A Longitudinal Qualitative Analysis Exploring Hispanic/Latino and Somali Immigrant Health Promoters' Perspectives on a Social Network Intervention to Address Cardiovascular Disease Disparities
Evidence-based health promotion programs are commonly assessed within research environments, yet there is a critical need to understand how to implement interventions across multiple settings, prioritizing populations who are underserved and under-resourced. A possible approach involves leveraging established social networks to enhance health outcomes. Within these networks, influential individuals, known as health promoters (HPs), play a key role in disseminating health information. The Rochester Healthy Community Partnership created a social network–based intervention called Healthy Immigrant Community (HIC), utilizing HPs to encourage healthy eating and physical activity to address cardiovascular disease outcomes among Hispanic/Latino and Somali immigrant populations. We conducted three focus groups pre-, mid-, and post intervention (nine groups total; n = 30) to understand HPs’ motivations for participating, implementation barriers and facilitators they faced, and suggestions for improvement.
BMC Public Health 2025
RHCP worked with Hispanic/Latino and Somali immigrant leaders to implement a social network–based health program called Healthy Immigrant Community (HIC). Health promoters (HPs) led sessions focused on improving diet and physical activity to reduce heart disease risk. Over time, HPs shifted their focus from weight loss to broader goals like overall health and community well-being. They gained leadership skills, built stronger social ties, and made lasting lifestyle changes. The program’s success was supported by peer motivation, culturally relevant materials, and strong relationships with health coaches.
Despite these gains, HPs faced barriers at multiple levels. Challenges included limited access to affordable gyms, high food costs, racism, and cultural differences in health beliefs. Somali participants highlighted safety concerns and the need for private exercise spaces for women. HPs suggested improvements like ongoing support, better access to resources, and reframing the program to emphasize health rather than weight loss. Their feedback helped shape future plans for HIC and informed broader efforts to reduce health disparities through community-driven, culturally tailored interventions.
Body Size Perceptions Associated with Body Mass Index and Weight Loss Intentions Among Two Immigrant Populations
The rates of obesity among immigrant populations within the USA rise with increasing duration of residency. The aims of this study were to examine weight self-perception and body image discrepancy within a large community sample of Hispanic and Somali predominantly immigrant adults.
Journal of Radical and Ethnic Health Disparities Jun 2025
RHCP surveyed over 1,200 Hispanic and Somali immigrant adults in Southeast Minnesota to better understand how people perceive their own body size and weight, and how those perceptions relate to their intentions to lose weight. While many participants had a body mass index (BMI) in the overweight or obese range, fewer identified themselves as such. However, when asked to choose images that represented their body size, responses were more closely aligned with actual BMI. This suggests that visual tools may be more accurate than verbal categories for self-assessment. Among Hispanic participants, those who saw themselves as overweight or had a larger gap between their perceived and ideal body size were more likely to say they intended to lose weight.
For Somali participants, the strongest link to weight loss intentions was body image discrepancy—how much heavier they saw themselves compared to their ideal. Actual BMI alone didn’t predict whether someone wanted to lose weight. These findings highlight the importance of understanding cultural and psychological factors in health behavior. They also suggest that using visual scales and exploring body image may be more effective than relying on BMI or verbal self-assessments when designing health interventions for immigrant communities.
Evaluation of a Photovoice Exhibit About Immigrant Health Priorities in Southeast Minnesota
Rochester Healthy Community Partnership, a 20-year community based participatory research partnership, used photovoice to learn about Hispanic/Latino and Somali immigrants’ health concerns. Participants photographed their health-related priorities, reflected, developed policy recommendations, and shared photographs at a public event and rotating exhibit in 2024. More than 100 people attended the event (19 decision makers, 64 members of the public, 11 immigrant leader participants, 11 research staff). All decision-maker and public survey respondents reported learning something new about the priorities of Hispanic/Latino and Somali immigrants.
American Journal of Public Health Feb 2025
RHCP collaborated with Hispanic/Latino and Somali immigrant leaders in Southeast Minnesota to create a photovoice exhibit that highlighted community health priorities. Participants took photos representing their concerns, discussed themes, and developed policy recommendations. These were shared at a public event and a rotating exhibit in 2024, reaching over 100 attendees including decision-makers, community members, and researchers. The exhibit aimed to raise awareness, foster dialogue, and promote advocacy by showcasing lived experiences and community assets through visual storytelling.
