Determinants Of Physical Activity Behavior Research Articles

A qualitative study of physical activity drivers in autistic individuals using COM-B. Autistic and non-autistic perspectives

BackgroundDespite evidence of the health benefits of physical activity in non-autistic populations and the additional benefits for autistic populations, physical activity levels remain stubbornly low in autistic individuals. Understanding the determinants of physical activity is essential in order to support intervention development. MethodsThe current research applied the Theoretical Domains Framework (TDF) and Capability Opportunity Motivation, Behaviour (COM-B) model of behaviour to identify determinants of physical activity behaviour, mechanisms of action, and potentially efficacious behaviour change techniques. Fifteen semi-structured interviews were conducted with autistic adults (N = 4) and children (N = 2), parents of autistic children (N = 4), and stakeholders in autism care and support (N = 5). A deductive approach was taken to map themes onto TDF and COM-B. ResultsParticipants identified three overarching themes: Discordance between autistic and non-autistic perspectives; physically active environments; and autonomy and choice. Eight subthemes were identified and mapped onto COM-B and TDF. Recommendations for intervention development are made and potential behaviour change techniques are identified. ConclusionsGiven the important role of care providers, future research should focus on the attitudes and behaviours of individuals who care for and support autistic individuals to identify barriers and drivers of physical activity promotion, particularly for individuals with high support needs. An argument is made for co-design in future intervention development.

But that's who I Am: The inability to enact physical activity identity is associated with depression and anxiety symptoms

There is strong evidence to suggest that physical activity reduces depression and anxiety symptoms, and recently there have been calls to consider the role of psychological determinants of physical activity behaviour as part of this effect. We investigated whether a person's physical activity identity moderated the impact of physical activity on depression and anxiety symptoms. Participants aged 19–33 years (N = 97; M = 21.8; 50.5% female, 44.3% Caucasian) self-reported their physical activity identity then wore activity monitors for six days. On the seventh day, participants self-reported their depression symptoms and anxiety symptoms. Multiple linear regression models were conducted to determine whether physical activity identity moderated the link of physical activity with prospective depression and anxiety symptoms. For people who had physical activity identity scores greater than 1.51 SD more than M, physical activity and depression symptoms were negatively associated. For people with a physical activity identity score greater than 0.52 SD more than M, physical activity and anxiety symptoms were negatively associated. For those with a strong physical activity identity, not being physically active was associated with more prospective depressive and anxiety symptoms although the effect sizes were small. It may be that there are negative mental health impacts of not being physical active for those with strong physical activity identities. Physical activity interventions targeting mental health outcomes may need to be tailored for a person's identity and provide support when people do not engage with the physical activity behaviour that they value as part of their identity standards.

Depression severity and psychosocial determinants of physical activity behavior in in-patients with major depressive disorders

BackgroundPhysical inactivity is a world-wide health issue. In people with major depressive disorders approximately 68% do not reach the recommended physical activity levels. Psychosocial determinants of and implicit attitudes towards physical activity serve to explain physical activity behavior and may form the basis of interventions to promote physical activity. The aim of this study was to examine, whether psychosocial determinants and implicit attitudes towards physical activity vary according to depression severity. MethodsPhysically inactive, adult in-patients diagnosed with major depressive disorder (according to ICD-10) were recruited from four Swiss psychiatric clinics. Psychosocial determinants of physical activity were assessed with seven questionnaires pertaining to motivational and volitional aspects of physical activity. Implicit attitudes towards physical activity were measured with a computer-based Single Target Implicit Association Test. ResultsIn-patients (N = 215, Mage = 41 ± 13 years, 53% female) with major depressive disorder reporting more severe (n = 52) depression symptomology exhibited less favorable psychosocial determinants for physical activity behavior (self-efficacy, negative outcome expectancies, intention, intrinsic motivation, introjected motivation, external motivation, action planning, perceived barriers, coping planning) compared to those with mild (n = 89) and moderate (n = 74) depression symptomology. Positive outcome expectancies, identified, social support and implicit attitudes towards physical activity did not vary according to depression severity. ConclusionsPsychosocial determinants of physical activity do vary according to depression severity. Attempts to promote physical activity among people with major depressive disorder should take depression severity into account when developing and delivering interventions. Trial registrationISRCTN registry, ISRCTN10469580, registered on 3rd September 2018, https://www.isrctn.com/ISRCTN10469580.

