Physical Environmental Barriers Research Articles

Examining the relationships between environmental barriers and leisure in community-dwelling individuals living with stroke

Objective: To characterize environmental barriers to leisure participation among individuals living with stroke; examine relationships between environmental barriers and leisure interest and satisfaction; and investigate participant factors associated with the perception of environmental barriers. Design: Survey. Setting: Community. Participants: Convenience sample of 51 community-dwelling adults less than six months post stroke. Interventions: Not applicable. Main outcome measure(s): Craig Hospital Inventory of Environmental Factors-Short Form. Results: Physical and structural environmental barriers were reported as the most frequent and large barrier to leisure participation (n = 26 (51%) rated as “monthly or more,” n = 12 (24%) rated as “big problem”). While attitude and support and policy barriers were not as commonly encountered, participants labeled these as “big problem(s)” (attitude and support n = 6 (12%), policy n = 7 (14%)). The presence of depressive symptoms was associated with the frequency in which attitudinal and support (rho = 0.50, P < 0.001), physical and structural (rho = 0.46, P < 0.001), and service and assistance (rho = 0.28, P = 0.04) barriers were reported, as well as magnitude of attitude and support barriers (rho = 0.48, P < 0.001). In multivariable regression analysis, depressive symptoms and walking capacity explained 21% of the variance of the frequency of attitude and support barriers (P = 0.004), where depressive symptoms was an independent correlate (P = 0.004). No other factors were associated with environmental barriers to leisure participation. Conclusion: Individuals with stroke report frequent and large physical and structural environmental barriers to leisure participation, which may be associated with the presence of depressive symptoms.

Campus Physical Environment Accessibility for Person with Disabilities in the Ethiopian Public Universities

The study has been conducted aiming to explore the perception of PWDs regarding the accessibility of universities Physical environment for their needs in five purposively selected public universities of Ethiopia. Students with physical disabilities and visual impairments were participants of the study. The study employed survey design to answer the basic questions of the research. Questionnaire has been used as exclusive data collection tool. In addition, quantitative analysis method has been used to analyze the collected data. The result of the study revealed that, in general, respondents believed that theuniversities buildings and overall campuses physical environment were inaccessible for the needs of PWDs. The study also investigated the most common perceived campus physical environment barriers for PWDs such as inaccessible classrooms, libraries, bookstores, auditoriums, dining halls, dorms, circulation areas, corridors and bathrooms. In addition, campus shops, parks, museums, students’ clinic and banks were perceived as not been barrier free to be easily accessed by PWDs. Furthermore, poor ramp designs, lack of elevators and lack of accessible building entrances were also perceived as barriers for PWDs.

Impact of physical and social environments on the walking behaviour of Hong Kong's older adults

Abstract Introduction This study examined the associations between physical environment (facilitators and barriers), social environment, and walking among older adults in Hong Kong. Methods Between April and December 2016, a sample of 679 adults aged 65 years or above was recruited in Neighbourhood Elderly Centres from across the 18 council districts of Hong Kong. Participants were asked to complete validated questionnaires that were used to assess the above constructs; participants were asked to track their daily step counts over 7 days using an accelerometer. Structural Equation Modelling was performed to examine the studied relationships by using maximum likelihood estimation in LISREL 9.3. Results The initial model did not fit the data adequately. The item ‘companionship’ was deleted because of its low standardised factor loading. A standardised residual of items was correlated with reference to the modification indices and high standardised residuals. The data were analysed again. The modified structural model fitted the data sufficiently, as indicated by the fit indices. Only physical environment–facilitators (i.e., land use mix, access, street connectivity, infrastructure, indoor facilities, presence of people, and easy access to residential entrances) were predictive of older adults’ steps per day. The findings provide a reference for policy makers seeking to provide supportive physical walking environments and promote active ageing among older adults.

