An Investigation Into the Health Outcomes of Canadian Ethnic Minorities Following a 17 Week Community-based Exercise Programme

Introduction: Despite the many advantages of physical activity, research has shown that a significant portion of the population does not regularly engage in exercise. What is particularly concerning is that racialised groups tend to have lower rates of physical activity participation and, in some cases, higher rates of chronic health conditions. In response to this issue, community-level initiatives have been implemented across the United States (US) to encourage greater involvement in exercise among ethnic minorities and reduce their risks of chronic diseases. These community exercise programmes have adopted a variety of multifaceted strategies to engage minority populations effectively. To the academic knowledge, no health research has been conducted in Canada to explore the impacts of disparities on socially vulnerable populations utilising a multilevel approach and an intersectional lens concerning community-level exercise programmes. Given the limited research on this and the research gap, the Fitness for Life (FFL), a physical literacy programme designed to promote exercise and recreational sports participation among ethnic minorities, presented a unique opportunity to study these diverse groups. In this thesis, two studies were conducted.

The first study assessed the participants' health outcomes across the five ethnic groups (Black or African Canadians, South Asians, Middle Eastern, Asians, and Europeans) who engaged in the FFL exercise programme.

Objectives: 1) to determine the overall effectiveness of FFL, 2) to compare the impact of the exercise programme on health outcomes, including the cardiovascular profiles (BP, HR, MAP, RPP, and PP) and body composition (body mass, BMI, percentage of body fat, and water percentage) among the five ethnic groups. 3) to analyse the two self-reported questionnaire responses of participants. In total, 365 participated in the FFL. The exercise programme was 17 weeks, including low to moderate impact aerobics and light strength training. The sessions operated 3 days a week. Two days were scheduled for aerobics exercise. The other was for strength training workouts. The strength training sessions consisted of 5 exercises targeting upper and lower body workouts. Each exercise session lasted 45 minutes long. Before the start of the programme, the study intake included participants completing two self-reported surveys: the Physical Activity Questionnaire and the Physical Activity Readiness Questionnaire (PAR-Q). The questionnaires were administered to determine participants' health status, such as their current health conditions and medications, to ensure their safety and to identify their medical needs by identifying symptoms and determining risk factors.

Results: Significant improvements were observed in all cardiovascular profiles and body composition metrics from baseline to post-exercise (p < 0.05) with small effect sizes (0.2). The comparisons saw more significant differences between South Asians and African Canadians (p < 0.05). Regression analysis for pre-systolic blood pressure showed significant results (R² = 7.00%, F = 3,307, p < 0.005). The questionnaires indicated variability across all ethnic groups. Conclusion: The findings from Study 1 indicated that the FFL exercise programme significantly impacted various cardiovascular and anthropometric parameters among the different ethnic groups studied. Following the exercise programme, there were differences in improvements in the cardiovascular profiles (e.g., lower BP) and reductions in body weight and BMI, suggesting the programme's effectiveness in promoting heart health and overall well-being. The self-reported questionnaire responses further highlighted the programme's positive impact on participants' health status. These findings contributed to and supported the understanding of the potential benefits of tailored exercise interventions within ethnically diverse communities. Further, the study highlighted the importance of promoting physical activity for improved health outcomes among ethnic groups.

The second study aimed to investigate the effect of 10 dance aerobic sessions exercise on the blood pressure indices in two specific subpopulations, African Canadians and South Asians, who were diagnosed with hypertension or high blood pressure (defined as 140/90 mm Hg) or other cardiovascular ailments. Moreover, the research is limited to inquiring into the effects of exercise on the RPP within racialised groups. As such, this gap is pressing because of the increased potential risks some of these populations might face from cardiovascular complications during physical exercise. These subgroups participated in 10 dance aerobic sessions on the RPP, a crucial cardiovascular indicator. Objectives: 1) to investigate changes in physiological responses, such as RPP, HR, and BP, on the 10 dance aerobic sessions and 2) to assess the degree of health improvements among the two groups. In total, 160 clients participated in this study (i.e., 80 African Canadians and 80 South Asians). Results: The study illustrated differences in SBP and HR (p < 0.05) between the two groups before and after the 10 dance aerobic sessions. However, the shifts in RPP (p > 0.05) did not yield much statistical significance. Improvements were also observed in MAP and PP, but PP was not significant (p > 0.05) measurements from the baseline to the completion of the 10 exercise sessions.

Conclusion: The African Canadians and South Asians responded differently regarding the effect of the BP measurements on the 10 dance aerobics. For example, the South Asians saw slightly lowered BP by 11 mm Hg compared to 10 mm Hg in the African Canadian group. The findings suggested that the prescribed 10 dance aerobic sessions led to changes and reduced BP, positively influencing cardiovascular health despite the RPP not reporting significant improvement. While further research is needed to fully understand the long-term effects and mechanisms underlying these changes, the findings provide valuable insights into the potential benefits of dance aerobic sessions as a non-pharmacological intervention for individuals with hypertension from diverse ethnic backgrounds. The study also highlights the importance of cultural diversity when designing exercise programmes for specific health conditions. Furthermore, each study in this thesis highlights the efficacy of adapting community-based exercise programmes to support ethnic groups' distinctive needs. Additionally, FFL contributed to reducing the health gap, specifically in physical movement. The initiative was crucial for participants to enjoy and benefit from participating in FFL.