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Global Health Promotion 1757-9759; Vol 0(0): 1 –9; 656347 Copyright © The Author(s) 2016, Reprints and permissions:
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Introduction
Evidence has routinely shown that regular
physical activity (PA) is effective in the primary and
secondary prevention of many chronic diseases
including diabetes, certain forms of cancer, and
cardiovascular disease (1), and associated with
several mental and physical health benefits including
improved health-related quality of life, mood states,
and functional capacity (2). Immigrants to Canada
are less likely to be physically active compared with
non-immigrants (3). In addition, research has found
that immigrants experience a steady decline in
health status over time while living in Canada (4,5).
In order to promote PA in immigrants, an
understanding of the diverse intra-individual and
extra-individual factors that impact PA participation
is required (6).
Social ecological models
Research examining the interrelations between
personal, cultural, organizational, and environmental
factors that influence PA for immigrants to Canada is
limited (7). Therefore, the present study used a social
ecological model (SEM) framework (8,9) to examine
PA participation of new Canadians. SEMs consider
multiple levels of influence including intrapersonal
(e.g. knowledge, attitudes), interpersonal (e.g. family,
social networks), institutional/organizational (e.g.
656347PED0010.1177/1757975916656347Original ArticleK. D. Curtin et al.
research-article2016
1. Faculty of Physical Education and Recreation, University of Alberta, Canada.
2. Alberta Centre for Active Living, University of Alberta, Canada.
3. School of Built Environment and Development Studies, University of Kwazulu-Natal, South Africa.
Correspondence to: Christina Loitz, University of Alberta - Alberta Centre for Active Living, 2–131 University Hall,
Edmonton, Alberta T6G 2H9, Canada. Email: cloitz@ualberta.ca
(This manuscript was submitted on 19 August 2015. Following blind peer review, it was accepted for publication on 8
March 2016)
Challenges of being new to Canada: considerations for
physical activity
Kimberley D. Curtin1, Christina C. Loitz1,2, Nancy Spencer-Cavaliere1
and Ernest Nene Khalema3
Abstract: Immigrants to Canada are less likely to be physically active compared with non-immigrants,
and the interrelations between personal and environmental factors that influence physical activity for
immigrants are largely unexplored. The goal of this qualitative descriptive study was to understand
how the experience of being new to Canada impacts opportunities and participation in physical
activity. Two focus group interviews with immigrants to Canada were conducted. The first group
(n=7) included multicultural health brokers. The second group (n=14) included English as a second
language students. Qualitative content analysis was used to determine three themes consistent with
the research question: transition to Canadian life, commitments and priorities, and accessibility.
Discussion was framed using a social ecological model. Implications for practice and policy are
suggested including enhanced community engagement, and organizational modifications. Overall,
the development and implementation of physical activity policies and practices for newcomers to
Canada should be centered on newcomers’ perspectives and experiences.
Keywords: health promotion, physical activity, recreation, qualitative, public health, newcomer
Original Article
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social institutions, schools), environmental (e.g.
weather, neighborhood walkability), community (e.g.
relationships between schools, informal networks),
and public policy (e.g. local policy, laws) (8,9). The
SEM lens has been recommended given the interaction
between intra-individual factors, such as motivation,
and extra-individual factors, such as access to
facilities for PA (6,10). Factors which led people to
immigrate in the first place (e.g. political unrest,
religious intolerance, hope for a better life), and the
nature of immigrating itself may be associated with a
range of challenges (11). These challenges may also
have implications for the PA engagement of
immigrants in ways that differ from other communities
of people. The purpose of this study was to understand
how the experience of being new to Canada impacts
opportunities and participation in PA.
Method
Participants and focus group procedures
Qualitative description was used to produce a
thorough and relevant reporting of the findings
according to participants’ expression of their
experiences (12). A snowball sampling approach
was used to identify potential participant groups
with various ethnic backgrounds, who were born
in a country other than Canada, and spoke English.
