A NATIONAL STUDY OF ADULTS WITH PHYSICAL DISABILITIES?? PHYSICAL ACTIVITY BEHAVIOR USING TRANSTHEORETICAL MODEL CONSTRUCTS

Abstract

A large percentage of adults with physical disabilities are inactive (56%). To improve this situation, more theory-based research is needed. One promising approach is offered by the Transtheoretical Model (TM). PURPOSE Assess adults with physical disabilities' physical activity behavior using each of the core constructs of TM, along with unique barriers experienced by this population segment, and determine if disability type has a moderating effect. METHODS This was a cross-sectional study whereby 411 people responded to national advertising, with 322 (78.3%) people meeting the study's eligibility criteria and returning usable surveys. On average participants were 52.5 yr. old, the majority were female (62.1%) and Caucasian (91.9%), and the majority had experienced one or more of the following disability types: post polio, multiple sclerosis, spinal cord injury, amputation, or cerebral palsy. Participants completed a demographic questionnaire and physical activity and disability specific measures of stage of change, processes of change, decisional balance, self-efficacy, and barriers. Data were analyzed using a 5 (stage of change [SOC]) × 6 (disability type) MANOVA. RESULTS Significant main effects (p < 0.01) were observed for both SOC and disability type, however the interaction was not significant (p > 0.25). Participants classified by their SOC differed on each of the TM constructs, as well as physical activity barriers. Intra-ocular observations revealed a gradient pattern of improvement from precontemplation through maintenance for all constructs. Across disability types, the behavioral processes of change, self-efficacy, and decisional balance all showed differential patterns of use. CONCLUSION These results generally support the utility of TM for understanding and describing adults with physical disabilities' physical activity behavior, though it does appear disability type may have a moderating effect. Funded by the National Institute on Disability and Rehabilitation Research, U.S. Department of Education.