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Factors Influencing Qatari Women's Physical Activity

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Factors Influencing Qatari Women's Physical Activity Factors Influencing Qatari Women’s Physical Activity A Thesis Submitted to the College of Graduate and Postdoctoral Studies In Partial Fulfillment of the Requirements For the Degree of Doctor of Philosophy In the Department of Community Health and Epidemiology University of Saskatchewan Saskatoon, Canada by Lena Mohammed Zimmo © Lena Mohammed Zimmo, April 2017. All rights reserved PERMISSION TO USE In presenting this thesis in partial fulfillment of the requirements for a Postgraduate degree from the University of Saskatchewan, I agree that the Libraries of this University may make it freely available for inspection. I further agree that permission for copying of this thesis in any manner, in whole or in part, for scholarly purposes may be granted by the professor or professors who supervised my thesis work or, in their absence, by the Head of the Department or the Dean of the College in which my thesis work was done. It is understood that any copying or publication or use of this thesis or parts thereof for financial gain shall not be allowed without my written permission. It is also understood that due recognition shall be given to me and to the University of Saskatchewan in any scholarly use which may be made of any material in my thesis. Requests for permission to copy or to make other uses of materials in this thesis in whole or part should be addressed to: Head of the Department of Community Health & Epidemiology Box 7, Health Science Building, 107 Wiggins Road University of Saskatchewan Saskatoon, Saskatchewan, S7N 5E5 i ABSTRACT Although physical activity (PA) has numerous health benefits, data show that 60% of Qatari women do not engage in regular PA. To successfully modify PA behavior among Qatari women, factors that influence this behavior must be understood. This study aims to understand the factors that influence Qatari women aged 18-44 to be physically active and to identify possible interventions for enhancing PA behavior among Qatari women. This ethnographic study is framed by Islamic Feminism and guided by the Socio-ecological Model. It involved three data collection methods: interview, photovoice, and participant observation. Eight Qatari women aged 18-44 years were involved in interviews and/or photovoice activities, and participant observation was carried out in public places. Thematic analysis was used to identify key themes and subthemes across all transcripts, photographs, and fieldnotes. Findings are organized under four themes: beliefs and faith, culture, the physical environment, and wealth and luxury. Four subthemes emerged within the beliefs and faith theme: positive perceptions of PA with some misconceptions, perceived low motivation for PA, Islam supports for women’s PA within specific guidelines, and Islamic activities create a domain for PA. The results of this study suggest that PA is informed by gender ideologies that structure the framework of men and women to engage in PA behavior. Six main culture-related issues that impact Qatari women’s PA are identified in this study: social roles and caregiving responsibilities, the need for approval to engage in outdoor PA, the conservative dress codes and behavioral expectations, the negative perception towards women walking in streets and neighborhoods, the restricted time rules for PA, and the fact that PA is not considered as leisure and social activity. The results of this study show that the natural environment in Qatar creates a challenge for the adoption of PA behavior and the built environment supports PA but only in specific locations. This study documents the effect of wealth, luxury, socio-economic transition, and the rapid urbanization on PA behavior. The opportunities, constraints, and needs identified in this study provide important insights about changes that could be undertaken to increase the PA of Qatari women. ii ACKNOWLEDGMENT I would like to express my sincere thankfulness and appreciation to my supervisor Dr. Bonnie Janzen for her continuous help and support during my PhD journey. I also extend my thanks to my advisory committee members, Dr. Sylvia Abonyi, Dr. Louise Humbert, and Dr. Marwa Farag, as well as to the chair of advisory committee, Dr. Lori Hanson, and the external examiner, Dr. Tam Donnelly, for giving their time and assistance in this thesis. I am truly thankful to have been given the chance to work with such inspirational women. I could not have imagined having a better supervisor and committee for my PhD study. I carry a depth of gratitude to my mom Basmah, dad Mohammed, sisters Amal and Reem, and brother Yasser, who have provided me with unending love, support and inspiration. They have rooted my eagerness to learn and ambition to reach my goals. They also helped me with my children, so I had time to finish my study. Thanks to my husband Rami and my children Mohammed, Abdulaziz and Yosuf, who have been by my side throughout this entire journey. Their endless patience, love and support have been the key to my achievement. Finally, my sincere gratitude to my friends and colleagues who were always willing to support me, especially Ezajul Choudhury, Oluafemi Oluwole, Heather McWhinney, Sultan Almalki, Dr. Mohamed Al Kuwari, Dr. Izzeldin Ibrahim, Mohammed Farooq, Nathan Carr, May Awartani, and Rima Tabanji. Without your ongoing support, it would have been a very lonely journey. iii PREFACE The main purpose of conducting this ethnographic study is to fulfill the requirements for the Degree of Doctor of Philosophy in the Community and Population Health Sciences, Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada. In ethnography, the researcher is considered the main instrument for data collection. The data may be affected by the ethnographer’s own values, background, socio-historical location, and political orientation. Therefore, it is important for researchers to assess, identify, and be transparent about their effects on the research throughout the various stages. Since I was the primary research instrument in this study, I have described my background below. I am originally from Saudi Arabia; I was born and raised in Jeddah, the second biggest city in Saudi Arabia after the capital Riyadh. Jeddah is distinguished from other cities in Saudi Arabia by virtue of being the principal gateway to both Mecca and Medina, Islam's holiest cities. The geographical location of Jeddah has attracted people to move to this city for over hundreds of years, thus enriching the social structure of the city. Jeddah is heavily populated by modest Muslims as a result of its ethnic and cultural diversity. My mother was born and raised in Palestine before she moved with her family to Saudi Arabia because of the war. My personality, beliefs, and viewpoints have been influenced by both Palestinian and Saudi cultures. After I had finished the course requirements for a Bachelor of Nursing degree in Jeddah, I married and moved to Qatar with my husband. I completed my internship requirement for my Bachelor’s Degree in Qatar. Since 2006, I have lived between Qatar and Canada due to my study commitments. I finished my Master’s degree in Health Administration at the University of Dalhousie, Halifax, and completed my PhD in Community and Population Health Sciences at the University of Saskatchewan, Saskatoon. My interest in understanding the factors influencing physical activity among women in Qatar came from one of my experiences there. At the time, I had just returned from Canada after finishing my Master’s degree. My children were restless, so I decided to take them outside. As I did not have a car, I put my two children in the stroller and walked to the nearest petrol station, which, like most petrol stations, included mini markets and service spots. It was very difficult to iv walk as the infrastructure was not designed for me to easily do so. Moreover, I felt that people were staring at me while I walked. Although no one bothered me, it was an uncomfortable experience that sparked an interest in the topic of physical activity among women. As a citizen of the Gulf (Saudi Arabia) and a resident in a Western country (Canada), I have a distinct position within Qatari society. I consider myself both an insider and an outsider at the same time. I think of myself an insider because I come from the same social background as most Qataris: Muslim, Gulf, and conservative society. I think of myself as an outsider as I have been exposed to different beliefs and viewpoints as a result of having lived in multiple cities and in a range of different societies (Saudi Arabia, Palestine, Qatar, and Canada). I consider myself a modest Sunni Muslim, with a good understanding of most of the Muslim sects, including the Wahhabism sect, the main sect in Saudi Arabia and Qatar. I am also bilingual as I can fluently speak and write in both Arabic and English. v TABLE OF CONTENTS CHAPTER 1 .................................................................................................................................. 1 INTRODUCTION......................................................................................................................... 1 1.1 Defining the Problem .......................................................................................................... 1 1.2 Research Questions ............................................................................................................. 2 1.3 Background about Qatar ...................................................................................................
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