Abstract
Background: Physical activity (PA) interventions are limited in number and reach for youth with physical disabilities (YPD) who experience systemic barriers that may preclude their in-person participation. Further, a lack of theory in the development and evaluation of PA interventions impedes our understanding and replication of active components of behavior change. These limitations pose challenges in the effective promotion of PA in YPD. Theory-based and more inclusive methods of PA intervention delivery must be explored in our efforts to promote PA and overall health in YPD.Methods: A pilot study was conducted to evaluate the feasibility and outcomes of an online, 4-week social cognitive theory-based PA intervention for YPD. Intervention feasibility (implementation fidelity, intervention compliance, and intervention acceptability) was evaluated through manual documentation, weekly feedback questionnaires, and open-ended feedback at 1-month post-intervention. Targeted social cognitive (outcome expectations, self-efficacy [task, self-regulatory, barrier] and self-regulation) and PA behavior outcomes were self-reported at baseline and 1-week and 1-month post-intervention.Results: Sixteen YPD (Mage = 17.4 ± 2.7 years, 69% female) completed the study. Intervention feasibility was supported by high implementation fidelity (100%), high intervention compliance (>90%), and positive ratings on indicators of acceptability for all weeks of the intervention (weekly feedback questionnaire means ranging from 5.74 to 6.19 out of 7). Through open-ended feedback, participants indicated the intervention was easy to use and understand, favorably shifted their self-awareness and personal meaning of PA, and provided value and potential for future use pertaining to the learned self-regulation skills and strategies. Participants also provided formatting and content recommendations for intervention improvement. Repeated measures ANOVAs showed significant and large effect sizes for changes in participants' task (p = 0.01, n2p = 0.28) and barrier (p = 0.02, n2p = 0.24) self-efficacy, goal-setting and planning and scheduling behaviors (ps < 0.001, n2ps = 0.42), and self-reported PA behavior (p = 0.02, n2p = 0.26).Conclusions: An online PA intervention for YPD is feasible and may offer potential benefit through the enhancement of self-efficacy, self-regulation, and PA behavior. Continued research is necessary to understand the efficacy and longer-term outcomes of online, theory-based interventions for YPD as a PA promotion strategy.
Highlights
4% of Canadian children and youth under the age of 15 years and 13% of Canadian youth and young adults ages 15–24 years have a disability causing daily activity limitations (1, 2)
Youth with physical disabilities (YPD) are at increased risk of experiencing health disparities and developing secondary health conditions related to the presence of health risk behaviors, such as insufficient physical activity (PA) (3)
Utilizing theory in the development and evaluation of behavior change interventions is critical for identifying and replicating the active components of an intervention leading to potential behavior change, with one of the most prominent theories in PA promotion research being social cognitive theory (SCT)
Summary
4% of Canadian children and youth under the age of 15 years and 13% of Canadian youth and young adults ages 15–24 years have a disability causing daily activity limitations (1, 2). There is evidence supporting the use of SCT in PA interventions for youth with visual impairments (10) and cerebral palsy (11), such that youth demonstrated an increase in at least one of the targeted SCT constructs (i.e., outcome expectations, self-efficacy, and self-regulation) and in their PA behavior, respectively. Despite the absence of maintenance effects in both studies, this early evidence of short-term social cognitive and behavioral change in youth with visual impairments and cerebral palsy demonstrates that SCT may be an appropriate. A lack of theory in the development and evaluation of PA interventions impedes our understanding and replication of active components of behavior change. These limitations pose challenges in the effective promotion of PA in YPD.
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