Dissertations, Theses, and Capstone Projects

Date of Degree

9-2023

Document Type

Dissertation

Degree Name

Ph.D.

Program

Psychology

Advisor

Tracey Revenson

Committee Members

Tyrel Starks

Cheryl Carmichael

Nadia Islam

Regina Miranda

Subject Categories

Behavioral Disciplines and Activities

Keywords

Physical activity, South Asian Americans, Cardiovascular Disease, Social Ecological Model, Culture, Family

Abstract

Cardiovascular disease (CVD), the number one cause of death in the U.S., disproportionately affects South Asian Americans (SAAs). Physical activity is a modifiable health behavior that can reduce cardiovascular risk. Health behaviors, such as physical activity, occur within specific social and cultural contexts and are influenced by multiple factors at multiple levels of the social ecological model. This dissertation aimed to provide a rich, culturally-informed understanding of the factors at multiple levels – individual, interpersonal, and cultural –associated with physical activity among SAAs at risk for CVD. A sequential exploratory mixed methods approach was employed to examine social and cultural factors that shape physical activity.

The first study (Study 1) was a secondary analysis of quantitative data from a randomized controlled trial of a community-level intervention designed to reduce CVD risk among SAAs with uncontrolled hypertension. The sample included 303 participants (M age 56.8 years, 54.1% female) who identified as SAA (60.3% born in Bangladesh, M years in the U.S. 13.7 years) and were at high risk for CVD (prevalence of hypertension at baseline: 86.6%). Regression analyses of data collected across three time points (baseline, three-month follow-up, and six-month follow-up) provided modest support for the proposed pathways from proxies of acculturation (an approximation for the process of cultural change) to moderate- to vigorous-intensity physical activity (MVPA) at the six-month follow-up, through mechanisms at the individual- and interpersonal-level.

The second study (Study 2) was a qualitative study of original data collected from semi-structured interviews with 10 SAA families (eight conducted in Bengali and two in English). The families described physical activity as any bodily movement, including both examples of planned (intentional) and unplanned (incidental) physical activity. Families generally felt encouraged to engage in physical activity, but also were met with barriers, including those that were culturally-specific (e.g., perceived sense of being watched and judged by the neighbors or members of the cultural community). Efforts to engage in physical activity were discussed in a collective manner; families described the ways in which their physical was connected to the health of their families and communities.

Taken together, findings from both studies suggest that a cultural approach to understand physical activity engagement among SAA populations at risk for CVD involves the consideration of social and cultural factors that may influence individual-level beliefs and behavioral outcomes.

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