Multicultural health (MCH) brokers were
purposefully sampled, as they are a key local liaison
for newcomers. MCH brokers are Canadians who
were born in another country, became leaders in
their Canadian community, and were recruited to
work for the MCH broker co-operative. These
individuals support the navigation of newcomers
in the Canadian system (health, education,
employment, immigration, etc.). A group of MCH
brokers participated in a focus group (FG) session
and identified other potential FG participants who
were newcomers to Canada, represented various
ethnic backgrounds and spoke English. The second
FG was recruited from an English as a Second
Language (ESL) class.
The one-hour interviews were recorded. Interview
questions were developed in advance, informed
by previous literature and the SEM, and were
reviewed by a group of practitioners (consultants,
coordinators, and directors) and researchers with
expertise in relevant areas (e.g. health promotion,
inclusive practices, marginalized populations,
newcomers’ health, social work, PA). Participants
were asked to (i) share their understanding of PA,
(ii) identify barriers and facilitators to their PA
engagement, (iii) list the forms of active
transportation, household PA and leisure-time PA
they participated in, and (iv) based on components
of the SEM, identify additional factors that
influenced their participation. Cognizant of cultural
differences and potential language barriers, the
interviewers also made use of visual aids,
representing various forms of PA to enhance
communication. The study was approved by a
university research ethics board and participants
provided informed consent.
Analysis
In line with qualitative description, qualitative
content analysis was used to interpret, describe, and
summarize the data (13). Two members of the
research team engaged in “the process of identifying,
coding, and categorizing the primary patterns” (14:
94). This was accomplished by listening to the
recordings followed by four independent readings
and coding of the transcripts. Once clear patterns
were evident and categories were determined, the
researchers interpreted them within the SEM which
led to initial themes (14). The researchers discussed
their independent findings, which were corroborated,
and presented to the entire research team (n=4), who
helped to further refine them.
Quality of research
Strategies consistent with the purpose of the study
and method were used to enhance rigor including:
(i) appropriate sampling of participants who could
provide rich description about the study topic, (ii)
maintaining an audit trail, and (ii) peer debriefing
throughout the study (13,14).
Results
All participants self-identified as newcomers to
Canada (i.e. born in another country and currently
resided in Canada). Study participants included 21
newcomers to Canada, (women n=14; men n=7;
mean age=38.4 years), who were sampled (13) from
local MCH brokers (n=7), and an ESL class (n=14).
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English was not the first acquired language for any
of the participants. Two researchers facilitated the
two FG interviews at the recruitment sites.
The FG discussions highlighted the unique
situations that influenced the lives of newcomers to
Canada and their engagement in PA. Three themes
were identified: transition to Canadian life,
commitments and priorities, and accessibility.
Transition to Canadian life
Throughout the FG discussions, participants
often compared life in their home countries with
life in Canada and related how these differences
influenced their PA participation. All participants
recognized the value of PA in terms of mental and
physical health. However, many described their
Canadian lifestyle as unconducive to PA compared
with their homelands. Participants frequently
discussed PA as a necessity for everyday life in their
home countries versus intentional PA (exercise) in
Canada. One participant explained, ‘I’m sure a lot
of us are being active doing housework… in my
country too that’s how we are being active at
home…but of course the other component, now
that we understand we’re here in Canada is having
to walk for half an hour.’ The cultural norms in
Canada include convenience, technology, and time-
saving activities which have led to fewer physical
activities of daily living. Another participant
described this transition, ‘…because transportation
is the biggest thing that makes you lazy because
you just pick up, get in the car. And over there
[homeland], people just walked and used public
transportation.’
Poor communication of opportunities to be
physically active was another barrier experienced.
A participant mentioned this, ‘When I was in my
country I played soccer, volleyball, basketball. But
now I only supervise hockey… sometimes I go to
game, you see, but I don’t know places.’
