Enablers and barriers to factors contributing to bone health among early adolescent Somali girls living in Minnesota.

Abstract

Purpose: This descriptive qualitative study aimed to (a) gain a better understanding of the socio-cultural and environmental factors that shape lifestyle practices contributing to bone health including the dietary intake of foods high in calcium and vitamin D, sunlight exposure, and physical activity, and (b) to identify enablers and barriers to these lifestyle practices among early adolescent Somali girls who live in urban and more rural areas of Minnesota. Theoretical/Conceptual Framework: Urie Bronfenbrenner's socio-ecological theory informed the framework used to guide this study. This theory recognizes the complex relationships between the individuals and their numerous environments and considers the individual's development within and across different levels of these environments. This theory was chosen because it acknowledges the social, cultural, historical, and environmental influences on development and behaviors over time. Subjects: Four cohorts of 6 to 12 girls of Somali ethnicity, ages 11 -14 years, were recruited from two Minnesota communities, Minneapolis and Owatonna. Thirty-nine girls participated. Of the 39 participants, 26 participated in all 3 sessions; 10 participated in only 2 sessions, and 3 girls participated in the first session only. Methods: A series of three focus groups was conducted with each cohort of girls, a younger cohort and an older cohort from each community, to gather information about enablers and barriers related to diet, dress, activity, and sunlight exposure relative to bone health. The focus groups were conducted according to guidelines published by Krueger and Casey (2000). Results: Descriptive content analysis was utilized to summarize information derived from the within and across cohort analysis of the focus group data and to identify enablers and barriers to factors contributing to bone health. Cultural tradition, age/developmental stage, acculturation, and environment emerged as key concepts that shaped lifestyle practices and contributed to enablers and barriers to bone health among study participants. Conclusion: Cultural tradition, developmental stage, acculturation and environment emerged as major contributors to factors shaping, enabling, and acting as barriers to bone health among Somali girls, ages 11 to 14 years, living in Minnesota. These findings must be considered when designing and implementing bone health promotion strategies within these communities.