DE-PASS Best Evidence Statement (BESt): modifiable determinants of physical activity and sedentary behaviour in children and adolescents aged 5–19 years–a protocol for systematic review and meta-analysis

IntroductionPhysical activity among children and adolescents remains insufficient, despite the substantial efforts made by researchers and policymakers. Identifying and furthering our understanding of potential modifiable determinants of physical activity behaviour...

Physical activity behavior during Covid 19 pandemic among Iranian dwellers in Southern Iran based on planned behavior theory: a SEM analysis

BackgroundThe COVID-19 pandemic restrictions curtailed physical activity. The current study applied an integrated Theory of Planned Behavior to identify the determinants of physical activity behavior and the processes involved in the COVID-19 pandemic.MethodsA cross-sectional study was conducted in Shiraz city, Southern Iran, among 2500 people who met the inclusion criteria were included in the study. Data were collected using the demographic information questions and questionnaire based on the Theory of Planned Behavior (TPB) constructs. The Questionnaire via WhatsApp, emails, and SMS was shared. Data analysis was performed using SPSS26 and Amos version 24. Mean and standard deviation was used to describe the data. Also, one-way ANOVA and structural equation analysis were used to analyze the data. The significance level in all the tests was considered to be 0.05.ResultsOne thousand one hundred sixty-nine samples (46.8%) said they had been exercising less than 3 days a week, and 47.6% of them did not have any exercise or physical activities (n = 1191). The mean score of attitudes, SN, PBC, and intention were 9.38 ± 2.07, 9.27 ± 2.03, 9.32 ± 2.05, and 12.29 ± 2.35, respectively. The effect size values demonstrate the independent variables’ high coefficient of influence on explaining the theoretical model. According to the results, the factors play an important role in samples’ intention (η2 ≥ 0.2, p ≤ 0.05). The effect size of intention on doing physical activities and exercise during the SARS-CoV-2 pandemic is Eta square = 0.777, which means the measure was high. The obtained model was good based on the main goodness of fit indices (Chi2 = 108.6, df = 25, n = 2500, Chi2/df = 4.344, RMSEA = 0.036, AGFI = 0.92, CFI = 0.95, GFI = 0.90, Fornell-Larcker criterion = 0.87, HTMT = 0.89).ConclusionThe TPB provides a useful framework to explore psychosocial determinants of physical activity behavior during the pandemic and identify key strategies for program planning aimed at improving exercise among people who were already influenced by quarantine and lockdown restrictions.

Cognitive predictors of physical activity behaviors among rural patients with type 2 diabetes: applicability of the Extended Theory of Reasoned Action (ETRA).

Background: This study aims to examine the cognitive-behavioral determinants of physical activity behaviors (PABs) of patients diagnosed with type 2 diabetes.Subjects and methods: In this cross-sectional study, census sampling was employed to enroll 120 rural patients with type 2 diabetes in the Chalderan County in 2015. To collect data, a valid and reliable instrument, based on the Extended Theory of Reasoned Action (ETRA) constructs, was used. Data were analyzed by SPSS 21 software using descriptive and inferential statistical methods.Results: Using the one-way ANOVA test, it was found that PABs had statistically significant correlation with all ETRA constructs except subjective norms (P=0.574). Knowledge (P=0.015), self-efficacy (P<0.001) and behavioral intention (P<0.001) had a significant association with PABs, respectively. Also, ETRA structures were able to reflect 41.0% of the behavioral changes. Among structures, knowledge (P=0.014), self-efficacy (P<0.001), and behavioral intention (P=0.020) were significant predictors of PABs (R2=0.414).Conclusions: Health care providers may consider the ETRA an appropriate framework to design educational interventions aimed at improving PABs among rural patients with type 2 diabetes.

Determinants of Physical Activity Behaviors among People Aged 30 to 50 Years: An Application of the Trans-Theoretical Model

Determinants of Physical Activity Behaviors among People Aged 30 to 50 Years: An Application of the Trans-Theoretical Model

Anxiety Sensitivity is Associated with Lower Enjoyment and an Anxiogenic Response to Physical Activity in Smokers.

