Barriers and Enablers to Older Indigenous People Engaging in Physical Activity—A Qualitative Systematic Review

Click name to view affiliation

Margaret J.R. Gidgup
Search for other papers by Margaret J.R. Gidgup in
Current site
Google Scholar
PubMed
Close
,
Marion Kickett
Search for other papers by Marion Kickett in
Current site
Google Scholar
PubMed
Close
,
Tammy Weselman
Search for other papers by Tammy Weselman in
Current site
Google Scholar
PubMed
Close
,
Keith Hill
Search for other papers by Keith Hill in
Current site
Google Scholar
PubMed
Close
,
Julieann Coombes
Search for other papers by Julieann Coombes in
Current site
Google Scholar
PubMed
Close
,
Rebecca Ivers
Search for other papers by Rebecca Ivers in
Current site
Google Scholar
PubMed
Close
,
Nicole Bowser
Search for other papers by Nicole Bowser in
Current site
Google Scholar
PubMed
Close
,
Vilma Palacios
Search for other papers by Vilma Palacios in
Current site
Google Scholar
PubMed
Close
, and
Anne-Marie Hill
Search for other papers by Anne-Marie Hill in
Current site
Google Scholar
PubMed
Close
Restricted access

The objective of this qualitative systematic review was to synthesize all evidence to understand the barriers and enablers to older Indigenous peoples (aged 40 years and older) engaging in physical activity. Four databases were searched. Study quality was assessed from an Indigenous perspective, using an Aboriginal and Torres Strait Islander quality appraisal tool. Data were analyzed using thematic synthesis. There were 4,246 articles screened with 23 articles and one report included from over 30 Indigenous communities across four countries. Cultural Safety and Security was a key enabler, including developing physical activity programs which are led by Indigenous communities and preference Indigenous values. Colonization was a key barrier that created mistrust and uncertainty. Social Determinants of Health, including cost, were supported by successful programs, but if not addressed, were demotivators of engagement. Older Indigenous peoples identified barriers and enablers that can direct the development of sustainable, culturally appropriate physical activity programs.

Gidgup, Weselman, and A.-M. Hill are with the Faculty of Health Science, School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia. Gidgup and Kickett are with the Centre for Aboriginal Studies, Curtin University, Perth, Western Australia, Australia. K. Hill is with the Rehabilitation Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia. Coombes is with The George Institute for Global Health, Sydney, New South Wales, Australia. Ivers is with the School of Population Health, University of New South Wales, Sydney, New South Wales, Australia. Bowser is with the South West Aboriginal Medical Service Aboriginal Corporation, Bunbury, Western Australia, Australia. Palacios is with the North Metropolitan Public Health Unit, WA North Metropolitan Health Service, Perth, Western Australia, Australia.

Gidgup (Margaret.gidgup@postgrad.curtin.edu.au) is corresponding author.

Supplementary Materials

    • Supplementary Material (PDF 557 KB)
  • Collapse
  • Expand
  • Anderson, I., Robson, B., Connolly, M., Al-Yaman, F., Bjertness, E., King, A., . . . Leslie Yap, L. (2016). Indigenous and tribal peoples’ health (The Lancet–Lowitja Institute Global Collaboration): A population study. The Lancet, 388(10040), 131157. doi:10.1016/S0140-6736(16)00345-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Aspin, C., Brown, N., Jowsey, T., Yen, L., & Leeder, S. (2012). Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: A qualitative study. BMC Health Services Research, 12(1), 143. PubMed ID: 22682035 doi:10.1186/1472-6963-12-143

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Australian Bureau of Statistics. (2013). Australian Aboriginal and Torres Strait Islander health survey: First results, Australia, 2012–13 (4727.0.55.001). Retrieved from https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4727.0.55.001main+features902012-13

    • Search Google Scholar
    • Export Citation
  • Australian Bureau of Statistics. (2018). Life tables for Aboriginal and Torres Strait Islander Australians: Life expectancy estimates for Aboriginal and Torres Strait Islander people for Australia and index of social-economic disadvantage. Retrieved from https://www.abs.gov.au/statistics/people/aboriginal-and-torres-strait-islander-peoples/life-tables-aboriginal-and-torres-strait-islander-australians/latest-release

    • Search Google Scholar
    • Export Citation
  • Barnabe, C. (2021). Towards attainment of indigenous health through empowerment: Resetting health systems, services and provider approaches. BMJ Global Health, 6, e004052. doi:10.1136/bmjgh-2020-004052

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Belza, B., Walwick, J., Shiu-Thornton, S., Schwartz, S., Taylor, M., & LoGerfo, J. (2004). Older adult perspectives on physical activity and exercise: Voices from multiple cultures. Preventing Chronic Disease, 1(4), A09. PubMed ID: 15670441 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1277949/.