Survey results showed that nearly all attendees learned something new and felt more connected to immigrant communities. Immigrant leaders valued the opportunity to share their perspectives, while decision-makers appreciated the insights and recommendations. Public respondents expressed empathy and a desire for policy change, with many reporting a sense of “linked fate”—the idea that immigrant well-being affects the broader community. The project demonstrated that photovoice can be a powerful tool for education, connection, and advocacy, though future efforts are needed to assess long-term impact and support sustained civic engagement.
Negative Mood is Associated with Sociobehavioral Factors Contributing to Cardiovascular Risk in an Immigrant Population
After settling in the United States (US), immigrants often accumulate obesity and cardiovascular risk factors. As mood is often associated with health behaviors in the US population, mood may be an important mediating factor in immigrant populations.
BMC Public Health Jul 2024
Among Hispanic/Latino and Somali immigrants in southeast Minnesota, those who reported feeling down or in a negative mood were more likely to face challenges with healthy eating, physical activity, and feeling connected to their communities. These individuals tended to eat fewer fruits and vegetables, drink more sugary beverages, and had lower confidence in their ability to maintain a healthy diet and exercise regularly. They also received less encouragement from family and friends to engage in healthy behaviors and were less likely to access community resources that support nutrition and physical activity.
The RHCP-led weight loss program, which uses social networks to promote healthier lifestyles, found that mood plays a key role in shaping health behaviors. Participants with a negative mood were more likely to feel isolated and less supported, which may contribute to higher cardiovascular risk. These findings suggest that addressing emotional well-being and building self-confidence could strengthen health interventions in immigrant communities. Incorporating strategies that boost mood and social support may help improve outcomes and reduce health disparities.
Healthy Immigrant Community Study Protocol: A Randomized Controlled Trial of a Social Network Intervention for Cardiovascular Risk Reduction Among Hispanic and Somali Adults
Evidence-based health promotion programs in group settings have been shown to be effective at improving health behaviors in general populations, [7] but despite calls for interventions to address obesity and health behaviors among immigrant populations, [8] few intervention studies have been reported. [9]
Contemporary Clinical Field Trials Feb 2024
The Healthy Immigrant Community (HIC) project is a community-driven health initiative developed by RHCP to reduce cardiovascular risks among Hispanic and Somali adults in Minnesota. The program uses a social network approach, where trained health promoters from each community lead group sessions focused on improving diet, physical activity, and overall wellness. These sessions include goal setting, food and activity tracking, and culturally tailored education. Participants are recruited through trusted social connections, and the intervention is delivered in two phases: an initial six-month program followed by a six-month maintenance phase. The study uses a stepped wedge randomized design to compare outcomes like BMI, blood pressure, cholesterol, and glucose levels across time.
The project builds on years of collaboration and research within immigrant communities, recognizing that social ties and cultural relevance are key to promoting lasting health changes. Early results show strong engagement, with 475 participants enrolled and a majority classified as obese at baseline. The intervention is designed to be flexible, scalable, and sustainable, leveraging peer support and community resources. While challenges like treatment fidelity and indirect influence on control groups exist, the approach offers a promising model for addressing health disparities through culturally grounded, community-led strategies.
Pilot Social Network Weight Loss Intervention With Two Immigrant Populations During the COVID-19 Pandemic
Immigrants often arrive to the United States (US) at a healthier weight compared to the general US population, but these healthy weight advantages disappear over time, and the rates of obesity, with associated complications, rise.
American Journal of Health Promotion 2022
During the COVID-19 pandemic, RHCP piloted a weight loss program for Somali and Hispanic immigrant communities in southeastern Minnesota. Lay health promoters from each community led small social network groups through a 12-week intervention focused on improving diet, physical activity, and overall health. The program began with in-person sessions but quickly shifted to virtual formats due to pandemic restrictions. Despite the change, all 39 participants completed the program, showing strong engagement and trust in their group leaders. Participants reported feeling more motivated and confident in making healthy choices, and they appreciated the culturally tailored support and peer accountability.
