Physical activity domains and their associations with psychosocial well-being and cardiometabolic outcomes among Ghanaians in Europe and Ghana: the RODAM study

Migrants in Europe report lower physical activity (PA), increasing chronic disease risk. Exercise programs show limited impact; targeting culturally familiar PA domains may be more effective. We compared PA domains (work, transport, recreational) between Ghanaians in Europe and Ghana and assessed associations with psychosocial well-being and cardiometabolic outcomes. Cross-sectional RODAM data included 2,397 Ghanaians in Europe and 2,363 in Ghana. PA was measured with GPAQ, psychosocial well-being with Interheart Study Psychosocial Stress Scale, and cardiometabolic outcomes by WHO criteria. Robust Poisson/Ordinal regressions, stratified by migrant status and adjusted for sociodemographic and lifestyle factors, were applied. In Ghana, 81% of PA came from work and 19% from transport, with negligible recreational PA. In Europe, work PA was 64%, transport PA was 31%, and recreational PA was 5%. In Ghana, higher work PA was linked to better psychosocial well-being (aOR = 0.950; 0.930–0.971), lower obesity (aPR = 0.969; 0.956–0.980), diabetes (aPR = 0.947; 0.913–0.983), and hypertension (aPR = 0.982; 0.965–0.999). No associations were found in Europe or transport/recreational PA. Ghanaians in Europe performed less work PA, potentially reducing work PA benefits seen in Ghana. Further studies are needed to guide culturally adapted interventions.