    • Search Google Scholar
    • Export Citation
  • Braun, K.L., Browne, C.V., Ka'opua, L.S., Kim, B.J., & Mokuau, N. (2014). Research on Indigenous Elders: From positivistic to decolonizing methodologies. The Gerontologist, 54(1), 117126. PubMed ID: 23841952 doi:10.1093/geront/gnt067

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Braun, V., & Clarke, V. (2013). Successful qualitative research: A practical guide for beginners. London, UK: SAGE Publications.

  • Brooks-Cleator, L.A., & Giles, A.R. (2016). Culturally relevant physical activity through elders in motion: Physical activity programming for older Aboriginal adults in the Northwest territories, Canada. Journal of Cross-Cultural Gerontology, 31(4), 449470. PubMed ID: 27682893 doi:10.1007/s10823-016-9307-z

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Brooks-Cleator, L.A., & Lewis, J.P. (2019). Alaska native elders’ perspectives on physical activity and successful aging. Canadian Journal on Aging, 39, 111. doi:10.1017/s0714980819000400

    • Search Google Scholar
    • Export Citation
  • Bruner, B., & Chad, K. (2013). Physical activity attitudes, beliefs, and practices among women in a Woodland Cree community. Journal of Physical Activity & Health, 10(8), 11191127. PubMed ID: 23223757 doi:10.1123/jpah.10.8.1119

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Carr, J.J., Lalara, J., Lalara, G., O’Hare, G., Massey, L., Kenny, N., . . . Barker, R.N. (2019). ‘Staying strong on the inside and outside’ to keep walking and moving around: Perspectives from Aboriginal people with Machado Joseph Disease and their families from the Groote Eylandt Archipelago, Australia. PLoS One, 14(3), e0212953. PubMed ID: 30856185 doi:10.1371/journal.pone.0212953

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Conte, K., Schure, M., & Goins, R. (2016). Older American Indians’ perspectives on health, arthritis, and physical activity: Implications for adapting evidence-based interventions, Oregon, 2013. Preventing Chronic Disease, 13, E81. doi:10.5888/pcd13.160098

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Coombes, J., Lukaszyk, C., Sherrington, C., Keay, L., Tiedemann, A., Moore, R., & Ivers, R. (2018). First Nation Elders’ perspectives on healthy ageing in NSW, Australia. Australian and New Zealand Journal of Public Health, 42(4), 361364. PubMed ID: 29888836 doi:10.1111/1753-6405.12796

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Coppell, K.J., Tipene-Leach, D.C., Pahau, H.L., Williams, S.M., Abel, S., Iles, M., . . . Mann, J.I. (2009). Two-year results from a community-wide diabetes prevention intervention in a high risk indigenous community: The Ngati and healthy project. Diabetes Research and Clinical Practice, 85(2), 220227. PubMed ID: 19525026 doi:10.1016/j.diabres.2009.05.009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Curtis, E., Jones, R., Tipene-Leach, D., Walker, C., Loring, B., Paine, S.J., & Reid, P. (2019). Why cultural safety rather than cultural competency is required to achieve health equity: A literature review and recommended definition. International Journal for Equity in Health, 18(1), 174. PubMed ID: 31727076 doi:10.1186/s12939-019-1082-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dahlberg, E.E., Hamilton, S.J., Hamid, F., & Thompson, S.C. (2018). Indigenous Australians perceptions’ of physical activity: A qualitative systematic review. International Journal of Environmental Research and Public Health, 15(7), 1492. doi:10.3390/ijerph15071492

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Department of Economic and Social Affairs Indigenous People. (2007). United Nation declaration of the rights of indigenous peoples. Retrieved from https://www.un.org/development/desa/indigenouspeoples/declaration-on-the-rights-of-indigenous-peoples.html

    • Search Google Scholar
    • Export Citation
  • Eckermann, A.-K., Dowd, T., Chong, E., Nixon, L., Gray, R., & Johnson, S.M. (2010). Binan Goonj: Bridging cultures in aboriginal health (3rd ed.). Chatswood, Australia: Churchill Livingstone.