The subjective affective response to, and enjoyment of, physical activity are strong predictors of engagement in physical activity. Anxiety sensitivity, the fear of bodily sensations, is a cognitive factor that may inhibit the pleasurable affective experience of physical activity, possibly contributing to low levels of physical activity. The current study evaluated anxiety sensitivity in relation to PA enjoyment and affective experience before and after exercise in smokers. Participants were low-active treatment-seeking smokers (n = 201) enrolled in a smoking cessation intervention. At baseline, participants completed self -report assessments of anxiety sensitivity, cigarette dependence, and physical activity enjoyment. State affect was also reported before and after a submaximal exercise test to index pre-exercise activity affect and affective response to exercise. Anxiety sensitivity was significantly negatively correlated with physical activity enjoyment, specifically lower enjoyable physical feelings of physical activity. Anxiety sensitivity was significantly correlated with lower state mood and higher state anxiety prior to the submaximal exercise test, and higher anxiety immediately after the exercise test. Additionally, anxiety sensitivity predicted increased anxiety, but not lower mood, in response to the submaximal exercise test. This is the first study to document an association of anxiety sensitivity with affective determinants of physical activity behavior in smokers. Anxiety sensitivity was associated with lower physical activity enjoyment, higher negative affect prior to after exercise testing, and an anxiogenic response to exercise. Future work is needed to understand how the current findings generalize beyond smokers.

Socio-economic determinants of physical activity across the life course: A "DEterminants of DIet and Physical ACtivity" (DEDIPAC) umbrella literature review.

BackgroundTo date, the scientific literature on socioeconomic correlates and determinants of physical activity behaviours has been dispersed throughout a number of systematic reviews, often focusing on one factor (e.g. education or parental income) in one specific age group (e.g. pre-school children or adults). The aim of this umbrella review is to provide a comprehensive and systematic overview of the scientific literature from previously conducted research by summarising and synthesising the importance and strength of the evidence related to socioeconomic correlates and determinants of PA behaviours across the life course.MethodsMedline, Embase, ISI Web of Science, Scopus and SPORTDiscus were searched for systematic literature reviews and meta-analyses of observational studies investigating the association between socioeconomic determinants of PA and PA itself (from January 2004 to September 2017). Data extraction evaluated the importance of determinants, strength of evidence, and methodological quality of the selected papers. The full protocol is available from PROSPERO (PROSPERO2014:CRD42015010616).ResultsNineteen reviews were included. Moderate methodological quality emerged. For adults, convincing evidence supports a relationship between PA and socioeconomic status (SES), especially in relation to leisure time (positive relationship) and occupational PA (negative relationship). Conversely, no association between PA and SES or parental SES was found for pre-school, school-aged children and adolescents.ConclusionsAvailable evidence on the socioeconomic determinants of PA behaviour across the life course is probable (shows fairly consistent associations) at best. While some evidence is available for adults, less was available for youth. This is mainly due to a limited quantity of primary studies, weak research designs and lack of accuracy in the PA and SES assessment methods employed. Further PA domain specific studies using longitudinal design and clear measures of SES and PA assessment are required.

A life course examination of the physical environmental determinants of physical activity behaviour: A "Determinants of Diet and Physical Activity" (DEDIPAC) umbrella systematic literature review.

BackgroundParticipation in regular physical activity is associated with a multitude of health benefits across the life course. However, many people fail to meet PA recommendations. Despite a plethora of studies, the evidence regarding the environmental (physical) determinants of physical activity remains inconclusive.ObjectiveTo identify the physical environmental determinants that influence PA across the life course.MethodsAn online systematic literature search was conducted using MEDLINE, ISI Web of Science, Scopus and SPORTDiscus. The search was limited to studies published in English (January 2004 to April 2016). Only systematic literature reviews (SLRs) and meta-analyses (MAs) of observational studies, that investigated the association between physical determinants and physical activity outcomes, were eligible for inclusion. The extracted data were assessed on the importance of determinants, strength of evidence and methodological quality.ResultsThe literature search identified 28 SLRs and 3 MAs on 67 physical environmental characteristics potentially related to physical activity that were eligible for inclusion. Among preschool children, a positive association was reported between availability of backyard space and outdoor toys/equipment in the home and overall physical activity. The availability of physical activity programs and equipment within schools, and neighbourhood features such as pedestrian and cyclist safety structure were positively associated with physical activity in children and adolescents. Negative street characteristics, for example, lack of sidewalks and streetlights, were negatively associated with physical activity in adults. Inconsistent associations were reported for the majority of reviewed determinants in adults.ConclusionThis umbrella SLR provided a comprehensive overview of the physical environment determinants of physical activity across the life course and has highlighted, particularly amongst youth, a number of key determinants that may be associated with overall physical activity. Given the limited evidence drawn mostly from cross-sectional studies, longitudinal studies are needed to further explore these associations.RegistrationPROSPERO CRD42015010616

Effects of a Theory Based Intervention on Physical Activity Among Female Employees: A Quasi-Experimental Study.

