The effects of a community-led physical activity intervention on physical performance of Bangladeshi women

Background: Bangladeshi (BD) women have the lowest rate of participation in the moderate-vigorous physical activity (PA) among ethnic minority communities in the UK. Low level of PA is linked with lower physical performance, higher prevalence of chronic conditions and poorer physical and mental health and well-being. No structured intervention study, grounded on theory and evidence to promote PA, has been conducted that particularly target BD women. The aim of this study is to evaluate the effects of a participant-led PA intervention on physical performance, other bio-psycho-social health risk factors and change in health behaviour.

Method: The intervention was designed and implemented by following the six steps of Intervention Mapping Protocol. Sixty-nine BD women (Age 18-46 years, Mean + SD = 34.24 + 6.5 years) took part in the intervention. Mixed method was adopted for data collection and analysis. Qualitative data were collected by conducting focus group discussion. Quantitative data were collected by conducting questionnaire survey and taking biological measures. Data were collected at baseline (T1), postintervention (T2) and eight months’ after the intervention (T3) to conduct the effect evaluation. Short Physical Performance Battery (SPPB) with its original and several modified versions were used to measure physical performance. Body mass index, waist circumference, waist to height ratio, arm fat index, saliva cortisol and C-reactive protein were the other selected biological risk factors. General Health Questionnaire was used to measure general mental well-being. International Physical Activity Questionnaire (short form) and accelerometers were used to assess the change in health behaviour. The process evaluation was conducted where both qualitative and quantitative data were collected by interviewing the participants and the facility providers mainly at post intervention. Thematic and content analysis were the main methods of interpreting qualitative data. A series of paired t-test and repeated measure ANOVA was used to analysis the change in health risk factors.

Results: The intervention had significant positive effect on improving physical performance. SPPB score was statistically significantly increased from T1 to T2 by 1.38 (95% CI, 0.83 to 1.93), p < .0005, and from T1 to T3 by 1.53 (95% CI, 1.00 to 2.06), p < .0005), but not from T2 to T3 by .16 (95% CI, - .04 to .36), p = .384. All versions of SPPB revealed this trend in change. The intervention had positive effects on BMI, waist circumference, arm circumference for a limited time and the intervention was beneficial for improvement of personal and social wellbeing. The intervention had effect in improving the social perception towards participation in PA. Self-reported change in behaviour related to PA had a significant increase from T2 to T1, but this was not supported by the data obtained from objectively measured PA. The intervention was effectively implemented, and it was adhered to and received positively by the young adults among Bangladeshi women.

Conclusion: BD women were found reachable and successfully engaged in a culturally appropriate PA intervention when the intervention was developed and implemented by using Intervention Mapping Protocol. The intervention had been useful for improving physical performance, other risk factors related to health and wellbeing and health behaviour to PA. The study exemplified future scope for developing interventions to promote PA in other communities with cultural reservations.