Original Research: Physical Activity among Chinese American Immigrants with Prediabetes or Type 2 Diabetes

Background: Although the benefits of aerobic exercise and strength training for patients with type 2 diabetes have been studied extensively, research on physical activity among Chinese American immigrants diagnosed with prediabetes or type 2 diabetes has been limited. Purpose: We sought to learn more about this population's knowledge of physical activity, the types and intensity levels performed, and the barriers to such activity. Design and methods: A concurrent mixed-methods design was used. The short version of the International Physical Activity Questionnaire-Chinese was used to quantitatively measure participants' levels of exercise intensity. Semistructured face-to-face interviews were conducted to obtain qualitative information regarding participants' knowledge about physical activity, the types performed, and the barriers to such activity. Results: A total of 100 Chinese American immigrants were recruited for the study from January to July 2012 in New York City. On average, participants had lived with a diagnosis of prediabetes or type 2 diabetes for 3.3 years and had lived in the United States for 21.5 years. Energy expenditure was measured in metabolic equivalent of task (MET) units; intensity was measured in cumulative MET-minutes per week. The mean total intensity score was 2,744 MET-minutes per week. This was achieved mainly through walking. The mean intensity score for walking was 1,454 MET-minutes per week; the mean duration was 79 minutes per day. Vigorous physical activity was least common. The mean intensity score for vigorous physical activity was 399 MET-minutes per week, and the mean duration was 17 minutes per week. Regarding types of physical activity, the most common were housekeeping, walking up stairs, and taking walking or stretching breaks every hour during the workday. Based on the interviews, three themes emerged regarding barriers to moderate or vigorous physical activity: insufficient education about physical activity, health concerns about physical activity, and work-related barriers to physical activity. Conclusions: The majority of Chinese American immigrants with prediabetes or type 2 diabetes do not engage in sufficient physical activity, performing at a rate significantly below that of the general U.S. population. Increases in the intensity and duration of physical activity should be promoted as part of diabetes management for Chinese American immigrants.