BackgroundRegular physical activity has been highlighted as an important factor in decreasing about 25 factors harmful to health, such as obesity, diabetes, heart failure, depression and osteoporosis. Female office workers, because of the long hours they stay seated in their workplace, are seriously threatened by immobility. The Theory of Planned Behavior has been successfully used several times to predict PA behaviorphysical activity (PA). The TPB studies also have identified perceived behavioral control as the key determinant of walking intentions.ObjectivesThe present study aims to assess the effectiveness of an intervention based on TPB to improve attitude, perceived behavioral control, Subjective norms, behavioral intention and PA behavior among female office workers.Materials and MethodsThe present study is an interventional, quasi-experimental study. Participants were 95 female office workers of the Tehran University that divided randomly in two case and control groups. Using the theory of planned behavior questionnaire and the International physical activity questionnaire, the participants were evaluated before the training and three months after that. The training was provided in the form of four 90-minute training sessions and some electronic messages sent through office automation system once every two weeks.ResultsThe intervention increased PBC, attitudes, intentions and objectively measured PA behavior. The effects of the intervention on intentions and behavior were mediated by PBC.ConclusionsThe present study has provided some of the data toward understanding determinants of physical activity behavior in female office workers. Specifically, the results suggest that interventions designed to promote physical activity in this population should focus on the development of PBC as well as positive attitude toward PA.

Impact of a South African School-based Intervention, HealthKick, on Fitness Correlates.

To assess the impact of a whole-of-school health promotion program targeting healthy eating and physical activity on physical fitness levels, and physical activity-related knowledge, attitudes and behavior of primary school children. Sixteen primary schools were randomly assigned as intervention (N = 8) and control (N = 8) schools. A selection of tests from the Eurofit testing battery was used to assess changes in fitness levels over the 3 years of the intervention. Anthropometric measurements included height and weight. A physical activity knowledge, attitude and behavior (KAB) questionnaire was administered to participants. Multi-level mixed effect linear models were used to assess differences between intervention and control schools. No overall improvement in physical fitness was found. The sit-ups score improved significantly in the intervention group (p < .05). No overall intervention effects were found on the determinants of physical activity behavior. Knowledge improved in both the intervention (p = .005) and control (p < .001) groups. The lack of a specific intervention effect on fitness levels and physical activity-related KAB indicates that a "low intensity" intervention is not effective in South African primary school settings.

Barriers, benefits, and strategies for physical activity in patients with schizophrenia.

Patients with schizophrenia have a substantially increased risk of cardiovascular disease and premature death compared with the general population. High prevalence of an unhealthy lifestyle contributes to the increased risk in these patients. Patients with schizophrenia are often physically inactive, and there is limited knowledge on the factors, such as barriers and incentives, that can influence physical activity in this patient group. The aim was to study the perception and experience of barriers to and incentives for physical activity in daily living in patients with schizophrenia, as reported by the patients themselves. An explorative study applying conventional qualitative content analysis was conducted. A purposeful sample of 20 patients with schizophrenia or schizoaffective disorder (13 men, 7 women; 22-63 years of age) registered at 3 psychiatric outpatient clinics in Sweden were interviewed using semistructured interviews. The analysis resulted in 3 main themes: (1) barriers-factors that complicate or obstruct physical activity, (2) reward-the motivation for physical activity, and (3) helpful strategies. The results may not reflect important factors related to physical activity in older patients (>65 years of age), newly diagnosed patients, or inpatients. In accordance with patients' perceptions, there may be biopsychosocial determinants of physical activity behavior that are unique for this group of patients. Future studies should investigate whether physical activity interventions for patients with schizophrenia benefit from individual analyses of barriers and reward for physical activity in combination with the use of tailored strategies such as personal support and activity planning.

