The amount of research examining perceived physical activity barriers and enablers among older minorities has grown in recent years. This is a useful area of research because minorities will represent increasingly large proportions of adults age 65 and over in the United States. The purpose of this study is to examine perceived physical activity enablers and barriers among a diverse group of older adults and to explore racial/ethnic differences in these enablers and barriers. Data were from 42 focus groups conducted with African Americans, American Indians, Latinos, Chinese, Vietnamese, and non-Hispanic Whites (hereafter Whites). The findings can be used to inform the development of messages promoting physical activity among older adults, as well as physical activity programs designed specifically for older adults.
The sections that follow describe themes and subthemes identified in the focus group results, including racial/ethnic similarities and differences.
Physical Activity Barriers
No barriers to physical activity were mentioned in common across all racial/ethnic groups. Barriers discussed frequently by at least three racial or ethnic groups are described as follows.
Physical Health Problems
Health problems were the most commonly reported barriers in the African American, White, and American Indian groups. Health problems mentioned included heart problems, arthritis, back problems, incontinence, and functional limitations. Whites talked frequently about health problems in general, without referencing specific diseases. African American participants said that pain associated with health problems keeps them from being active.
Fear of Falling
Fear of falling was mentioned by African Americans, Whites, and American Indians as a barrier to physical activity.
Physical Activity as Inconvenient
Whites, American Indians, and Latinos said that physical activity was difficult or inconvenient to fit into their current lifestyles.
African Americans, Latinos, Whites, and American Indians mentioned the built environment as a barrier to physical activity, although these comments were most common among American Indians. Participants said they would like to walk for transportation and leisure but that their communities made this challenging.
Lack of Knowledge
More often than other racial/ethnic groups, American Indians said they lacked knowledge about types of physical activity they should engage in. Participants said they had access to exercise facilities and exercise equipment such as treadmills but that they were uncomfortable exercising without instruction and felt it was unsafe.
Financial cost was mentioned as a barrier only by African Americans. They said they wanted to be more active but that exercise groups and facilities were too expensive.
Additional barriers mentioned less frequently in various groups included lack of transportation to places where participants could be active, weather, lack of time, overdoing it, self-consciousness, and being too old.
Physical Activity Enablers
The most commonly reported enabler among all groups was the expectation of positive outcomes. Outcome expectations included both health benefits and a general sense of feeling better. Health benefits of physical activity were mentioned in every racial/ethnic group; all said physical activity improves brain health. Several African Americans and Whites said physical activity helps with blood circulation. Several African Americans, Whites, and American Indians said physical activity helps manage weight. Two of the American Indian groups focused primarily on physical activity as useful for weight loss. Additional health benefits mentioned less frequently included improvements with back problems, prevention of osteoporosis, and improved mental health. American Indians were more likely to report health benefits of physical activity than participants from other racial/ethnic groups. Several African American, White, and Chinese participants mentioned that physical activity helps people feel good or feel better, without mentioning a specific health condition. Participants said that physical activity helps them feel younger, have more energy, and become relaxed.
The value of social support was mentioned in the African American, Chinese, White, and American Indian groups. Participants emphasized that physical activity is more enjoyable when you have company.
Access to Physical Activity Facilities and Programs
African American, White, American Indian, Latino, and Chinese groups said that physical activity programs and facilities were important enablers. Several White, Chinese, and Latino participants mentioned senior centers as an enabler, with a Chinese participant emphasizing the importance of ethnic-specific senior centers. Whites, African Americans, and American Indians commented about the importance of physical activity programs specifically designed for older adults.
Additional enablers mentioned less frequently included seeing other people being active, having medical assistive devices, having a conducive built environment, low-cost activities, and education about physical activity.
The findings from this study provide a foundation for developing health communications to promote physical activity among older adults. For example, messages may be needed specifically for older adults who feel that they are too old to be active or that they cannot be active because they have a chronic condition. Messages targeting these groups could provide ideas for low-impact activities such as water aerobics and chair exercises. Messages could also include information about local community resources with free or low-cost exercise instruction designed specifically for older adults and/or for individuals in particular racial/ethnic groups. It may be useful for communication to promote activities preferred by particular racial/ethnic groups, such as yoga and Tai Chi for older Chinese and Vietnamese people.
While broader messages based on physical activity barriers mentioned by several groups could target multiple racial/ethnic groups (e.g., information about low-impact activities), messages targeted to specific groups based on racial/ethnic differences in perceived physical activity enablers and barriers may also be useful. When developing messages for specific racial/ethnic groups, cultural sensitivity and consideration of values and other characteristics of the population of focus are vital. Developing targeted messages based on racial/ethnic differences in physical activity barriers and enablers may enhance the cultural appropriateness and effectiveness of messages, as they are perceived based on the beliefs and experiences of the target population.
Our findings also suggest several implications for practice and policy. Participants mentioned several physical activity enablers that could help older adults continue to be active despite health problems. For example, they mentioned needs for physical activity programs designed specifically for older adults and low-impact exercises that would be easier on their joints, such as water aerobics. Several participants mentioned how assistive devices such as walkers and canes have enabled them to continue being active despite functional limitations. With medical issues continually reported in the literature as a major barrier to physical activity, it is useful for health professionals to take these suggestions into consideration when planning physical activity programs for older adults. Modified physical activity programs allowing older adults with functional limitations and disabilities to remain active can provide opportunities for improved quality of life, because physical activity plays a major role in improving functional ability in older adults.
Effectively promoting increased physical activity to multiple racial/ethnic groups is important. Even small increases in physical activity may improve health, delaying morbidity and mortality. There are differences by race/ethnicity in physical activity barriers and enablers. It is likely that there will also be differences in preferences for physical activity health-promotion messages and programs. When developing programs to promote cognitive health, public health professionals need to respond to the preferences of groups that identify themselves by race, ethnicity, or culture.
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