    • Search Google Scholar
    • Export Citation
  • Elliott, T. (2002). Falls prevention: The Aboriginal elders water-based exercise group. Aboriginal and Islander Health Worker Journal, 26(3), 1215. Retrieved from https://search.informit.org/doi/abs/10.3316/ielapa.187502996984432

    • Search Google Scholar
    • Export Citation
  • Gray, C., Macniven, R., & Thomson, N. (2013). Review of physical activity among Indigenous people. Australian Indigenous Health Bulletin, 13(3). Retrieved from http://healthbulletin.org.au/wp-content/uploads/2013/08/physical_activity_review_2013.pdf

    • Search Google Scholar
    • Export Citation
  • Grunseit, A.C., Bohn-Goldbaum, E., Crane, M., Milat, A., Cashmore, A., Fonua, R., . . . Bauman, A. (2019). Participant profile and impacts of an Aboriginal healthy lifestyle and weight loss challenge over four years 2012-2015. Australian and New Zealand Journal of Public Health, 43(4), 328333. PubMed ID: 31268219 doi:10.1111/1753-6405.12914

    • Search Google Scholar
    • Export Citation
  • Harfield, S., Pearson, O., Morey, K., Kite, E., Canuto, K., Glover, K., . . . Braunack-Mayer, A. (2020). Assessing the quality of health research from an Indigenous perspective: The Aboriginal and Torres Strait Islander quality appraisal tool. BMC Medical Research Methodology, 20(1), 79. PubMed ID: 32276606 doi:10.1186/s12874-020-00959-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Heesch, K.C., Brown, D.R., & Blanton, C.J. (2000). Perceived barriers to exercise and stage of exercise adoption in older women of different racial/ethnic groups. Women & Health, 30(4), 6176. PubMed ID: 10983610 doi:10.1300/J013v30n04_05

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Henderson, K.A., & Ainsworth, B.E. (2000). Enablers and constraints to walking for older African American and American Indian women: The cultural activity participation study. Research Quarterly for Exercise and Sport, 71(4), 313321. PubMed ID: 11125529 doi:10.1080/02701367.2000.10608914

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Henderson, K.A., & Ainsworth, B.E. (2003). A synthesis of perceptions about physical activity among older African American and American Indian women. American Journal of Public Health, 93(2), 313317. PubMed ID: 12554592 doi:10.2105/AJPH.93.2.313

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hunt, J., Marshall, A.L., & Jenkins, D. (2008). Exploring the meaning of, the barriers to and potential strategies for promoting physical activity among urban Indigenous Australians. Health Promotion Journal of Australia: Official Journal of Australian Association of Health Promotion Professionals, 19(2), 102108. doi:10.1071/HE08102

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Joanna Briggs Institute. (2019). Critical appraisal tools. Retrieved from https://joannabriggs.org/critical-appraisal-tools

  • Keikelame, M.J., & Swartz, L. (2019). Decolonising research methodologies: lessons from a qualitative research project, Cape Town, South Africa. Global Health Action, 12(1), 1561175. PubMed ID: 30661464 doi:10.1080/16549716.2018.1561175

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kinchin, I., McCalman, J., Bainbridge, R., Tsey, K., & Lui, F.W. (2017). Does Indigenous health research have impact? A systematic review of reviews. International Journal for Equity in Health, 16(1), 52. doi:10.1186/s12939-017-0548-4

    • Crossref
    • Search Google Scholar
    • Export Citation
  • King, M., Smith, A., & Gracey, M. (2009). Indigenous health part 2: The underlying causes of the health gap. The Lancet, 374(9683), 7685. doi:10.1016/S0140-6736(09)60827-8

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lai, H.P.H., Miles, R.M., Bredin, S.S.D., Kaufman, K.L., Chua, C.Z.Y., Hare, J., . . . Warburton, D.E.R. (2019). “With every step, we grow stronger”: The cardio metabolic benefits of an Indigenous-led and community-based healthy lifestyle intervention. Journal of Clinical Medicine, 8(4), 422. doi:10.3390/jcm8040422

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Laverty, M., McDermott, D.R., & Calma, T. (2017). Embedding cultural safety in Australia’s main health care standards. The Medical Journal of Australia, 207(1), 1516. PubMed ID: 28659104 doi:10.5694/mja17.00328

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Liamputtong, P. (2011). Focus group methodology: Principles and practice. Singapore: SAGE. doi:10.4135/9781473957657