Accelerometer Use with Children, Older Adults, and Adults with Functional Limitations

Accurately assessing physical activity behavior in children, older adults, and adults with functional limitations is essential to further our understanding of determinants of physical activity behavior in these populations and to design, implement, and evaluate interventions designed to increase physical activity participation. Objective methods to assess physical activity behavior, owing to improvements in accuracy and precision over self-report measures, have become common in research and practice settings. This article reviews the current use of objective methods to assess physical activity in observational, determinant, and intervention studies for children, older adults, and adults with functional limitations. Important considerations are presented when adopting prediction algorithms developed on one population, and using in another population that is markedly different in age, health, and functional status. Best practices are presented, along with future recommendations for research to advance this area of scientific inquiry.

Exercising choice: The economic determinants of physical activity behaviour of an employed population

Lack of physical activity is a major contributing factor to the worldwide obesity epidemic, and to the overall burden of disease. The deindustrialisation of developed economies and move to more sedentary employment has impacted on the opportunities of working individuals to participate in physical activity. This can have negative effects on productivity and worker health potentially influencing economic growth. Thus, it is important to determine the factors influencing the frequency of participation in physical activity for employed individuals. This paper uses a modified time allocation framework to explore this issue. We use data from the first six waves of the Household Income and Labour Dynamics of Australia survey (HILDA). The analysis examines frequency of participation in physical activity using a generalised random effects ordered probit model. We control for non-parallel cut-points between the physical activity categories and individual heterogeneity, as well as exploring differences across gender. The results indicate that there is a time trade-off between non-market work, market work, and the frequency of physical activity participation. This effect is moderated by gender. For example, dependent children have a larger negative effect on the frequency of physical activity participation for women. Education and marriage have a larger negative effect on the frequency of participation for men. The findings suggests that policies which make exercise more convenient, and hence decrease the opportunity cost of exercise, will help to encourage more frequent participation in physical activity for working adults.

Physical Activity Behavior of Patients 1 Year After Primary Total Hip Arthroplasty: A Prospective Multicenter Cohort Study

Besides the important beneficial effects of regular physical activity on general health, some of the musculoskeletal effects of physical activity are of particular interest for older adults after total hip arthroplasty (THA). However, research on physical activity behavior of patients after THA is scarce. The purpose of this study was to gain insight into the physical activity behavior and fulfillment of guidelines for health-enhancing physical activity of patients 1 year after THA. Design This was a prospective multicenter cohort study. To determine level of physical activity, 653 participants (response rate=77%) completed the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH). Comparisons were made between participants in 2 age groups (≤75 and >75 years). Determinants of physical activity behavior were assessed. The participants were physically active a mean of 1,468 minutes per week. Most time was spent in household and leisure activities. Younger participants were physically more active than older participants. A lower body mass index was predictive of a higher level of physical activity. Participants adhered to the guidelines of health-enhancing physical activity in 67% of cases. The guidelines were met more often by younger participants, male participants, and those without problems in the lower extremities. Limitations A nonresponse analysis was not conducted; thus, there might have been a selection bias. Use of a self-administered recall questionnaire to assess physical activity behavior may have been subject to memory and recall skill limitations of the participants, and patients tend to overestimate their physical activity level. This study gives detailed insight into the physical activity of patients 1 year after primary THA. As among the general population, a considerable number of patients were found to be insufficiently physically active.

Aging and the Social Cognitive Determinants of Physical Activity Behavior and Behavior Change: Evidence from the Guide to Health Trial

Part one of this study investigated the effect of aging on social-cognitive characteristics related to physical activity (PA) among adults in the baseline phase of a health promotion intervention. Participants' questionnaire responses and activity logs indicated PA levels and self-efficacy declined with age, while social support and the use of self-regulatory behaviors (e.g., goal setting, planning, and keeping track) increased. With age participants were also less likely to expect PA to interfere with their daily routines and social obligations. Part two of the study was among overweight/obese, inactive participants completing the intervention; it examined whether improvements in psychosocial variables might counteract declining PA associated with age. After treatment, participants were more active and decreased body weight regardless of age, and improved self-efficacy, outcome expectations, and self-regulatory behaviors. In a causal model, increases in self-efficacy at 7-months lead to increased PA levels and, albeit marginally, weight loss at 16 months; increased PA was associated with greater weight loss. Aging adults who were more confident exercised more and as a result lost more weight. This longitudinal study suggests interventions that offset the effect of aging on self-efficacy may be more successful in helping older participants become more active and avoid weight gain.

