Background: South Asian immigrants in western countries are at a high risk for metabolic syndrome and associated chronic disease. While a physically active lifestyle is crucial in decreasing this risk, physical activity (PA) levels among this group remain low. The objectives of this study were to explore social and cultural factors that influence PA behavior, investigate how immigration process intersects with PA behaviors to influence PA levels and to engage community in a discussion about what can be done to increase PA in the South Asian community. Methods: For this qualitative study, we conducted four Focus Group Discussions (FGDs) among a subset of participants who were part of a larger study. FGD data was coded and analysed using directed content analysis to identify key categories. Results: Participants expressed a range of opinions, attitudes and beliefs about PA. Most believed they were sufficiently active. Women talked about restrictive social and cultural norms that discouraged uptake of exercise. Post-immigration levels of PA were low due to change in type of work and added responsibilities. Conclusion: Health promoters need to consider social, cultural, and structural contexts when exploring possible behavior change interventions for South Asian immigrants.

Background: Face mask use has been associated with declines in COVID-19 incidence rates worldwide. A handful of studies have examined the factors associated with face mask use in North America during the COVID-19 pandemic; however, much less is known about the patterns of face mask use and the impact of mask mandates during this time. This information could have important policy implications, now and in the event of future pandemics. Objective: To address existing knowledge gaps, we assessed face mask usage patterns among British Columbia COVID-19 Population Mixing Patterns (BC-Mix) survey respondents and evaluated the impact of the provincial mask mandate on these usage patterns. Methods: Between September 2020 and July 2022, adult British Columbia residents completed the web-based BC-Mix survey, answering questions on the circumstances surrounding face mask use or lack thereof, movement patterns, and COVID-19–related beliefs. Trends in face mask use over time were assessed, and associated factors were evaluated using multivariable logistic regression. A stratified analysis was done to examine effect modification by the provincial mask mandate. Results: Of the 44,301 respondents, 81.9% reported wearing face masks during the 23-month period. In-store and public transit mask mandates supported monthly face mask usage rates of approximately 80%, which was further bolstered up to 92% with the introduction of the provincial mask mandate. Face mask users mostly visited retail locations (51.8%) and travelled alone by car (49.6%), whereas nonusers mostly traveled by car with others (35.2%) to their destinations—most commonly parks (45.7%). Nonusers of face masks were much more likely to be male than female, especially in retail locations and restaurants, bars, and cafés. In a multivariable logistic regression model adjusted for possible confounders, factors associated with face mask use included age, ethnicity, health region, mode of travel, destination, and time period. The odds of face mask use were 3.68 times greater when the provincial mask mandate was in effect than when it was not (adjusted odds ratio [aOR] 3.68, 95% CI 3.33-4.05). The impact of the mask mandate was greatest in restaurants, bars, or cafés (mandate: aOR 7.35, 95% CI 4.23-12.78 vs no mandate: aOR 2.81, 95% CI 1.50-5.26) and in retail locations (mandate: aOR 19.94, 95% CI 14.86-26.77 vs no mandate: aOR 7.71, 95% CI 5.68-10.46). Conclusions: Study findings provide added insight into the dynamics of face mask use during the COVID-19 pandemic. Mask mandates supported increased and sustained high face mask usage rates during the first 2 years of the pandemic, having the greatest impact in indoor public locations with limited opportunity for physical distancing targeted by these mandates. These findings highlight the utility of mask mandates in supporting high face mask usage rates during the COVID-19 pandemic.

South Asians are one of the fastest growing ethnic groups in western countries with a high incidence of chronic diseases like metabolic syndrome and cardiovascular disease occurring at younger ages and lower body weight compared with white Europeans. Physically active lifestyle and reduced sedentary time are modifiable risk factors that can decrease burden of chronic diseases. Population-level surveys based on self-report show South Asians engage in low levels of physical activity. Because of known limitations with self-report data, we aimed to synthesize available evidence to generate a physical activity /sedentary time profile of South Asians from studies using accelerometry. We systematically searched Medline, EMBASE, CINAHL, PsycINFO, and SportDiscus. We included studies applying accelerometry to measure physical activity /sedentary time under free-living. Studies with an exclusive focus on drugs or including participants with health conditions/physical disability, and special populations (athletes/pregnant women) were excluded. Two authors independently adjudicated inclusion of citations at title/abstract and full text. We applied a standardized data abstraction form to extract relevant data. We evaluated methodological quality using Newcastle Ottawa Quality Assessment Scale. Due to variability and inconsistencies in measurement and reporting of physical activity /sedentary time, we only provide a narrative synthesis. We identified only 14 studies(n = 1,338). Despite using similar accelerometry assumptions, we noted variability in reported outcomes for physical activity and sedentary time. Sedentary time ranged from 482(98) to 587 min/day. Mean light physical activity ranged from 211.69(67. 38) to 574(227) min/day. Moderate to vigorous physical activity among South Asian women ranged from 17–41 min/day and among men, 32–43 min/day. South Asians exhibited higher levels of physical activity when compared to the Canadian population level survey but not when compared to the American population level survey. Overall, fewer studies, and small sample sizes led to considerable variability limiting any effective comparisons. Results highlight the importance of conducting methodologically robust studies based on random sampling to advance the field, and to capture true levels of sedentary time and physical activity in the South Asian population.