Instructions for exercise participation and/or
obtaining and use of recreation passes were
experienced as complex and difficult to understand,
especially when in a new language. One of the
contributing factors to this lack of knowledge
about opportunities to be physically active was a
feeling of isolation and lack of community
connections in Canada. The impact of this isolation
on mental health was observed by one participant:
Back home, people were working and they were
taking care of their children, but there was always
enough time to have a social life, to be connected
to others, not to be distressed. I never seen, you
know, such a depression in my community that
I’m seeing right now because people are very
isolated.
Another participant noted ‘exercise is important
but it depends on relationships. This moment I
breathe, I have a hard time or don’t know the
program… I don’t have some friends to participate
in exercise… .’ Despite policies designed to
increase accessibility, a lack of social support
remained a barrier. One participant explained
‘I also see [policies] motivated the low-income
single parent but no friend, no connection between
the people in the community. And the resource is
there but they don’t come.’
Neighborhood connectedness was perceived to be
weaker in Canadian culture compared with
participants’ homelands, and this lack of community
support impeded participation in PA. A participant
shared, ‘knowing our neighbors; we don’t see each
other, we don’t contact, we don’t meet, you know?
A neighborhood activity, you know, it’s been my
goal since I come to Canada – how come neighbors
they don’t know each other?’ The lack of community
connectedness was a new barrier for immigrants
which negatively impacted engagement in PA.
A final factor inhibiting PA that was mentioned
by nearly every participant was the cold climate in
Canada. For example, one participant said, ‘…here,
difficult weather. Summer I will go swimming, and
walking. Winter’s very cold.’ Both cold outdoor
activities and transportation in the winter climate
were noted as difficulties. Families were also
reluctant to be physically active in the cold, ‘getting
the kids out and walking in the cold weather…
that’s one of the barriers.’ In addition, safety
concerns were identified because in northern Canada
‘it gets very dark’ in the early evening. Regardless
of the amount of time spent in Canada the climate
was experienced as a common PA barrier.
Commitments and priorities
The FG discussions revealed that newcomers
experienced increased demands on their time in the
form of commitments and priorities aside from PA
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(e.g. family, work, and leisure activities). Family was
of paramount importance, and facilitated PA by
providing motivation and social support. However,
family was occasionally perceived as a barrier due to
obligations of care and associated duties, such as
cooking and transportation. A participant described
spending time with her children through PA as
enjoyable, ‘When you play with your children, it’s
relax[ing]’, while others spoke about being
physically active while transporting children to
school or running family errands. Children also
acted as motivation to stay active and healthy, ‘…we
have kids and we have to keep up with their energy.’
Care for the family was a high priority for all the
participants, resulting in little extra time or energy
to participate in PA. For example, a participant
noted, ‘I’m kind of like the taxi driver in my family,
so no I’m not taking the bus. I’m picking up kids.’
The participants were more invested in providing
their children with PA opportunities than themselves.
‘I’m just moving them [children] around…from
swimming to karate to different things.’
Other priorities took the form of work, study,
or leisure. One participant spoke about the
demands on their time due to schoolwork: ‘In my
country, I was active, but now I don’t have free
time.’ Other participants, however, indicated a
lack of participation due to competing activities
and lack of motivation, “I just have a hard time,
after my children are sleeping, I’m watching the
internet, that’s it.” A solution offered by a
participant to help combat this lack of time and
motivation was that more activities could be
offered on the weekends to accommodate working
hours and family needs. Participants had many
demands on their time that required negotiation
in order to accommodate PA.
Accessibility
Accessibility was highlighted throughout the FG
discussions as a significant barrier to PA through
monetary cost, government support programs, and
lack of supporting facilities or programs for families.
Several participants referred to different types of
expenses such as purchasing equipment and paying
gym memberships. Participants acknowledged
supports designed to assist lower-income families
gain access to PA opportunities exist in Canada.
