Most immigrant groups to the UK from low and middle-income countries have a high risk of overweight/obesity and of associated non-communicable diseases. Community readiness to engage in interventions needs to be understood before appropriate interventions can be implemented. This study assesses community readiness to prevent overweight/obesity among Ghanaian immigrants in Greater Manchester, England. The community readiness model (CRM) was applied using a semi- structured interview tool with 13 key informants (religious and other key community members) addressing five readiness dimensions (community knowledge of efforts, leadership, community climate, knowledge of the issue and resources). A maximum of 9 points per dimension (from 1 = no awareness to 9 = high level of community ownership), alongside qualitative textual thematic analysis. The mean readiness score indicated that the study population was in the “vague awareness stage” (3.08 ± 0.98). The highest score was observed for community knowledge of the issue (4.42 ± 0.99) which was in the pre-planning phase, followed by community climate (vague awareness; 3.58 ± 0.62). The lowest scores were seen for resources (denial/resistance; 2.70± 0.61) and Knowledge of efforts (no awareness; 1.53 ± 0.44). Explanations are sought in terms of structural barriers and socio-cultural norms where structural barriers include poor living conditions as a result of poorly paid menial jobs and high workload, contributing to the adoption of unhealthy eating behaviours. Socio-cultural factors such as fatalism, hereditary factors and social status were associated with acceptance of overweight. Despite recognising overweight/obesity as an important health issue in these communities especially among women, it is not seen as a priority. To help these communities to become more ready for interventions that tackle overweight/obesity, the focus should initially be to address the structural barriers identified, reduce poverty and then focus on the socio-cultural factors.
Acknowledgments
The authors are very grateful to the key informants for participating in this research. This work was supported by the AXA Research Fund
