Understanding Native American Women's Views of Physical Activity to Inform Family-Based Program Development

Introduction

The recommended physical activity guidelines for adults in the U. S. is 30 minutes or more of moderate physical activity, 5 or more days per week, or 20 minutes or more of vigorous physical activity, 3 or more days per week. In 2009, 47.1% of adults in Oklahoma reported following the recommended physical activity guidelines, compared to 51.0% of U. S. adults (BRFSS, 2009). In general, most Americans do not get the physical activity needed to promote optimal health, and both state and national rates are in need of improvement.

Physical activity levels have declined more drastically among Native Americans over the last several decades with the adoption of more sedentary lifestyles and occupations (IHS, 2000). Native Americans often experience a variety of barriers to physical activity related to economic status, education, personal traits, social support, environmental situation, and age (Coble & Rhodes, 2006). It is important for educators to understand what types of physical activity Native American participants are willing to do as well as benefits and barriers to engaging in physical activity.

Telephone Interviews

Telephone interviews are time and cost efficient and can be used to assess needs (Kempf & Remington, 2007; Lavrakas, 1993). A telephone interview was administered to participants eligible to receive Food Distribution Program on Indian Reservations (FDPIR) or Supplemental Nutrition Assistance Program (SNAP) benefits to determine family preferences for daily physical activity among limited resource Native American women in Oklahoma. To participate in the telephone interview, women were required to have at least one child living in the household who was less than 18 years of age, because the findings were to be used to inform the development of family-based nutrition and physical activity programs.

A semi-structured script was developed to identify product and price social marketing principles related to physical activity perceptions. The social marketing principles of product and price were defined in terms of physical activity as a family and the benefits and barriers associated with incorporating more physical activity, respectively.

Participants were asked the following questions:

1. What do you and your family do for fun? (To identify physical activity product.)
2. What physical activities would you be willing to do with your family? (To identify physical activity product.)
3. If you do not do these activities now, how do you think you could do these with your family? (To identify price of engaging in physical activity.)

Telephone interviews were audio-recorded and transcribed verbatim. Transcripts were analyzed using thematic content analysis (Charmaz, 2006). Findings from interviews with 21 participants are presented.

 Findings

To identify opportunities for addressing physical activity, participants were asked to describe what they did with their family for fun. The most common physical activities described included outdoor recreation activities, outdoor play activities, and sports. Outdoor recreation activities required participants to travel to a location outside of their home or neighborhood and included going to the park, camping, fishing, and other recreational activities performed outdoors.

Outdoor play was the second most common type of physical activity mentioned. Outdoor play included activities that could be performed at home or in the neighborhood, with the most common including riding bikes or throwing a ball around outdoors. Sport-type activities were the next most frequently reported and included basketball, baseball, or softball. Participants primarily described organized sports as activities in which their children participated and not activities in which they personally participated. Participants also reported engaging in sedentary activities for enjoyment, which included reading, going to the movies, or watching television.

To probe further about physical activity preferences, participants were asked what activities they would be willing to do with their families. Themes that emerged were similar to those participants reported they were currently doing for fun. Outdoor play, including riding bicycles and playing outside, and outdoor recreation activities like going to the park ranked highest. Playing sports and walking were also mentioned as something participants would be willing to do with their family.

Participants reported a benefit of being active as a family was that it provided time to be with family members. An additional benefit for the incorporation of physical activity was that participants and their children often enjoyed the activities mentioned. More barriers than benefits were discussed in terms of incorporating physical activity. The perception of already having an active lifestyle was the primary barrier expressed by participants. Participants also conveyed lack of time as a barrier for engaging in physical activity.

Implications

These findings can be used as a basis for understanding Native American preferences for physical activity. Extension educators might consider developing family-based programming that allows family members to attend together and spend time as a family unit. Additionally, identifying and incorporating various types of games into curriculum, similar to what participants and their children already do, is recommended. Extension educators could identify places where participants commonly gather with their families for activities and offer programs at these sites. Providing education at organized sporting events where parents observe their children may be an opportunity to disseminate information.

To overcome barriers associated with physical activity, an asset-based approach focusing on the benefits of physical activity for family well-being is recommended. Programs could emphasize small steps to improved health and provide suggestions like household chores, yard work, or dancing as ways to increase physical activity (Rice, 2007). Developing activities that work within current lifestyle patterns and do not call for the addition of another activity into already busy and time-constrained lifestyles is recommended. Partnering with pre-formed groups like WIC, Head Start, EFNEP, or SNAP-Ed to offer programs is an important strategy to overcome time constraints (Benavente, Jayaratne, & Jones, 2009).

Alves reported that "working with Native American audiences or any culturally diverse group means Extension educators must adapt their traditional methods for reaching traditional audiences" (Alves, 1993). As Extension audiences become increasingly diverse, it is important for educators to develop culturally appropriate programs by partnering with individual Indian Nations to develop culturally relevant approaches such as organized games and activities.

References

Alves, J. L., (1993). Reaching Native Americans. Journal of Extension [On-line], 31(1) Article 1FEA7. Available at: https://www.joe.org/joe/1993spring/a7.php

Benavente, L. M., Jayaratne, K. S. U., & Jones, L. (2009). Challenges, alternatives, and educational strategies in reaching limited income audiences. Journal of Extension [On-line], 47(6) Article 6RIB2. Available at: https://www.joe.org/joe/2009december/rb2.php

Centers for Disease Control and Prevention (CDC). (2009). Behavioral risk factor surveillance system survey data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Retrieved from: http://apps.nccd.cdc.gov/BRFSS/

Charmaz, K., (2006). Constructing grounded theory. Thousand Oaks, CA: Sage Publications.

Coble, J. D., & Rhodes, R. E. (2006). Physical activity and Native Americans: A Review. American Journal of Preventative Medicine. 31(1): 36-46.

Indian Health Service (IHS). (2000). Trends in Indian health 1998-1999. Rockville, MD: U.S. Department of Health and Human Services, Indian Health Service. Retrieved from: http://www.ihs.gov/publicinfo/publications/trends98/trends98.asp

Kempf, A. M., & Remington, P. L., (2007). New challenges for telephone survey research in the twenty-first century. Annual Review Public Health. 28: 113-126.

Lavrakas, P. J., (1993). Telephone survey methods: Sampling, selection, and supervision. Newbury Park, CA: Sage Publications.

Rice, L. L. (2007). Physical activity programming for limited resource audiences: Get Moving Kentucky! Journal of Extension [On-line], 45(1) Article 1IAW4. Available at: https://www.joe.org/joe/2007february/iw4.php