Abstract 4141546: Acculturation Class Influences Physical Activity Among African Immigrants Living with Diabetes and/or Hypertension: A Qualitative Analysis

Background: Physical activity (PA) (e.g., walking) is critical for maintaining health, minimizing illness, and reducing mortality in adults living with diabetes and hypertension. Although acculturation may influence PA engagement, we know little about the PA of African immigrants who are more or less acculturated and factors perceived as barriers and facilitators to PA in this population. Methods: We conducted a descriptive qualitative study between March 2020 and September 2021 in the Northeastern U.S. We enrolled a purposive sample of 24 self-identified sub-Saharan African immigrant adults with symptomatic hypertension and/or diabetes. All spoke and understood English. Participants were classified as either high or low acculturated based on scores from a modified Short Acculturation Scale, reliability index (0.92), and validity index (0.65). Audio-recorded and transcribed interviews were imported to NVivo 13 and content analyzed to identify themes. Results: The sample was mean= 59 years (range 40-72). Most were Nigerian (n=16), male (n=16), married (n=17), living with family (n=21), highly educated (n=21), employed (n=16), and reported having enough to meet their needs (n=21). High acculturated participants were more (n=16). Both the high acculturated and low acculturated participants received information about PA from medical providers. Walking was the primary form of PA reported. Low acculturated participants walked with spouses/family members as is typically done back “home,” while high acculturated participants walked with friends/non-familial social connections, which is more Western. Although both groups used a treadmill or gym, only the high acculturated African immigrants had a gym membership. Family and friends facilitated PA; the high acculturated African immigrants were encouraged by friends to exercise, while the low acculturated stated that family motivated them to engage in PA. Arthritis, lack of enjoyment, mental stress, “laziness,” time, and neighborhood safety were barriers to engaging in PA. Conclusion: Interventions to promote PA should capitalize on socially relevant influences (e.g., family and friends) and address barriers to PA in immigrant populations.