According to FG participants, these resources (e.g.
fee assistance programs) were often ineffective for
newcomers, as many people did not know about the
programs or the application process. Furthermore,
participants expressed difficulties associated with
qualifying for subsidy programs. In order to support
the family, many participants reported that both
parents worked full time which helped to meet
family needs, but placed them above the cutoff for
government support for PA despite not having the
disposable income to make this a priority. This was
described by one participant:
I would say that economic barriers in two ways,
one that because of their economic situation they
have to work extra. You don’t have time or energy
to do that. And secondly, the families who you
know, fall through the crack, the families who are
above the cutoff line and who are not making
enough money to support these activities, they
can’t pay—those are the one are always neglected
and unnoticed in any situation.
Another participant also described how the
conditions and processes involved in applying for
support was a barrier, ‘You don’t qualify for this but
if you have three children, then you can, if you have
two, you cannot, you know, things like that. That
really… turns people off going there.’
In addition, ancillary costs (e.g. transportation,
childcare) were not considered when providing
access cards to recreation facilities. Concerns were
expressed regarding the practicality of policies for
newcomers as they disregarded differences in culture
and necessary adaptations to make recreation
facilities accessible:
I have to do this and this and this and how I’m
going to bundle my children and all that… the
mainstream service providers, or the people who
make the programs, they don’t think about those
things. They just think, okay according to them,
they’re thinking this way, ‘okay this looks good.
This is good’, but is it good for the people who are
going to use it?
A further discussion of practicality emerged when
participants mentioned that although the systems
were in place, the lack of community focus or
involvement was perceived as a barrier to using
Canadian facilities or programs:
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The [Canadian] system is not very community
friendly or not easily accessible. What I mean to
say is … [in] Europe and places [if you] wanna go
city recreation, there are systems in place. [In
Canada], you have to do this level to do this, you
have to have this ticket, you have this, that. It’s not
something [that is] open for community, you go in,
and do whatever you want to do and get out.
Although systems were in place to support PA for
people living with lower incomes in Canada, they
were not perceived or experienced as accessible.
Discussion
The findings are discussed and interpreted using
the ecological levels of the SEM (8,9). The contents
of the themes and the levels within which they are
discussed are not mutually exclusive.
Intrapersonal/individual barriers
Individual knowledge and attitudes of immigrants
to Canada have been found to impact PA in several
ways (15). This was evident in discussions of
intentional PA in the present study, which was not
prominent in their home countries. For example,
incidental PA such as walking for transportation or
doing housework were viewed as necessary rather
than ways of being physically active. This finding is
supported in ethnographic research with immigrant
women from India living in Canada (15). These
women reported that incidental PA was simply part
of daily life in India, and there was no need to engage
in prescriptive exercise regimes. Similarly, African
Americans, Hispanics, Hmong and Native
Hawaiians in America identified that PA is an
inherent part of their cultures and that purposeful
PA was an unfamiliar concept (16). The literature
has also identified motivation as a barrier among
several minority populations (17,18). Fleury and
Lee (17) proposed that a lack of readiness and
confidence to be physically active were barriers to
PA participation. Reflective of Canadian society,
lack of motivation was apparent for some of the
participants in the FGs. Interventions targeting
individual knowledge, motivation, goal setting and
strategies to overcome barriers would help to
facilitate activity in combination with improvements
in other levels of influence on PA (17,18).
Interpersonal/cultural barriers and facilitators
PA and social interactions are intertwined in
immigrant and minority cultures (15,19).
Maintaining cultural traditions and caring for
family have been identified as barriers for many
immigrants (7,15,20), and almost all participants in
the FGs identified interpersonal relationships and
neighborhood communities as strong influences on
PA. Little research has examined the facilitative
influence of family on immigrant PA (21); however,
given the importance of family and community in
the lives of immigrants, strategies that focus on
community are highly relevant. Suggestions from
previous research include: generating and
maintaining social support systems (20), community
campaigns, family-based social support (19,22), and
collaboration and involvement of community
members in creating change (18). Specifically,
recommendations to increase community PA include
facilitating family and cultural norms along with
social support for PA, goal setting through behavioral
contracts, and building on existing social networks
such as workplace or family relationships (18,22).
