a large number of physically and financially costly problems for low-income Latinas. Am J Health Promot.
discrete motivators of and barriers to physi- of overweight and obesity that plague the 2008; 22(3):155-163.
cal activity identified in the present research United States. 9. Pate RR, Long bJ, Heath GW. Descriptive
and the high degree of similarity between the epidemiology of physical activity in adolescents.
respective adolescent and adult focus groups ACKNOwLEDGEMENTS Pediatr Exerc Sci. 1994; 6:434-437.
in terms of the most commonly reported The present study is part of a larger, 10. Sallis JF, Patrick K, Frank E, Pratt M,
motivators and barriers suggest important multi-phase research project titled “The Wechsler H, Galuska DA. Interventions in health
implications for health education. First, in- Family Health Self-Empowerment Project care settings to promote healthful eating and
tervention programs and health education for Modifying and Preventing Obesity.” physical activity in children and adolescents. Prev
programs designed to increase physical ac- The research project is funded by a grant Med. 2000; 31:S112-S120.
tivity among adolescents and adults with low from the PepsiCo Foundation. The authors 11. Numark-Sztainer D, Croll J, Story M,
family incomes likely should include an as- would like to thank the research assistants Hannan P, French SA, Perry C . Ethnic/racial
sessment of physical activity motivators and and community research consultants who differences in weight-related concerns and be-
barriers, so that interventions and education contributed to this study. haviors among adolescent girls and boys: Find-
efforts to promote physical activity can be ings from Project EAT. J Psychosom Res. 2002;
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