Physical activity levels and determinants of change in young adults: a longitudinal panel study.

BackgroundThere is growing concern about physical inactivity in adolescents and young adults. Identifying determinants that are associated with low levels of physical activity and with changes in physical activity levels will help to develop specific prevention strategies. The present study describes the prevalence and potential determinants of physical activity behavior and behavior changes of young adults. The study is based on the Swiss Household Panel (SHP), a longitudinal study assessing social changes in a representative sample of Swiss households since 1999.MethodsData is collected yearly using computer-assisted telephone interviews. Information is obtained from each household member over 14 years of age. Participants between 14 and 24 years entering the SHP between 1999 and 2006 were included (N = 3,068). "Inactive" was defined as less than 1 day/week of at least 30 minutes of moderate physical activity, "no sport" as exercising less than once a week. Age, gender, nationality, linguistic region, household income, education, membership in a sport club, reading, and Internet use were included as potential determinants of physical activity behavior and behavior change.ResultsIn both young men and young women, the prevalence of inactivity, "no sport", and non-membership in a sport club was increasing with age. Women were less active than men of the same age. From one wave to the following, 11.1% of young men and 12.1% of young women became active, and 11.9% of men and 13.7% of women became inactive, respectively (pooled data over all eight waves). Non-membership in a sport club was the strongest predictor for "no sport" (ORmen 6.7 [4.9-8.9]; ORwomen 8.1 [5.7-11.4]), but also for being inactive (OR 4.6 [3.5-6.0]; 4.6 [3.3-6.4]). Leaving a sport club (OR 7.8 [4.4-14.0]; 11.9 [5.9-24.1]) and remaining non-member (OR 7.8 [4.7-12.9]; 12.4 [6.4-24.1]) were the strongest predictors of becoming "no sport". Effects for becoming inactive were similar, though smaller (OR 5.9 [3.4-10.5] and 5.1 [2.7-9.6] for leaving a club, OR 5.1 [3.1-8.4] and 6.9 [4.0-11.8] for remaining non-member).ConclusionsThe most important findings were the strong effects of sport club membership on general physical activity. The correlation between sport club membership and exercise was not surprising in its nature, but in its strength.

Does the difference between physically active and couch potato lie in the dopamine system?

Obesity and other inactivity related diseases are increasing at an alarming rate especially in Western societies. Because of this, it is important to understand the regulating mechanisms involved in physical activity behavior. Much research has been done in regard to the psychological determinants of physical activity behavior; however, little is known about the underlying genetic and biological factors that may contribute to regulation of this complex trait. It is true that a significant portion of any trait is regulated by genetic and biological factors. In the case of voluntary physical activity behavior, these regulating mechanisms appear to be concentrated in the central nervous system. In particular, the dopamine system has been shown to regulate motor movement, as well as motivation and reward behavior. The pattern of regulation of voluntary physical activity by the dopamine system is yet to be fully elucidated. This review will summarize what is known about the dopamine system and regulation of physical activity, and will present a hypothesis of how this signaling pathway is mechanistically involved in regulating voluntary physical activity behavior. Future research in this area will aid in developing personalized strategies to prevent inactivity related diseases.

Underlying mechanisms of improving physical activity behavior after rehabilitation

Regular physical activity is beneficial for the health and functioning of people with a disability. Effective components of successful physical activity promotion interventions should be identified and disseminated. To study the underlying mechanisms of the combined sport stimulation program "Rehabilitation & Sports" (R&S) and daily physical activity promotion program "Active after Rehabilitation" (AaR). Subjects in four rehabilitation centers received R&S + AaR (n = 284). Subjects in six control centers (n = 603) received usual care. Physical activity and its determinants were assessed with questionnaires at seven weeks before and nine weeks and one year after rehabilitation. Variables that were determinants of the intervention-induced improvement in physical activity behavior at both follow-up measurements were attitude, the perceived benefits "improved health and reduced risk of disease," "better feeling about oneself," and "improved fitness," and the barrier "limited environmental possibilities." The percentage change in the intervention coefficient caused by these determinants ranged from -35.3% to -16.3% and from -28.4% to -11.3% at nine weeks and one year after rehabilitation, respectively. Personalized tailored counseling interventions can improve physical activity behavior in people with a disability by targeting both personal and environmental determinants of physical activity behavior.