In addition to promoting PAs such as walking
groups, and recreational sport within communities
which are accessible and open to all community
members, alternative approaches such as community
gardens have shown positive outcomes (e.g. physical
and mental health) (23,24). Initiatives such as these
would support community members’ involvement
in a project that may align better with their previous
experiences and lifestyles in their countries of origin.
Research has demonstrated that community sport
and recreation can help alleviate some stresses
accompanying relocation to a new country (25).
Heath et al. (26) examined PA interventions from
various countries, and found that PA can be
successfully promoted through strategies involving
communities, neighborhoods, and worksites. For
example, community PA classes led by instructors
that take place in public spaces such as parks or
community centers provide a source of free PA close
to home, a source of social support, and a venue that
affords educational and promotional resources (26).
Another example is the Ciclovía-Recreativa which is
a transnational community-based program in which
streets ranging from 1 to 121 km in length are closed
to motorized transport to allow access for PA and
socialization (e.g. walking, running, cycling,
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rollerblading) (27). These events are most common
in Latin America; however, two Canadian cities
have adopted Ciclovías. Overall, these programs are
highly supported by communities as they increase
the promotion of leisure, encourage social
interaction, and help increase PA levels (27).
Institutional/organizational barriers
Several barriers related to accessibility can be
exhibited at the institutional/organizational level.
Immigrants are often expected to assimilate quickly
to Canadian culture, and the lack of familiarity with
Canadian PA program delivery is often ignored
(7,20). Barriers tied to organizations and institutions
were related to a lack of access to facilities due to
long working hours. Places to be physically active
were closed or did not offer programming when
participants were available. In addition, the cost,
language differences, and lack of knowledge of
recreation center etiquette, program delivery, and
fee assistance in Canada limited participation.
Participants provided solutions such as offering
more activities on weekends, providing childcare,
and building community programs modeled after
newcomers’ experiences of inclusive, open and
accessible systems similar to those in their country
of origin. PA messages and programs may be tailored
to address the needs and lifestyles of immigrant
groups, to increase awareness and access to PA
opportunities (7,16,20). Importantly, these should
be informed by immigrants and their experiences.
Physical environment barriers
Physical environmental factors such as cold
weather and fewer hours of sunlight can greatly
affect the PA of immigrants and non-immigrants. In
addition, research has found that the availability of
bike lanes, walking paths, and city aesthetics
influenced PA participation (17,18,26). Specific
strategies to introduce winter activities to newcomers
are important. The City of Edmonton, Alberta
works to make outdoor recreation and transportation
more accessible by clearing trails of snow, providing
skates, leading ‘winter walk days’, etc. (28).
Car dependence is high in Canadian cities and has
a negative impact on PA participation (29). Active
transportation and PA have been related to
environmental factors such as access to stores, the
presence of sidewalks, connected streets, and
aesthetically pleasing environments (30). Improving
these factors could help facilitate a more natural
method of being physically active.
Public policy barriers
Many accessibility barriers can be targeted
effectively through changes in policy. For the new
Canadians in the FGs, policy barriers included lack
of accessibility to government programs (e.g.
income-based subsidies), lack of knowledge
regarding policies to encourage participation, and
the inability to navigate application systems.
Furthermore, participants expressed challenges
with the qualification criteria for fee assistance,
which often resulted in some people inappropriately
being excluded from receiving support. Policies do
not consider family circumstances (i.e. dual income,
number of dependent family members, etc.) or
stages of transition to Canada, as some seem to be
assumed or missed for many new Canadians.
Research in inclusion practices with Chinese
women in Vancouver, Canada offered several
suggestions to improve leisure access policies (7).
These included providing free or subsidized passes
through immigration services or cultural
associations in the first year of immigration and
providing continued support to newcomers after
the first year (7). The need to engage those most
affected by policy is essential in making the
procedures and practices more inclusive and
supportive of PA participation (7).
Overall recommendations
All levels of the SEM need attention to effectively
facilitate PA involvement (9). For example,
participants mentioned that policies may be in
place; however, they are ineffective if people have
no social connections, or knowledge about the
programs. Favorable community interventions are
long term, highly visible, and target both
individuals and communities as a whole.
