Barriers and facilitators to physical activity amongst overweight and obese women in the Caribbean: a qualitative study

ABSTRACT

OBJECTIVE: To identify modifiable barriers to physical activity and to explore factors that facilitate physical activity among overweight and obese women in Barbados. DESIGN AND METHODS: Seventeen women aged 25 to 35 years with a body mass index (BMI) ≥25, purposefully sampled from a population-based cross-sectional study, were recruited to participate in in-depth semi-structured interviews. Twelve women participated in one or more additional ethnographic sessions in which the researcher joined and observed a routine activity chosen by the participant. More than 50 hours of ethnographic data collection were accumulated and documented in field notes. Thematic content analysis was performed on transcribed interviews and field notes. RESULTS: Social, health-related, and structural barriers to physical activity were identified. Social factors related to gender norms and expectations. Women tended to be active with their female friends rather than partners or male peers, and reported peer support but also alienation. Being active also competed with family responsibilities and expectations. Health-related barriers included perceptions about chronic disease and competing strategies for weight loss. Structural barriers included few opportunities for active commuting, limited indoor space for exercise in the home, and low perceived access to convenient and affordable exercise classes. Several successful strategies associated with sustained activity were observed, including walking and highly social, low-cost exercise groups. CONCLUSIONS: This study highlights the role that gender norms and health beliefs play in shaping experiences of physical activity. Affordable and accessible group exercise classes are feasible within a Caribbean context and successful models have the potential to be replicated.