Is Exercise Extra? A Mixed Methods Examination of Cultural Barriers and Enablers of Physical Activity in Management of Type 2 Diabetes in M’Bour, Senegal

Objective: This study seeks to produce culturally-attuned recommendations for disease management in individuals with type 2 diabetes in M’Bour, Senegal. Methods: The PEN-3 Cultural Model (PEN-3) framed this mixed methods study to capture a) the qualitative barriers and enablers to participating in physical activity through narrative interviews; as well as b) the quantitative extent to which participants engaged in physical activity through the International Physical Activity Questionnaire (IPAQ). Content analysis identified emergent themes from interviews and descriptive statistics summarized IPAQ responses. Results: Among 41 individuals formally diagnosed with diabetes, the mean age was 58 (SD=11.8). Results elicited from PEN-3 included several barriers and enablers to physical activity.  Barriers included prohibitive costs of gym membership and exercise equipment; limb pain; and feeling ill. Participants reported walking as their main source of exercise, with an average frequency of 4 days per week (SD=2.8). Although patients reported a lack of others with whom to exercise, familial support aided in maintaining exercise behaviors such as walking. Conclusions: Given participants’ need for exercise companions, group-based activities ​may be useful. Patients with diabetes may also benefit from complimentary home-based exercises that are gentle and pain alleviating.