Table 3.

Barriers to physical activity among immigrants and refugees to Minnesota

Sub-theme	Summary	Representative Quotes
Lack of time	Participants described the variety of competing work, family and school demands for their time that limit time for physical activity.	SudW: “Because I am doing two jobs and at the same time I go to school… you have to wake up early morning and prepare breakfast and … pack up the kids and all those things.” SomB: “They’re [parents] just too busy because they work like overtime or something and they just come home and sleep. That’s basically what they do. SomB: “Like some of the parents, they have a lot of kids to take care of and have like other kid relatives. Money is their first priority.”
Excessive workload	Adult participants described the fatigue they feel from working long days. Beyond the limitations this puts on time, this work drains energy levels and motivation to exercise.	SudM: “I wake up at 3 o’clock in the morning, I come home at 5 o’clock, no sun, nothing. You get up in the dark; you come back in the dark, so. It is miserable. But then like uncle say, that is the American way.”
Lack of transportation to exercise facilities	Adult participants described how lack of transportation limits access to organized exercise; adolescents saw public transportation as a solution.	CamW: “If you really think about it, over at the church the programs are free…the exercise program and stuff like that, but the only thing that’s more of a block is the transportation. If we could get everybody to get transportation out there then it is good.”
Time spent with electronics	Participants described the amount of time that is spent with electronics such as computers, videogames, television, social media, and movies as time not spent being physically active.	SudM: “We have a problem here: TV and games…The kids, they like to play…to watch a game or play the game and eat too much, that’s what I discovered. They can just down the hall to figure they can get something and snack down there and then you can see, you know, what you can spend a week when there is no school. You will see that in your budget, and when they have school, you know so.”
Not needing to be as physically active to maintain a home or working life in the US	Participants described the lack of need to be physically as active to do the work of living (job, homemaking, etc.) in their country of residence as in their home country.	SomM: “When I was in Somalia, you don’t need time to set aside for physical activity. Physical activity was part of the life. I get up early in the morning. For example, my elementary school was more than five kilometers away from my home. Every day, I had to walk 5 kilometers to the school and 5 back. That’s pretty much…you’re done with your physical activity for the day.”
Weather	Participants described the limitations to physical activity because of the cold Minnesota weather and snow.	CamW: “If it was the summer we could go outside and exercise very easy but in the winter is it truly difficult to exercise.” CamM: “The snow. The snow creates a little difficulty and the winter season because naturally his body feels more tired and wants to sleep and just huddle up in a blanket all of the time, but it is mind over matter. You can break that habit…”
Illness	Adult women described the limitations to physical activity because of such symptoms as pain and swelling.	SomW: “I just feel pain all over. It’s a challenge. The intense pain I think comes from the change in lifestyle, change in the weather. It’s this weather. The weather is what caused the pain. You can’t get out of bed. You want to cover yourself with the blanket, but when the heat is high, it’s difficult to breathe. It bothers me. When you turn it off, you feel much better.”
Not having a place to gather for group exercise	Adult participants described the lack of gathering places for physical activity that were available to groups of people that share the same language and culture.	SudM: “I think we have lack of centers here. We need some time a community center… Our people, some of them, they don’t have access to a lot of things here.” HisM: “There [are] no places for the public, for the general population to go … where you can go and grab your ball, throw some hoops, and go in the wintertime… some place indoors to run, because you can’t run outside, but for the public, not just for membership, you know, for everyone.”
Cost or access to facility for physical activity	Participants described the cost of access to facilities as a limiting factor for physical activity; funding is needed for child care and memberships.	SudM: “Even financial, for example…we won’t see you here. You have to pay for example a certain amount of money so they be allowed to go to [gym] for 6 months for example…maybe. But some people they don’t have this money for this.”
Gender is a barrier to physical activity for women	Adult and adolescent female participants perceived less flexibility in their schedules to be physically active than men due to their obligations towards children and the household.	SudG: “Usually girls stay home cook, clean, do all the stuff while the guys usually are the healthier ones because they go outside, they can play, more time, but us girls usually home from afterschool, do homework, clean, and then just stay home and take care of the kids.” SomG: “They [Somali boys] don’t have any responsibilities holding them down. The teenage guys don’t really have responsibility, like holding them back you know, and we have more responsibilities to do, you know. They have like more free time to do…exercise and stuff. You’re like in the house and all you have to do is like clean, babysit.”
Unfamiliar gym culture	Participants described lack of knowledge of how to exercise in a gym or with gym equipment and get involved, especially if language is a barrier.	SudM: “Some of the people are unaware or uneducated about how to get out and get involved in activities… if you have a family with low income you can go to YMCA you know, and get it going with your family. Some people they …have no clue.”

CamW=Cambodian woman; CamM=Cambodian man; CamG=Cambodian girl; CamB=Cambodian boy; HisW=Hispanic woman; HisM=Hispanic man; HisG=Hispanic girl; HisB=Hispanic boy; SomW=Somali woman; SomM=Somali man; SomG=Somali girl; SomB=Somali boy; SudW=Sudanese woman; SudM=Sudanese man; SudG=Sudanese girl; SudB=Sudanese boy.