Perceived influences on diet and physical activity among women in socioeconomically disadvantaged neighbourhoods in Uppsala, Sweden: A qualitative study

Abstract: Background: Type 2 diabetes (T2D) is of increasing public health concern in Sweden. Socioeconomically disadvantaged areas report a higher disease burden of T2D. T2D is highly preventable through health behaviour like eating a healthy diet and being physically active (PA). Factors influencing diet and PA behaviours are therefore essential to understand to implement targeted health interventions. Hence the aim of this study is to understand factors influencing diet and PA in women living in socioeconomic disadvantaged areas in Uppsala, Sweden. Method: A qualitative study design with 10 semi-structured in-depth interviews were conducted among women in selected neighbourhoods. Reflexive thematic analysis was used to analyse the data and the concept of information power was used to assess the adequacy of sample size. Trustworthiness was considered together with the author`s reflexivity and positionality.  Result: Women’s diet and PA behaviour are influenced by a variety of factors. Two main themes were identified: One´s own power and priorities and One´s own life situation. Theme 1 consists of personal characteristics of health knowledge, responsibility, value on health, adaptability, prioritizing simplicity and wellbeing and joy. Theme 2 consists of external influences from family, childhood, friends, colleagues, norms and the physical environment.  Conclusion: The participants experienced influences by both internal and external (norms, social- and physical environment) factors. Family and upbringing were perceived to be the major external influences. Psychological strength in combination with perceiving a healthy diet and PA as joyful and simple were important internal factors for practicing and maintaining those behaviours.