Background: Racialized populations in the United States, Canada, and the United Kingdom have been disproportionately affected by COVID-19. Higher vaccine hesitancy has been reported among racial and ethnic minorities in some of these countries. In the United Kingdom, for example, higher vaccine hesitancy has been observed among the South Asian population and Black compared with the White population, and this has been attributed to lack of trust in government due to historical and ongoing racism and discrimination. Objective: This study aimed to assess vaccine receipt by ethnicity and its relationship with mistrust among ethnic groups in British Columbia (BC), Canada. Methods: We included adults ≥18 years of age who participated in the BC COVID-19 Population Mixing Patterns Survey (BC-Mix) from March 8, 2021, to August 8, 2022. The survey included questions about vaccine receipt and beliefs based on a behavioral framework. Multivariable logistic regression was used to assess the association between mistrust in vaccines and vaccine receipt among ethnic groups. Results: The analysis included 25,640 adults. Overall, 76.7% (22,010/28,696) of respondents reported having received at least 1 dose of COVID-19 vaccines (Chinese=86.1%, South Asian=79.6%, White=75.5%, and other ethnicity=73.2%). Overall, 13.7% (3513/25,640) of respondents reported mistrust of COVID-19 vaccines (Chinese=7.1%, South Asian=8.2%, White=15.4%, and other ethnicity=15.2%). In the multivariable model (adjusting for age, sex, ethnicity, educational attainment, and household size), mistrust was associated with a 93% reduced odds of vaccine receipt (adjusted odds ratio 0.07, 95% CI 0.06-0.08). In the models stratified by ethnicity, mistrust was associated with 81%, 92%, 94%, and 95% reduced odds of vaccine receipt among South Asian, Chinese, White, and other ethnicities, respectively. Indecision, whether to trust the vaccine or not, was significantly associated with a 70% and 78% reduced odds of vaccine receipt among those who identified as White and of other ethnic groups, respectively. Conclusions: Vaccine receipt among those who identified as South Asian and Chinese in BC was higher than that among the White population. Vaccine mistrust was associated with a lower odds of vaccine receipt in all ethnicities, but it had a lower effect on vaccine receipt among the South Asian and Chinese populations. Future research needs to focus on sources of mistrust to better understand its potential influence on vaccine receipt among visible minorities in Canada.

Background: South Asians have high incidence of chronic disease. Physical activity (PA) and sedentary time are modifiable risk factors for chronic disease but their assessment in South Asians has been primarily based on self-report. This study presents directly-measured PA and sedentary time in South Asian adults in Canada. Methods: A subset of 100 South Asian participants from a larger study who were identified at being at a higher risk for type 2 diabetes wore Actical accelerometers for 7 days. Anthropometric measures were taken and socio-demographic factors including age, income, education level, years since immigration, presence of children under the age of 12 years in the household and employment status were self-reported. Results: Ninety-one participants (mean age 65.6 years) provided valid accelerometer data. Participants accumulated mean 673.5 (95% CI: 656.6, 691.0) min/day sedentary time, 130.5 (95% CI: 117.3, 145.3) min/day light PA (LPA) and 2.3 (95% CI: 1.3, 4.2) min/day moderate-to-vigorous PA (MVPA). For sedentary time and LPA, sex and BMI explained 51% of variability. For MVPA, BMI, season of assessment and employment status explained 23% variability with those who were employed accumulating significantly higher mean min/day of MVPA compared to those who were unemployed; (5.8, 95% CI: 1.5, 21.7) vs (1.5, 95% CI: 5.3, 20.0) respectively. Conclusion: High sedentary time, and low MVPA indicates the need to focus health promotion efforts on shifting sedentary time into LPA while trying to increase MVPA. Future studies need to be based on larger, representative samples of South Asians.