Exploring obesogenic environments: the design and development of the migrant obesogenic perception of the environment questionnaire (MOPE-Q) using a sample of Iranian migrants in Australia

Abstract

BACKGROUND: Although there are a number of studies examining the effect of migration on obesity, these studies tend to focus on the role of acculturation in this relationship. However, there are indications that the change in environment may also be an important factor. Indeed, there is a considerable lack of psychometric tools designed to assess the association between environment and migrant health behaviour. The current study aimed to assess the literature on the link between environment and health for migrants, and on the basis of this information, design and develop the Migrant Obesogenic Perception of the Environment questionnaire (MOPE-Q). The MOPE-Q is the first comprehensive measure of the impact of environmental factors on migrant health behaviour related to physical activity, food habits and body image concern, as well as weight change. METHODS: Using a systematic approach, an initial pool of items for the questionnaire was developed and refined on the basis of rigorous content and face validity assessments and factor analysis. Further, reliability tests and test re-test studies were undertaken. Differences between Iranian and Australian environmental factors as they relate to obesogenic behaviour were explored using the developed measure. RESULTS: A total of 36 items were developed for the MOPE-Q. Principal factor analysis identified three similar factor structures of environmental factors related to obesity (categorized in terms of facilitators, barriers and pressures) for each country. The final questionnaire consisted of four distinct subscales pertaining specifically to the Australian environment and five subscales pertaining to the Iranian environment, accounting for 59% and 63%, respectively, of the total variance in obesity rates. Data suggests that the MOPE-Q is a reliable and valid self-report measure for assessing the relationship between environmental factors linked to obesity and obesogenic behaviour for this particular migrant group. CONCLUSION: The variations in environmental factors linked to obesity behaviour between home (Iran) and host (Australia) countries have been incorporated into the MOPE-Q instrument which has shown good psychometric properties. The MOPE-Q can be adapted and applied to other environments and populations to help explain changes in diet, physical activity patterns and body weight in migrant groups as they acculturate.