Table 4.

Motivations to be physically active among immigrants and refugees to Minnesota

Sub-themes	Summary	Representative Quotes
Doctors’ advice is considered important and taken seriously	Participants described how adults take doctors’ advice on physical activity seriously.	SudB: “I think it’s…the parents…when the doctor tells them to, they’ll consider it as something more serious, so they will actually start to do the exercising and they won’t give up as easy.”
Motivation comes from oneself: personal responsibility	Some participants were aware that being motivated is a personal thing that comes from oneself. A person has to make the decision to be physically active and stay committed to it.	CamW: “That is really hard because it is up to them if they want to take care of themselves and they want to take care of their health, then they would come, but if they don’t want to then they won’t come.” HisG: “Anybody can just go out to the park and go play basketball with their family, but it takes them to say that they want to go outside…rather than go sit down and watch a movie. Like it just…it, I mean its motivation in themselves. They have to decide.”
Motivation comes from other people: Family/friends, role models etc.	Participants realized that they cannot do it on their own. Support from others such as going to the gym together, pep talks, caring about each other’s health were considered very important. Participants were inspired by people they know who are successful at being physically active.	CamW: “My husband is very, very healthy. Seven days a week; biking, running and he goes to the gym 7 days a week, so now I am doing it too, although I am pregnant he still makes me do it.” SomG: “Daily recordings of somebody else, like somebody watching you lose weight…because you know how we don’t like really…you hear stuff from other people’s…other people other than yourself?” SomW: “I would say if you stop by my door asking me to come along, I would.”
Electronics/Technology can either be positive motivators or negative motivators	Participants related that electronics such as TV and video games could be helpful in motivating them to exercise without being aware of the work that is involved; but at the same time they could prevent them from going outside to be physically active when they become addicted to those devices.	SomG: “I remember I used to have a treadmill and right on top, like right in front of the TV and I don’t notice how long I’m working out…I swear.” HisM: “Sometimes it’s difficult to do something, you know, when you start getting addicted to a TV show and you know it continues on so you want to watch the next episode, and pretty soon, you watch the next episode after that episode after the one you wanted to watch and now you got 2 hours booked in the evening for watching TV. By the time you have those two over with, it’s 9 o’clock and you don’t feel like exercising at 9-o’clock and I’m going to get ready for bed.” SudG: “And technology nowadays like Facebook, phones and stuff…you’ll just be sitting down and doing that the whole entire day.”
“Seeing is believing”	Participants described how motivated they are when they actually see the results and benefits of exercising such as losing weight, being more energized. However, inability to meet a goal (e.g., weight loss), could sometimes become a negative motivator to continue exercise or physical activity.	HisG: “The scale. Like if you go to the scale and after like three days of exercising you check how many pounds you lost, if you lose like pounds that motivate you even more…to lose even more to go to your desired goal. On the other hand, if you don’t lose weight it’s kind of hard for you to keep going.” CamG: “You get more energized, pumped-up each time.”
“Lead by good example”	Adult participants described how “leading by good example” could be challenging and yet are great motivators for young people.	HisM: “But also your kids need to see you and need to watch you exercise because then they will do it themselves. If I tell my kids they need to be involved in soccer, then they tell me, ‘Why are you trying to get me involved when you’re not practicing anything? You’re not running yourself.’ I tell them they need to be physically active, but then they tell me that ‘you’re not active, so why should I be?’”
Religious/cultural beliefs as positive or negative motivator	Some adult participants described how their culture and religion does not permit them to wear the required outfit for gyms and work-out facilities. They also described how exercise areas are not separated for men and women. Some adult participants stated that they are compelled to be physically active as part of their religious beliefs.	SomW: “Each person has adapted in her own way, but there are things that we need that we don’t have because we wear hijab (lose fitting clothes that cover nearly entirely body). When at the YMCA, the exercise equipment is difficult to use, men and women are exercising together and that’s forbidden in our religion. They can’t go running in the morning wearing tight running clothes. The religion doesn’t allow it. Even if they are not religious, the culture doesn’t allow it.” SomW: “I used to go to the YMCA…, but I used to go there with my abaya (loose fitting clothes). Then the staff there told me that I could not wear the abaya because it was risk for injury. I told them that I paid to be there and that I was going to use the machine. We argued and went to the supervisor to settle it. He suggested I wear clothes that were a little shorter, so that it won’t reach the machine. What have I covered?” CamM: “The Monks were really clear about exercise and activity and they are really clear about telling them that meditation and physical activity was all part of exercise too.”
Physical activity as disease prevention	Participants stated that when they see other people with life threatening disease such as diabetes, they are compelled to be more active.	CamW: “Yes, [they exercise] because they want to be healthy. They see a lot of people just passing by, they all just die and they don’t want to die; they are afraid.”
“Being together”	Participants were aware that doing activities together as a family and as a community serve as great positive motivation to other members of the community.	HisW: “So she’s saying, you know, building communities to for kids, where she sees a lot of um, you know, kids who look like him who go in teams and participate in organized sports… just more of a sense of community” SudG: “I think like if a family like does stuff together like work out together and what not and just go do physical stuff together, I think they’re more likely to be more fit because they encourage each other and they can like tell each other ‘oh no don’t eat that, that’s unhealthy’ or whatever, so I think that would help”

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.