The intervention led to measurable health improvements, including weight loss, lower blood pressure, and better cholesterol levels. Participants also increased their intake of fruits and vegetables and doubled their physical activity. Focus groups revealed that shared language, cultural understanding, and strong social connections were key to the program’s success. Challenges included time constraints, cultural expectations around food, and adapting to virtual formats. Still, the program’s flexibility and emphasis on social support helped overcome these barriers. The pilot suggests that using trusted community members to lead health interventions within existing social networks is a promising strategy for promoting wellness in immigrant populations.
Lay Health Worker as Interventionist Training: Reflective Writing in US Family Health Promotion Practice.
Lay health worker-led health promotion interventions are well received within racial and ethnic minority communities. Increasing numbers of trained lay health workers will be needed to meet global health goals.
Health Promotion International Feb 2021
Lay health workers from immigrant and refugee communities in Rochester were trained to deliver a family-based nutrition and physical activity program through RHCP. These Family Health Promoters (FHPs) worked directly with families to set small, meaningful health goals, adapting their approach to each family's unique needs and circumstances. Their reflections showed that they used motivational interviewing techniques, respected cultural differences, and tailored lesson content to fit real-life situations. The intervention emphasized building trust and supporting behavior change through flexible, family-centered communication.
As the FHPs gained experience, they reported personal growth and a deeper connection to their work. They became more confident, patient, and emotionally invested in helping families improve their health. Their reflections revealed that the relationships they built were central to their success and transformation. This process evaluation highlights how real-time reflective writing can enhance training and support for lay health workers, offering valuable insights for future health promotion programs in diverse communities.
Healthy Eating in a Boys and Girls Club Afterschool Programme: Barriers, Facilitators, and Opportunities
Obesity and poor dietary habits are a significant health problem for children from economically and socially disadvantaged backgrounds. In the USA, children from minority and low-income backgrounds face substantially greater environmental challenges to engage in healthy eating and other health behaviors to maintain a healthy weight.
Health Education Journal Jul 2020
Children at the Boys & Girls Club in Rochester face significant challenges to healthy eating, with nearly half classified as overweight or obese and many falling short of basic nutrition guidelines. Through RHCP’s Club Fit initiative, youth, staff, and caregivers shared insights into barriers like limited access to fresh food, time constraints, and the appeal of junk food. Members described how stress, boredom, and lack of knowledge influenced their choices, while staff and caregivers pointed to affordability and availability issues. Despite these challenges, all groups expressed strong interest in promoting healthier habits and identified opportunities for change within the Club environment.
Suggestions from participants emphasized the importance of adult role modeling, structured nutrition programs, and engaging activities like gardening and cooking. Members wanted more variety and better presentation of healthy foods, while caregivers asked for practical support like recipes and communication about Club meals. Staff highlighted the need for resources and training to support nutrition education and family engagement. Together, these perspectives support a multi-layered approach to improving dietary habits, combining individual education, supportive relationships, and environmental changes to address health disparities among underserved youth.
Club Fit: Development of a Physical Activity and Healthy Eating Intervention at a Boys & Girls Club After School Program
The childhood obesity epidemic includes well documented health and psychosocial comorbidities that affect 17% of children in the United States. Previous research has demonstrated that children and adolescents from minority and low income backgrounds face substantially greater social and environmental challenges to engage in physical activity and healthy eating to maintain a healthy weight.
Journal of Primary Prevention. 2020 Apr;41(2):153-170
Background: The childhood obesity epidemic includes well documented health and psychosocial comorbidities that affect 17% of children in the United States (Ogden, Carroll, Kit, & Flegal, 2012). Previous research has demonstrated that children and adolescents from minority and low income backgrounds face substantially greater social and environmental challenges to engage in physical activity and healthy eating to maintain a healthy weight (Miech et al., 2006). Low levels of physical activity, high levels of sedentary behavior and poor dietary quality are the primary drivers of childhood obesity, and these behaviors are more prevalent among youth from low income and underserved families.
Methods: The study was part of Club Fit, a collaboration of Boys & Girls Club of Rochester, MN, (BGCR) and the Rochester Healthy Community Partnership (RHCP). BGCR is a community organization that offers after-school programs for youth. Its health promotion programs are designed to demonstrate and promote healthy eating and physical activity among youth. BGCR is particularly well-positioned to address health disparities in the community related to nutrition, physical activity, and risk for childhood obesity, as it serves a diverse population of children with large representation of youth from low-income backgrounds; 73% of BGCR members receive free or reduced meals at school, and 41% live in single-parent homes. The mission of RHCP is ‘to promote health and wellbeing among the Rochester community through CBPR, education, and civic engagement to achieve health for all’ (www.roche sterh ealth y.org). RHCP has 12 years of experience implementing and evaluating theorydriven community-based interventions, including work aimed at obesity prevention (Wieland et al., 2016).
