The socio-demographic factors and baseline health assessments of the low and high attendees were compared. Low attendees were more likely to be employed (7 low attendees compared to 5 high attendees), were less likely to have dependants under the age of 18 (4 low attendees compared to 2 high attendees), and on average lived 2.6 km further from where classes were held. Compared to high attendees, low attendees were on average nearly 4 years younger and 7.6 kg heavier, with a waist circumferences 9.5 cm larger, and a fasting insulin 5.6 mmol/L higher. There was no difference between groups for educational attainment, annual household income, fasting glucose, HbA1c or lipid profile. These differences were noted, but due to the small number of participants no statistical analysis was conducted and no firm conclusions can be drawn about their significance.
Program motivation
The global theme of program motivation was comprised of participant’s initial motivation to enrol, and their motivation to attend the fitness program following enrolment. As depicted in Figure
1, motivation was not static, but changed as women gained experience with the program.
Motivation to enrol
The motivations driving participants to enrol were similar regardless of attendance level. All participants, with the exception of one, identified a desire to improve their personal health and wellbeing in general or to mitigate an existing health issue as the impetus for registering. For example, “I just thought it might be a good way to kick start my health again.” For others, their health concern was linked to improving a specific health-related outcome, for example, “to hopefully get fit and lose a bit of weight” or improve an existing medical condition, “I’ve got high blood pressure and I want to try and get off as much tablets as I can.” Only one participant did not mention personal health as a motivation for enrolling, however she was a low attendee who provided a short phone interview which had gaps in the transcript due to telephone line interference and background noise.
Some participants were curious about the program and thought they would see what it had to offer, “I just thought I'd just try it and see what it was like” and because there was no financial cost they felt they had nothing to lose, “any exercise you can do for free, why not!” Other participants were attracted by its social aspect to either “meet new people”, to network with other Aboriginal and Torres Strait Islander women, or thought it was a great opportunity to “get together as a group of Aboriginal and Torres Strait Islander people …and do it.” Finally, a secondary motive for joining the program related to participants supporting the research, “…and also to support the program because I think it’s a really good program.”
Motivation to attend
From the women’s stories we identified five sources of motivation related to their ongoing attendance, specifically, their original motivation to enrol in the program, their self-motivation to be active, the motivation they received from family and friends, motivation gained from experience they had in the program, and their personal circumstances.
Self-motivation was realised through participants prioritising their needs and/or a strong commitment to completing the program. “I just made that a priority for me and then I just worked around that.” Participants were also motivated and encouraged to attend regularly by their family and friends:
“… my family and friends – they knew I was participating in the program and they thought it was really good and especially my Mum – she reminded – “Oh, you’ve got that thing tonight at six – remember that.”
Overall, a participant’s program experience seemed to have either a positive or a negative impact on their motivation for ongoing attendance. “I loved it; I enjoyed going there, that’s why I went there all the time.” When asked if there was anything about the program they found particularly motivating, a participant explained:
“I think just the atmosphere of everyone was willing to give it a go, that was motivating and the fact that they were also supportive, just (staff members) – they were like really supporting. They were like “C’mon …, you can do another one of those.” And plus all the ladies – I found them really supporting because I was the youngest one and they were all just encouraging me little by little you know. So it was just the atmosphere really that was motivating me to keep going.”
The personal circumstances of each participant also impacted on their motivation to attend classes. Some of these factors are described below and even though most were not specifically linked by some participants to their motivation others noted that factors such as logistical issues could make them feel ‘reluctant’ to attend.
Participant circumstances
A participant's personal circumstances influenced their ability to engage in the program regardless of their motivation to enrol. Personal health issues, ‘logistics’, competing priorities, and instrumental support acted to either constrain or enable their participation.
Personal health
Personal health issues surfaced as a strong barrier to class attendance. Low attendees were more likely to report long-term injuries or illnesses during the 12-week program:
“Well for me I know that I missed the first couple of weeks because I was actually injured from netball.”
High attendees, on the other hand, only experienced mild or short-term illnesses or injuries.
Logistics
For high attendees logistical factors were not identified as barriers to attendance although, for some, parking was noted as a nuisance. Most high attendees found the class times and location convenient, as illustrated in the examples below:
“I found it good, like the location, because it was in close proximity to my work”,
“The timing was really good because they do it at 6-7[pm] … Tuesday and a Thursday so yeah if it was any earlier then maybe I wouldn’t have been able to.”
Whereas, for some low attendees, the location was a barrier to attendance,
“Yeah I did half the program. I stopped because it got too far away for me.
Even though some logistical issues were more ‘inconveniences’ rather than barriers, participants noted the effect on their motivation to attend:
“Sometimes it made me reluctant. Do I feel like sitting through traffic?”
Crèche was often mentioned by the women who used the service; however, it is unknown if its absence would have been a limiting factor for these participants or just an added convenience. The fact that the program was ‘free’ was regularly mentioned by interviewees. Some participants also discussed the cost of gyms and other activities:
“…a lot of people can't afford something like that (gym membership) because most people in (suburb) are on the dole or on a pension (government welfare).”
Competing obligations
Competing obligations were barriers to class attendance and included family obligations, work, study and/or other commitments. The impact of competing obligations varied significantly; some were one-off events, such as a family member’s birthday, while others were short-term priorities, such as being asked to work back late for several days, or study commitments, “going away on block study caused a bit of an interruption.” High attendees reported less competing obligations, while low attendees either reported having several obligations, or they experienced major life events that completely hindered attendance for a significant block of time, such as death in the family.