  • Lin, I.B., Ryder, K., Coffin, J., Green, C., Dalgety, E., Scott, B., . . . O’Sullivan, P.B. (2017). Addressing disparities in low back pain care by developing culturally appropriate information for Aboriginal Australians: “My back on track, my future.” Pain Medicine, 18(11), 20702080. PubMed ID: 28087847 doi:10.1093/pm/pnw314%

    • Search Google Scholar
    • Export Citation
  • LoGiudice, D. (2016) The health of older Aboriginal and Torres Strait Islander peoples. Australasian Journal of Ageing, 35(2), 8285. doi:10.1111/ajag.12332

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lukaszyk, C., Coombes, J., Sherrington, C., Tiedemann, A., Keay, L., Mackean, T., Clemson, L., . . . Ivers, R. (2018). The Ironbark program: Implementation and impact of a community-based fall prevention pilot program for older Aboriginal and Torres Strait Islander people. Health Promotion Journal of Australia, 29(2), 189198. PubMed ID: 30159986 doi:10.1002/hpja.25

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Maxwell, H., O’Shea, M., Stronach, M., & Pearce, S. (2019). Empowerment through digital health trackers: An exploration of Indigenous Australian women and physical activity in leisure settings. Annals of Leisure Research, 24(1), 150167 . doi:10.1080/11745398.2019.1674677

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mbuzi, V., Fulbrook, P., & Jessup, M. (2018). Effectiveness of programs to promote cardiovascular health of Indigenous Australians: A systematic review. International Journal for Equity in Health, 17(1), 153. PubMed ID: 30261878 doi:10.1186/s12939-018-0867-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McPhee, J.S., French, D.P., Jackson, D., Nazroo, J., Pendleton, N., & Degens, H. (2016). Physical activity in older age: Perspectives for healthy ageing and frailty. Biogerontology, 17(3), 567580. PubMed ID: 26936444 doi:10.1007/s10522-016-9641-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mills, K., Gatton, M.L., Mahoney, R., & Nelson, A. (2017). ‘Work it out’: Evaluation of a chronic condition self-management program for urban Aboriginal and Torres Strait Islander people, with or at risk of cardiovascular disease. BMC Health Services Research, 17(1), 680. PubMed ID: 28950874 doi:10.1186/s12913-017-2631-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., & The PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), e1000097. doi:10.1371/journal.pmed.1000097

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Moy, K.L., Sallis, J.F., Ice, C.L., & Thompson, K.M. (2010). Physical activity correlates for native Hawaiians and Pacific Islanders in the mainland United States. Journal of Health Care for the Poor and Underserved, 21(4), 12031214. PubMed ID: 21099072 doi:10.1353/hpu.2010.0943oct/04_0028.htm

    • Search Google Scholar
    • Export Citation
  • Panaretto, K.S., Wenitong, M., Button, S., & Ring, I.T. (2014), Aboriginal community controlled health services: Leading the way in primary care. Medical Journal of Australia, 200(11): 649652. doi:10.5694/mja13.00005

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Passmore, E., Shepherd, B., Milat, A., Maher, L., Hennessey, K., Havrlant, R., . . . Mitchell, J. (2017). The impact of a community-led program promoting weight loss and healthy living in Aboriginal communities: The New South Wales knockout health challenge. BMC Public Health, 17(1), 951951. PubMed ID: 29237437 doi:10.1186/s12889-017-4955-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pedersen, M., Harris, K.J., Brown, B., Anderson, K., & Lewis, J.P. (2021). A Systematic review of interventions to increase physical activity among American Indian and Alaska Native older adults. The Gerontologist. Advance online publication. doi:10.1093/geront/gnab020.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • Pelletier, C.A., Smith-Forrester, J., & Klassen-Ross, T. (2017). A systematic review of physical activity interventions to improve physical fitness and health outcomes among Indigenous adults living in Canada. Preventive Medicine Reports, 8, 242249. PubMed ID: 29181296 doi:10.1016/j.pmedr.2017.11.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Péloquin, C., Doering, T., Alley, S., & Rebar, A. (2017). The facilitators and barriers of physical activity among Aboriginal and Torres Strait Islander regional sport participants. Australian and New Zealand Journal of Public Health, 41(5), 474479. PubMed ID: 28749566 doi:10.1111/1753-6405.12701

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ramsden, I. (2000). Cultural safety/Kawa Whakaruruhau ten years on: A personal overview. Nursing Praxis in New Zealand, 15(1), 412. PubMed ID: 11221309 doi:10.36951/NgPxNZ.2000.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ryan, C.J., Cooke, M., Kirkpatrick, S.I., Leatherdale, S.T., & Wilk, P. (2018). The correlates of physical activity among adult Metis. Ethnicity & Health, 23(6), 629648. PubMed ID: 28277016 doi:10.1080/13557858.2017.1294655