Results: The mean age of participants was 10.4 years, and the majority of participants were female (69%), not White (66%), and overweight or obese (52%). Of the 61 participants, only 9 were older than 12 years, and their attendance at Club Fit Huddles was considerably lower than for participants ages 8–12 (mean 5.3 ± 1.8 vs. 9 ± 5.2; p = 0.08). There were statistically significant improvements in self-efficacy and motivation for physical activity from baseline to 6 months and nonsignificant improvements for fruit and vegetable consumption, sugary beverage consumption, and screen time. There were no improvements in social support, physical activity, dietary quality, or BMI z score. Results of univariate analyses did not find significant differences by age, ethnicity, or sex. The mean (SD) attendance at Club Fit Huddles was 8.1 (4.9) sessions out of 32 total Huddles. The mean attendance at Club Fit Huddles and Fitness Challenge was 12.8 (7.5) sessions out of 46 total opportunities. There was a statistically significant correlation between increased Huddle attendance and decreased BMI z score.
Conclusion: Club Fit is a childhood obesity prevention initiative that promotes physical activity and healthy eating at a Boys & Girls Club after-school program. Results of this pilot study indicated that while there were no differences in nutrition outcomes, the intervention was associated with improved self-efficacy and motivational level for physical activity and that increased attendance in Club Fit programming was correlated with decreased BMI z scores. According to these promising preliminary data and the revisions to the intervention components that were informed by the pilot, this intervention warrants testing through a controlled experiment with other after-school programs. Processes and products from this study may be helpful to other communities aiming to address childhood obesity prevention through after-school programs.
Association of Social Network Factors With Weight Status and Weight Loss Intentions Among Hispanic Adults
In the midst of a well-documented obesity epidemic in the United States, Hispanic adults are 1.2 times more likely to be obese than non-Hispanic whites, representing the highest age-adjusted obesity prevalence in the country.
Journal of Behavioral Medicine Jun 2019
RHCP surveyed 610 Hispanic adults in Rochester, Minnesota to understand how friends and family influence weight and health habits. They found that people who were overweight or obese often had social circles with similar weight issues. However, it wasn’t just who people knew—it was how those relationships worked. Supportive friends and family who encouraged healthy eating and weight loss made a big difference. People who felt their social circles were trying to lose weight were much more likely to want to lose weight themselves.
The study showed that encouragement, shared goals, and strong social bonds mattered more than the number of people in someone’s network. When participants felt supported and saw others around them making healthy changes, they were more motivated to do the same. These findings suggest that health programs for Hispanic communities could be more effective if they focus on building supportive social environments that promote healthy habits and weight loss.
Social Networks and Obesity Among Somali Immigrants and Refugees
Somali immigrants and refugees to the United States are at high risk for obesity and related cardiovascular risk. Social network factors influence health behaviors and are important contributors to the obesity epidemic.
BMC Public Health Feb 2020
A community-based participatory research project led by RHCP examined the relationship between social networks and obesity among Somali immigrants and refugees in Rochester, Minnesota. Survey and biometric data from 646 participants revealed that half were overweight or obese, and those with higher BMI tended to have more overweight individuals in their social networks. This clustering was especially pronounced among men and adults aged 50 and older. Participants who intended to lose weight were more likely to report supportive social norms, higher social cohesion, and encouragement from family and friends. Functional network factors—such as social support for healthy eating and norms favoring weight loss—were positively associated with weight loss intentions.
The study found that social networks among Somali immigrants are distinct and influential in shaping health behaviors, particularly around obesity and weight loss. While structural network characteristics like network size did not mediate weight status, functional aspects such as social norms and support played a significant role. These findings suggest that a social network intervention targeting weight loss, grounded in CBPR principles, is feasible and potentially effective for this population. The research highlights the importance of leveraging community ties and culturally relevant strategies to address obesity and promote healthier lifestyles in immigrant communities.