“I was able to keep up with it for the first month, then after the first six weeks I started decreasing because I had other (health and family) issues and other (study and work) interruptions.”
“…but then unfortunately during the last few weeks I had a death in the family so I had to go out of town so that didn’t really help because I was out – I was completely out in the middle of nowhere.”
Instrumental support
Instrumental supports emerged as tangible or practical supports normally offered by family members or friends. In our analysis, we found that instrumental supports modified a competing obligation or logistical issue. For example a participant who was normally responsible for getting her children ready in the morning and taking them to childcare and kindergarten received instrumental support from her husband so that she could attend morning exercise classes:
“So obviously my husband is quite supportive in terms of like getting the kids up … because I would leave home by 6:30 am.”
Another participant who attended evening classes was assisted by her mother who loaned her a car, “I used her (mother’s) car for most of the time … so I wouldn’t be catching the buses that late.” However, having support did not prove essential to attendance. Participants who did not identify any barriers or competing priorities did not require support to enable their attendance.
“Well I didn’t have really, any family commitments, because my daughter’s away, and really, not that much work really, it’s just your 9 to 5 during the week, so I didn’t have really, no problem about attending any sessions or exercise classes and things like that, so, no that was pretty easy for me.”
Participant’s program experience
All participants, with the exception of one, reported their program experiences to be all positive. The program experience reflected the program suitability, professionalism of the program, class encouragement (from participants and staff), program atmosphere, and personal reinforcing factors.
Program suitability
Participants reported that the program was a good fit for themselves and other participants. It met their needs and expectations. They particularly liked the fact that the activities accommodated participant’s different fitness levels:
“(they) catered for all different levels, you know what I mean, like say if you were just a beginner or something … you could work at that level or you could be higher fitness level, whatever and it's a, it accommodates to that as well.”
Participants enjoyed the exercises, and this impacted their motivation to attend, “I was really enjoying the classes so that just kept me coming back for more.”
Unfortunately one participant, a low attendee, found that the program was not what she expected. She also felt the program was not suited to her fitness level, consequently she felt “uncomfortable.”
“Well at first I thought the circuit class was going to be good but I found some of the exercise was a little bit hard for me … so yes I did an adaptation of some of those exercises that the instructor would say if you can’t do that one well you do it this way and she’d show you a different way and that was good but I still felt a bit uncomfortable … maybe if it was like one group was over one side of the room and the other group was on the other side so that we were able to go at a slower pace…”
Professional program
The professionalism of the program contributed to the overall program experience. Most women reported that they felt confident that the staff were knowledgeable and professional, reliable and had good communication skills. They also found the program well organised which made the program “easy and not a chore.”
“I thought that it was really good and run really well, kept up to date with everything and good communication, people were friendly.”
Class encouragement
During the interviews many women discussed the encouragement they received from program staff and their fellow participants. Participants indicated that they found the encouragement during class motivated them to put their full efforts into the activities, thereby influencing their motivation to attend the classes.
“When the instructors sort of pushed you, and challenged you to try the new things actually it was surprising to think, oh my goodness I can actually do that exercise…”
“I think that was just the environment and the people that were there, and a lot goes to the staff that were doing it. Like you know they were very encouraging whether it was (staff member) or (researcher) or any of the instructors that were there, everyone was encouraging and yeah.”
Program atmosphere
The atmosphere of classes had a significant impact on the participants’ program experience. This included the relationships that the women formed with fellow participants and program staff. When participants were asked what they found particularly motivating about the class most talked about the group environment, a positive atmosphere and feeling comfortable. All participants made reference to liking the fact that the program was “a group of women and they were going to be with other Nungas or other Aboriginal, Torres Strait Islander women” or that the participants shared goals or were on a similar journey or that they “felt comfortable.”
‘I think it was supportive like everyone was really encouraging … being all Aboriginal women was good, you didn’t feel out of place … It was a program that specialised to make their environment as comfortable as it could be for participation … it just helped with the participation or your ability to do some of the exercises.’
There was a sense of women sharing a journey together and in a culturally safe environment in which they felt ‘no shame’. These factors contributed to their program experience and ongoing motivation to attend the classes.
Personal reinforcing experiences
All participants reported perceived improvements on one or more aspects of their physical or emotional well-being. The most common reinforcing factors were participants perceiving physical improvements such as feeling the exercises becoming ‘easier’ or feeling ‘fitter’ during the 12-week program.
“I could feel the difference in the fitness level of myself. I guess and I was able to do some of the exercises a lot more easier than when I first started.”
These physical improvements extended to women talking about losing weight, sleeping better, having improved blood pressure, as well as experiencing reduced pain in their joints and improved mobility.
The women also reported having ‘more energy’ “…like I said, I feel fitter, healthier, more energy”,
Beyond improvements in energy, women also shared stories about perceived improvements to their mental well-being, such as feeling less stressed or feeling better about themselves.
“…since I started the program and exercising and stuff it just lifted me and helped me to feel better about myself. I wasn’t depressed or anything, but I just didn’t have any motivation to do anything, whereas now I know with exercise and eating well you feel good and you know, it’s a benefit.”
Participants also commonly reported that they ‘felt good’ after the exercise sessions. Additionally high attendees reported a sense of achievement or accomplishment:
“…it was hard work, and we felt really good after it, a real high after it. And it took away all that stress and you felt really happy.”
As discussed earlier and depicted in Figure
1 the participant’s circumstances and their program experience fed into their motivation to attend the classes, which was also influenced by their initial motivation to enrol, their self-motivation and the motivation that they received from their family and friends.