Furthermore, these community interventions
include ongoing media support, social components
(e.g. support, buddy systems, counseling, goal
setting, and knowledge acquisition), and
environmental support (e.g. creation of trails,
events) (22). Promoting and cultivating social and
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physical activities through culturally relevant
recreation in collaboration with community
members is key (17,18,20). Generally, high-income
countries focus on individual-level interventions,
while lower-income countries target communities
(26). The importance placed on community and
family involvement should not be underestimated
as a powerful tool to promote PA in Canada.
Unique considerations for immigrant
populations
The nature of transitioning to life in a new
country involves a collection of unique experiences
that influence every aspect of an immigrant’s life.
Although PA is valued in Canadian culture, it may
carry little value to immigrants while negotiating
major life changes and everyday challenges
associated with acculturation (e.g. language
barriers, family care, financial concerns). Common
stressors for immigrants have been identified,
including employment, economic status,
educational background, sociopolitical factors,
and immigration status (31).
Using the themes identified and the discussions of
each level of the SEM, several recommendations
specific to new Canadians can be made. In keeping
with the interconnected nature of the levels of the
SEM, the needs of newcomers could be partially
met by involving family and community in PA
programming, or facilitating childcare and
transportation to recreational facilities (20).
Moreover, the solutions offered should consider
that many newcomers to Canada are working long
hours. Coordinators need to work with immigrant
organizations to effectively communicate access
policies, procedures, and programs to newcomers
while considering the perspectives and priorities of
the newcomers. Recent research with Latin
American immigrants to Canada found that lack of
time, resources, social integration, and migration
stress were barriers to PA, and several similar
recommendations were made, and included social
support systems, mental health programs, and
consideration of family and gender roles (32).
Other research identified individual considerations
for migrants such as education on health behaviors
and cultural sensitivity of health care providers (20).
Furthermore, community health resources located
in residential areas, and exploring opportunities to
be active in an employment setting could be
implemented at a community, organizational, or
policy level (20).
Limitations and future directions
The participants in the present study self-identified
as newcomers to Canada representing several
countries of origin. This allowed for the exploration
of several perspectives and strengthened the
transferability of the findings; however, culturally
specific influences could not be distinguished (14).
In addition, length of time in Canada could also play
a role in changing perspectives. Evidence suggests a
relationship between time since immigration and the
type of PA participation, leisure activities and
immigrant health (4,33–35). Further investigation
of this factor is imperative as the intersection of
culture and time generates unique contexts for PA
outcomes. In addition, the findings may be shared
by both immigrants and non-immigrants. For
example, physical environment aspects (e.g.
sidewalks, distance to retail stores), socioeconomic
factors, bus route access, and proximity to fitness
centers may influence PA of community members
regardless of immigration status. Although the SEM
provided a comprehensive framework for
understanding PA influences, researchers have
argued that the model lacks specificity in
conceptualizing problems, and the identification of
intervention strategies may be challenging (8,17,36).
More sophisticated operational models are the next
step in developing testable hypotheses to guide
interventions (36).
Conclusion
There are a multitude of factors that both
constrain and facilitate PA for new Canadians. It is
clear that this population has a unique set of needs,
values, and perspectives for practitioners to
acknowledge and work within. The diverse ways in
which moving to a new culture is experienced need
to be considered (32,34), acknowledging that PA
may only be relevant or a priority if other needs are
met, such as family care and social connectedness.
Integrating PA participation as an important aspect
of transitioning to Canada can be incorporated
through multiple strategies to support immigrant
health and wellness.
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Acknowledgements
The authors are grateful to the intermediaries involved in
the recruitment of focus group participants and the
newcomers to Canada who volunteered to participate in
our study. In addition, we would like to thank Ms. Angela
Torry for her assistance with data collection.
Declaration of conflicting interests
The authors declare that there is no conflict of interest.
Funding
This research received no specific grant from any funding
agency in the public, commercial, or not-for-profit sectors.
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