Identifying Opportunities to Promote Physical Activity in a Diverse Low-Income Population: A Mixed-Method Study at a Boys & Girls Club Site
Prevalence and consequences of obesity and sedentary lifestyle are well-documented public health concerns for youth in the United State of America (USA) that disproportionally affect children from low income and minority families.
Journal of Research and Practice in Children's Services: Child & Youth Care Forum Sept 2019
A mixed-method study conducted through RHCP and the Boys & Girls Club of Rochester (BGCR) explored physical activity engagement among children from diverse, low-income backgrounds. Quantitative data showed that while most children met physical activity guidelines, nearly half were overweight or obese and fewer than half met screen time recommendations. Focus groups with youth, staff, and caregivers revealed that environmental barriers—such as lack of equipment, staffing, and safe spaces—along with interpersonal and intrapersonal challenges like fear of judgment and competing responsibilities, limited physical activity. Facilitators included social support, adult modeling, structured activities, and access to outdoor spaces and equipment.
Stakeholders recommended enhancing physical activity through competitions, incentives, staff training, and increased family engagement. Caregivers expressed interest in supporting BGCR’s efforts but cited time and resource constraints. Staff emphasized the need for a community-wide vision for youth health and better infrastructure. The study highlighted the relevance of CBPR in designing interventions that address health disparities and suggested that afterschool programs like BGCR are promising venues for promoting physical activity. A hybrid model involving staff, peers, and caregivers may be more feasible and effective than traditional family-based interventions, especially for underserved populations.
Healthy Immigrant Families: Randomized Controlled Trial of a Family-Based Nutrition and Physical Activity Intervention
Populations that immigrate to high-income nations generally have less healthy behaviors than the nonimmigrant majority populations.
American Journal of Health Promotion 2018
RHCP’s Healthy Immigrant Families study was a randomized controlled trial designed to improve dietary quality and physical activity among Hispanic, Somali, and Sudanese immigrant families in Rochester, Minnesota. Using a CBPR approach, community and academic partners co-developed a 12-module intervention delivered by trained, language-congruent Family Health Promoters through home visits and follow-up calls. The intervention emphasized culturally relevant strategies, family engagement, and behavior change principles rooted in social cognitive theory. At 12 and 24 months, adults in the intervention group showed significant and sustained improvements in dietary quality, particularly in reducing empty calories and increasing intake of greens and beans. However, no significant changes were observed in physical activity levels or biometric outcomes such as BMI and blood pressure.
Adolescents did not experience sustained improvements in dietary or physical activity outcomes, likely due to inconsistent participation and competing commitments. Despite high baseline physical activity levels, which may have created a ceiling effect, the intervention did not significantly impact activity patterns. The study demonstrated strong treatment fidelity, high adherence, and successful community-led recruitment and retention, validating the feasibility of conducting rigorous trials in immigrant populations. RHCP’s participatory model highlights the importance of culturally tailored, family-centered interventions and suggests that future efforts should include more targeted strategies for adolescent engagement and potentially integrate weight loss components for adults.
Relationship Between Negative Mood and Health Behaviors in an Immigrant and Refugee Population
Immigrants experience an escalation of negative health behaviors after arrival to the United States.
Journal of Immigrant and Minority Health Sept 2016
Baseline data from RHCP’s Healthy Immigrant Families project revealed a strong link between mood and health behaviors among immigrant and refugee adolescents and adults in Rochester, Minnesota. Adolescents with positive mood were significantly more active, consumed less soda, and reported greater social support for physical activity. Adults with positive mood showed higher self-efficacy for physical activity, snacked more frequently on fruits and vegetables, and rated their physical well-being more positively. These findings suggest that mood may influence both motivation and engagement in healthy behaviors, with social support and self-confidence acting as key mediators.
The study highlights the importance of integrating mood assessment and management into health interventions targeting immigrant populations. While physical activity levels among adults did not differ significantly by mood, their confidence and perceived well-being did, indicating potential for future behavior change. The results underscore the need for culturally tailored, community-based programs that address emotional health alongside nutrition and physical activity. RHCP’s CBPR approach, which emphasized trust, cultural relevance, and community ownership, provides a promising model for addressing health disparities in immigrant and refugee communities.
