Ethnic differences in physical activity participation when managing gestational diabetes mellitus : A mixed-methods study comparing ethnic Chinese migrants and Australian women

Background
Physical activity is a key component in gestational diabetes mellitus management to optimise glycaemic control and reduce adverse pregnancy outcomes. However, inadequate physical activity during pregnancy is common. Underpinned by a woman-centred pregnancy care model, appropriate strategies targeting patients’ cultural needs may facilitate physical activity participation. Ethnic Chinese migrants have a four-fold higher risk of gestational diabetes mellitus than the Australian Caucasian host population. To identify potentially effective disease management strategies to improve physical activity participation, understanding and comparing ethnic Chinese migrants’ and Caucasian women’s views will provide insights into developing an end-user-informed intervention.

Aims
This study aimed to compare perceptions and practices around physical activity participation during pregnancy between 44 ethnic Chinese migrants and 39 Australian-born Caucasian women with gestational diabetes mellitus.

Methods
This mixed-methods study used in-depth, semi-structured audio-recorded interviews, validated pregnancy physical activity questionnaires and pedometers. Qualitative data were thematically analysed and compared between ethnicities. SPSS (SPSS Inc) was used in quantitative data analysis. Data triangulation was made to identify patterns in participant characteristics, physical activity beliefs and participation.

Results
Despite both ethnic groups doing less physical activity than recommended, Chinese participants were less physically active than Caucasian participants. Chinese participants expressed greater safety concerns about physical activity and opted for a more sedentary lifestyle. Data triangulation indicated that non-Australian-born Chinese participants whose husbands were Asian were overcautious about miscarriage risk related to physical activity, which promoted a sedentary lifestyle. Chinese participants suggested individualised, specific physical activity advice on safe physical activity during pregnancy would mitigate their concerns. Caucasian participants reported that digital step measurement technologies motivated their participation in physical activity.

Conclusion
Different strategies are suggested by Chinese and Caucasian participants to improve physical activity participation to manage gestational diabetes mellitus among ethnic Chinese and Caucasian populations, which will be evaluated in future interventions.

© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.