1. Exercising in a new home: The experiences of immigrant adults when starting an exercise program in Australia.
Lauren Banting
Institute of Sport, Exercise and Active Living (ISEAL): Victoria University

2. introduction
2006 Census
44% of Victorians were born overseas or have parents who were born overseas.
18% of Victorians were born overseas in a non-English speaking country.
20% of Victorians speak a language other than English at home.
Many immigrants to Australia are at a greater risk of developing chronic diseases (e.g. Type 2 diabetes) due to genetic and environmental factors.

3. Research questions
What are the barriers and facilitators of exercise for people from non-English speaking backgrounds and culturally diverse populations? Are these barriers similar or different to those commonly reported by the general population? Exercise programs targeted at immigrant and refugee populations typically cater to one specific cultural group. Is this the necessary or preferred design of exercise programs?

4. Study design
Online focus group n= 12 4 open ended questions with opportunity for discussion 6 Chinese (4 Mandarin speaking, 2 Cantonese), 3 Sudanese, 3 Iranian Semi-structured interviews n= 20 6 open ended questions with additional probing questions All responses transcribed verbatim and analysed using Nvivo 9. Various cultural groups (Chinese, Ethiopian, Sudanese, Syrian, Iranian, Afghani)

5. Barriers
“It is not always so easy to go to the gym or the pool or the class because I don’t know the people, and I, you know, worry that I misunderstand what to do... I like to have some friends maybe and then ahh, we can go together and help each other or all make the same mistakes!”
Chinese Female, 52
“I just don’t know what to do like, I see when I have gone all the women go here and the men go here. Or if I want an equipment, do I line or wait or ask? I don’t understand the patterns when you go” Sudanese Male, 39

6. Barriers
“I don’t want to go and fill in the forms because you know, my reading is not good and I can’t write in English. It take so long and everybody has to wait. Maybe if I could take paper home, my children can help me, nobody sees” Afghani Female, 46
“Always if they want the information I can’t remember it all. I don’t know my medicine information or my other information they might ask. It’s too much so I don’t go.” Ethiopian Female, 30
“The people there and the noise. It’s very hard for us to hear and listen so maybe that makes me not go. Maybe I say the wrong things or do the wrong things. One time I did mistakes at the soccer so I was very embarrassed so I never go again. I didn’t know the goals so I asked and the big umm, board showed the goals right there.”
Sudanese Male, 39

7. Barriers
“I don’t have time usually to do exercise. I don’t know, it’s hard to make time. Kids and the schools and getting enrolled, they have extra language classes and my husband is working in the nights too. I can’t drive so to take bus is getting too much. Maybe one hour, two hours just for exercise”. Sudanese Female, 36
“We still have the community meeting and the old ones need to be looked after. My parents are not here and so I take care of some old parents because their children aren’t here. You know, cook, clean, talking. So the day is very busy, and when the children come home, you know you do the same for them. So no time anywhere for these things [exercise]”. Etheopian Female, 30

8. Barriers
“I don’t know, you know, they try to do some walking thing, so free, but nobody goes. Like why? Why I want to walk around? Nothing to see, just go in a circle. Yaa, so why do I do this? I don’t”. Iranian Male, 59
“You know we see these women on the machines there [gym] and it’s funny, not even going anywhere. We laugh, what are they doing? So we watch them at the coffee place and just laugh. I don’t know why they go” Sudanese Female, 26
“I come to here because there is too much hard work in my country. I don’t come here to get tired, to get fatigued. I come here to be healthy, to feel calm and to enjoy life and be safe. I will not do that, umm, get heated and do running or walking.” Sudanese Male, 36

9. facilitators
The lady she told us that you know, to be careful with food, do some movement more, umm try to stay slim. So the mothers we go to the class, it’s nice. Share the car, our children play so it helps. See friends, do the fitness, the teacher she knows us now, so we’re friends too.
Sudanese Female, 26
“So my husband he takes me and collects me after. Takes care of the children while I do my exercise. I have to tell him that I need to be healthy and he understands and then can help.” Afghani Female, 46
“Before I thought I would be the only one from my country, but there are lots. It’s very good. I feel like you know, they understand. And they help explain the systems to me. So I don’t feel alone.”
Ethiopian female, 36

10. facilitators
I like when I know someone there, because you know, they could go and understand, and maybe help me. And I won’t be the only Sudanese. You know, I ask them how they like it, so I know I will like it. Mmm, I like when I know there is someone there I know.” Sudanese Male, 39
“We did a class with the people at the centre. It was good, you know, you come and go. Only give a coin, no forms, no nothing. You can bring your friends and then you can go every day or no days. Very easy”.
Ethiopian Female, 30
“I like when the class is in English, because I’m trying to learn. But when there are people there who speak like me it’s good, in case I can’t understand, someone can help me. But I like the English teachers.”
Sudanese Female, 26

11. facilitators
Sometimes, I like to meet new people, it’s nice to maybe have one friend but I like to learn the Australian exercises and meet new people. For my English it is good. I see some of the mothers from my children’s school so I say Hello.
Afghani Female, 46
“I find it a good way to meet the new people from my community or from the ahh, others. I don’t know really the reason for the exercises but I think the meeting people is good for me and my wife”.
Sudanese Male, 42

12. facilitators
“One time, it was every Wednesday and you have to go at this time. Umm, maybe Wednesday I am busy, so when do I go? I like the things I do on my own. Maybe with friends but when I like”.
Sudanese Female, 26
“When I have the choice to go, I like it. Because you know we have so many things we have to do- go for visas, go for interviews, go for this and umm, you know, go for see the officer. So if I need to go do exercising then it is not so fun.
Ethiopian Female, 30

13. summary
Barriers and facilitators are similar to those commonly identified by general population.
Social support and social interaction are good facilitators and motivators for exercise.
Programs may not need to be in English or culturally specific but having a friend from a similar background can be helpful.
Fear of not understanding the systems and exercise environment is a significant barrier. Providing tours, take-home paper work and information would be useful.

14. Exercising in a new home: The experiences of immigrant adults when starting an exercise program in Australia.
Lauren Banting, Remco Polman, Erika Borkoles & Hong Xu
Victoria University