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ryder, C., Mackean, T., Coombs, J., Williams, H., Hunter, K., Holland, A.J.A., & Ivers, R. Q. (2020). Indigenous research methodology—Weaving a research interface. International Journal of Social Research Methodology, 23(3), 255267. doi:10.1080/13645579.2019.1669923

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sawchuk, C.N., Russo, J.E., Bogart, A., Charles, S., Goldberg, J., Forquera, R., . . . Buchwald, D. (2011). Barriers and facilitators to walking and physical activity among American Indian elders. Preventing Chronic Disease, 8(3), A63. PubMed ID: 21477503 https://pubmed.ncbi.nlm.nih.gov/21477503/

    • Search Google Scholar
    • Export Citation
  • Sawchuk, C.N., Russo, J.E., Roy-Byrne, P., Goldberg, J., Forquera, R., & Buchwald, D. (2017). Changes in physical activity barriers among American Indian elders: A pilot study. American Indian and Alaska Native Mental Health Research, 24(1), 127140. doi:10.5820/aian.2401.2017.127

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sherwood J. (2013). Colonisation—It’s bad for your health: The context of Aboriginal health. Contemporary Nurse, 46 (1 ), 2840. PubMed ID: 24716759 doi:10.5172/conu.2013.46.1.28

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Smith, L. (2012). Decolonizing methodologies (Revised ed.). Otago, New Zealand: Otago University Press.

  • Son, J.S., & Hutchinson, S.L. (2009). Conceptualizing leisure self‐care in an exploratory study of American Indian elders’ health beliefs and behaviours. Leisure/Loisir, 33(2), 479509. doi:10.1080/14927713.2009.9651450

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stronach, M., Maxwell, H., & Taylor, T. (2016). ‘Sistas’ and aunties: sport, physical activity, and Indigenous Australian women. Annals of Leisure Research, 19(1), 726. doi:10.1080/11745398.2015.1051067

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sushames, A., Van Uffelen, J.G., & Gebel, K. (2016). Do physical activity interventions in Indigenous people in Australia and New Zealand improve activity levels and health outcomes? A systematic review. The International Journal of Behavioral Nutrition and Physical Activity, 13(1), 129. PubMed ID: 28003015 doi:10.1186/s12966-016-0455-x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Temple, J.B., Wilson, T., Taylor, A., Kelaher, M., & Eades, S. (2020). Ageing of the Aboriginal and Torres Strait Islander population: Numerical, structural, timing and spatial aspects. Australian and New Zealand Journal of Public Health, 44(4), 271278. PubMed ID: 32510736 doi:10.1111/1753-6405.13001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8(1), 45. doi:10.1186/1471-2288-8-45

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tjepkema, M., Bushnik T., & Bougie E. (2019). Life expectancy of First Nations, Métis and Inuit household populations in Canada. Statistics Canada. Catalogue Health Reports, 30(12), 310. doi:10.25318/82-003-x201901200001-eng

    • Search Google Scholar
    • Export Citation
  • Warbrick, I., Wilson, D., & Boulton, A. (2016). Provider, father, and bro-sedentary Māori men and their thoughts on physical activity International Journal for Equity in Health, 15(1), 22. PubMed ID: 26846319 doi:10.1186/s12939-016-0313-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Waterworth, P., Pescud, M., Braham, R., Dimmock, J., & Rosenberg, M. (2015). Factors influencing the health behaviour of Indigenous Australians: Perspectives from support people. PLoS One, 10(11), e0142323. doi:10.1371/journal.pone.0142323

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wilson, S. (2008). Research is ceremony, Indigenous research methods. Halifax and Winnipeg, Canada: Fernwood Publishing.

  • World Health Organization. (2016). Physical activity and older adults. Retrieved from http://www.who.int/dietphysicalactivity/factsheet_olderadults/en

    • Search Google Scholar
    • Export Citation
  • Ziabakhsh, S., Pederson, A., Prodan-Bhalla, N., Middagh, D., & Jinkerson-Brass, S. (2016). Women-centered and culturally responsive heart health promotion among Indigenous women in Canada. Health Promotion Practice, 17(6), 814826. PubMed ID: 27052639 doi:10.1177/1524839916633238

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 5626 1149 143
Full Text Views 247 125 18
PDF Downloads 270 106 19