Treatment Fidelity Among Family Health Promoters Delivering a Physical Activity and Nutrition Intervention to Immigrant and Refugee Families
Lack of treatment fidelity can be an important source of variation affecting the credibility and utility of outcomes from behavioral intervention research.
Health Education & Behavior Jun 2016
RHCP implemented a culturally tailored physical activity and nutrition intervention for Hispanic, Somali, and Sudanese immigrant and refugee families in Rochester, Minnesota, using a CBPR approach. Family Health Promoters (FHPs) from each community delivered 12 modules through home visits and follow-up calls, focusing on behavior change strategies grounded in social cognitive theory and motivational interviewing. The intervention emphasized family engagement, cultural relevance, and flexibility, with sessions conducted in participants’ native languages and adapted to their schedules. Fidelity was monitored across five domains—design, training, delivery, receipt, and enactment—using standardized manuals, structured training, session checklists, and follow-up assessments.
Despite challenges such as language barriers, scheduling conflicts, and limitations in recording sessions, RHCP maintained high treatment fidelity through rigorous training, supervision, and community involvement. FHPs demonstrated strong adherence to protocols, with over 97% of sessions documented and an average adherence rate of 84.3%. The participatory development and delivery of the intervention fostered trust and cultural sensitivity, while fidelity monitoring ensured consistent implementation and allowed for real-time adjustments. This model highlights the importance of integrating community expertise into intervention design and fidelity planning to enhance effectiveness and sustainability in underserved populations.
Healthy Immigrant Families: Participatory Development and Baseline Characteristics of a Community-Based Physical Activity and Nutrition Intervention
US immigrants often have escalating cardiovascular risk. Barriers to optimal physical activity and diet have a significant role in this risk accumulation.
Contemporary Clinical Trials Dec 2015
RHCP developed and tested a culturally tailored physical activity and nutrition intervention for immigrant and refugee families in Rochester, Minnesota, using a community-based participatory research (CBPR) approach. The intervention was co-created by academic and community partners from Hispanic, Somali, and Sudanese backgrounds and delivered by trained bilingual Family Health Promoters (FHPs) through home visits and follow-up calls. The program included 12 modules covering physical activity, nutrition, and behavior change strategies grounded in social cognitive theory. Baseline data showed that while participants engaged in moderate levels of physical activity and had relatively high fruit and vegetable intake, most were overweight or obese and did not meet dietary guidelines.
The intervention design emphasized community ownership, cultural relevance, and family engagement. Focus groups revealed that shared immigration experiences shaped health behaviors more than cultural differences, and social support was a key motivator for change. Recruitment and implementation were led by community partners, resulting in high participation and trust. The randomized trial design included a delayed-intervention control group, with measurements taken at multiple time points. RHCP’s approach demonstrates the feasibility and impact of participatory, family-focused interventions in addressing cardiovascular risk and promoting health equity among immigrant populations.
A Focus Group Study of Healthy Eating Knowledge, Practices, and Barriers among Adult and Adolescent Immigrants and Refugees in the United States
Immigrants and refugees to the United States exhibit lower dietary quality than the general population, but reasons for this disparity are poorly understood.
International Journal of Behavioral Nutrition and Physical Activity 2014
This qualitative study examines how adult and adolescent immigrants and refugees from Somali, Mexican, Cambodian, and Sudanese communities in Minnesota understand and practice healthy eating. Using a community-based participatory research approach, researchers conducted 16 focus groups to explore participants’ knowledge, eating habits, and barriers to healthy eating. Across all groups, participants recognized the importance of balanced meals and avoiding processed and fatty foods, but they also faced significant challenges such as cravings, time constraints, financial limitations, and cultural traditions. Generational differences emerged, with adolescents often more aware of healthy eating guidelines but constrained by family norms and limited autonomy in food choices.
The study found that acculturation influences dietary patterns in complex ways, with both adults and youth adopting aspects of American food culture—often less healthy—while retaining traditional practices. Structural barriers like cost and time, along with cultural expectations and family dynamics, were key obstacles to healthier eating. Participants expressed a strong desire for family-based and community-level interventions, including education on preparing healthier traditional meals and promoting dietary change through culturally sensitive outreach. The findings suggest that effective health promotion strategies must address intergenerational differences and the broader social context shaping immigrant families’ food choices.
Perspectives on Physical Activity Among Immigrants and Refugees to a Small Urban Community in Minnesota
Immigrants and refugees to the United States exhibit relatively low levels of physical activity, but reasons for this disparity are poorly understood.
Journal of Immigrant and Minority Health Sept 2013
RHCP conducted a qualitative study in Rochester, Minnesota, to explore how immigrants and refugees from Cambodian, Mexican, Somali, and Sudanese backgrounds perceive and engage in physical activity. Through 16 gender- and age-stratified focus groups with 127 participants, the research identified shared and unique barriers and motivators to physical activity. While participants recognized the health benefits of being active, many faced challenges such as unfamiliarity with exercise norms in the U.S., time constraints, weather, cost, and limited access to culturally appropriate facilities. Gender and generational differences also emerged, with women more likely to cite household responsibilities and cultural clothing norms as barriers, and adolescents more comfortable navigating gym environments.
Despite these obstacles, participants expressed strong motivation to be active, especially when supported by family, friends, and community. Social support, role modeling, and a sense of “togetherness” were key motivators, as was the desire to prevent disease and follow medical advice. The study emphasized that shared experiences of immigration—such as language barriers and socioeconomic challenges—play a more significant role in shaping physical activity behaviors than cultural differences alone. These findings suggest that effective interventions should be community-driven, culturally responsive, and designed to address both individual and structural barriers, ideally implemented soon after immigration to prevent declines in physical activity.
Physical Activity Among Somali Men in Minnesota: Barriers, Facilitators, and Recommendations
Immigrants and refugees arrive to the United States healthier than the general population, but this advantage declines with increasing duration of residence.
American Journal of Men’s Health Jan 2014
A community-based participatory research (CBPR) project led by RHCP explored barriers and facilitators to physical activity among Somali men in Rochester, Minnesota. Through age-stratified focus groups and interviews with 20 participants, the study identified a range of challenges, including competing priorities like employment, embarrassment about exercise attire, unfamiliarity with gym environments, fear of harassment, high costs, limited transportation for elders, and harsh winter weather. Participants noted a decline in daily walking compared to life in Somalia, where walking was a routine part of daily activities. Despite these barriers, there was a strong awareness of the health benefits of physical activity and a desire to be active, especially when inspired by peers or supported by community networks.
Facilitators included high levels of knowledge about exercise, motivation from success stories within the community, and strong social cohesion that could support group-based activities. Participants recommended culturally sensitive programming that avoids structured classes but offers a variety of activities, including walking groups and buddy systems. They emphasized the importance of creating inclusive, low-cost opportunities that align with their daily routines and cultural norms. The study concluded that interventions should leverage existing community strengths while addressing multilevel barriers, and that early engagement after immigration is critical to sustaining healthy behaviors. These findings offer actionable insights for designing effective physical activity programs for Somali immigrant men in the U.S.
Physical Activity and Nutrition Among Immigrant and Refugee Women: A Community-Based Participatory Research Approach
Immigrant and refugee populations arrive to the U.S. healthier than the general population, but the longer they reside, the more they approximate the cardiovascular risk profiles of the country.
Women’s Health Issues Oct 2011
RHCP developed and evaluated a culturally tailored physical activity and nutrition program for immigrant and refugee women in Rochester, Minnesota, using a community-based participatory research (CBPR) approach. The program was informed by focus groups and a fitness retreat, where participants provided input on preferred exercise styles and nutrition education methods. A six-week pilot included twice-weekly classes combining aerobic dance, strength training, and nutrition education, with support services like childcare, transportation, and culturally relevant materials. The program attracted 45 women from Hispanic, Somali, Cambodian, and African American communities, with high attendance and strong satisfaction scores across all domains, including enjoyment, learning, and stress reduction.
Participants reported significant improvements in physical activity and quality of life, with trends toward better biometric outcomes such as reduced weight, waist circumference, and blood pressure. The program also increased self-efficacy for exercise and healthy eating. Key lessons included the importance of family involvement, language-specific nutrition education, and flexible programming to address shifting barriers. While the study lacked a control group and was underpowered for clinical outcomes, it demonstrated the feasibility and acceptability of CBPR-driven interventions. The findings support the value of community-led, socioculturally responsive health programs in addressing disparities among immigrant and refugee populations.