Interactions between the environment, physical demands, and social engagement at an Aphasia Camp

Individuals with aphasia experience impairments in communication that can be exacerbated by environmental and task demands. This investigation examined the interaction between physical-demands, social-engagement, and environment. An interdisciplinary team, including speech language pathologists and a kinesiologist measured the activities of individuals with aphasia at the Chippewa Valley Aphasia Camp. Accelerometers were used to measure degree of physical exertion as an indication of physical demands. The Clinical Discourse Assessment (Damico, 1991), Measure of Participation in Conversation and Measure of Skill in Supported Conversation (Kagan et al., 2004), qualitative analyses, and investigator field notes served as indicators of social engagement. The International Classification of Disease Functioning (ICF) was used to code environmental factors, which either served as a facilitator or barrier to participation. Qualitative analyses indicate that the presence of physical environmental barriers and more strenuous physical exertion sometimes serve to decrease social engagement and exchange. However, partners who served as facilitators enabled participants to overcome high environmental and/or physical task demands to support successful social engagement and exchange. These analyses suggest that participants with aphasia can overcome physical environmental barriers and/or high physical task demands, given effective partner supports. This investigation contributes to a small body of research regarding the interaction between environmental demands and social communication among individuals with aphasia. Further, the investigation contributes empirical information about the environment and social communication context of a rustic Aphasia Camp.

Evaluating the Social Validity of Project TEAM: A Problem-Solving Intervention to Teach Transition Age Youth with Developmental Disabilities to Resolve Environmental Barriers

Project TEAM teaches transition-age youth with developmental disabilities (DD) to identify physical and social environmental barriers and supports, generate solutions to barriers, and request modifications to increase participation. Establishing the social validity of this environment focused intervention with youth and their parents is critical, given the significant shift the intervention represents from rehabilitation’s more traditional focus on body structures and function. University researchers and youth research collaborators conducted a participatory evaluation of the purpose, procedures, and perceived benefits of Project TEAM. Youth with DD (n = 42) provided feedback using three methods: activity voting, a survey, and a focus group. Parents (n = 37) also provided feedback. Results suggest that both youth and parents find Project TEAM acceptable and relevant to youth’s current and future lives. The majority of youth and parents felt Project TEAM fostered independence and empowerment, although some youth and parents reported challenges with the unique environment-focused approach.

Cohabitants' perspective on housing adaptations: a piece of the puzzle.

As part of the Swedish state-funded healthcare system, housing adaptations are used to promote safe and independent living for disabled people in ordinary housing through the elimination of physical environmental barriers in the home. The aim of this study was to describe the cohabitants' expectations and experiences of how a housing adaptation, intended for the partner, would impact their everyday life. In-depth interviews were conducted with cohabitants of nine people applying for a housing adaptation, initially at the time of the application and then again 3 months after the housing adaptation was installed. A longitudinal analysis was performed including analysis procedures from Grounded Theory. The findings revealed the expectations and experiences in four categories: partners' activities and independence; cohabitants' everyday activities and caregiving; couples' shared recreational/leisure activities; and housing decisions. A core category putting the intervention into perspective was called 'Housing adaptations - A piece of the puzzle'. From the cohabitants' perspective, new insights on housing adaptations emerged, which are important to consider when planning and carrying out successful housing adaptations.

Factors Which Facilitate or Impede Interpersonal Interactions and Relationships after Spinal Cord Injury: A Scoping Review with Suggestions for Rehabilitation

Interpersonal interactions and relationships can influence an individual's perceptions of health and quality of life in the presence of disability. In the case of people with spinal cord injury (SCI), positive interpersonal interactions and relationships have been shown to contribute to resilience and adaptability. Understanding factors which facilitate or impede the development and maintenance of relationships after SCI may form the basis for proactive relationship support for people with SCI. To gain a broad insight into these factors, a scoping review was undertaken. Databases were searched for English language studies published between 2000 and 2015 that informed the review question. Sixty-two (62) studies were identified. Thematic analysis was conducted on data extracted from the studies and 51 factors which may facilitate relationships and 38 factors which may impede relationships after SCI were noted. The majority of factors could be categorized as environmental or personal according to the domains of the International Classification of Functioning, Disability, and Health (ICF). The facilitating factors included partner and social support, reciprocity in relationships, and presenting oneself positively. Impeding factors included physical environmental barriers, real and perceived social biases, and poor self-image. Factors identified may inform the provision of supportive, holistic rehabilitation for people with SCI.

Typology of person-environment fit constellations: a platform addressing accessibility problems in the built environment for people with functional limitations.

BackgroundMaking the built environment accessible for all regardless of functional capacity is an important goal for public health efforts. Considerable impediments to achieving this goal suggest the need for valid measurements of acccessibility and for greater attention to the complexity of person-environment fit issues. To address these needs, this study aimed to provide a methodological platform, useful for further research and instrument development within accessibility research. This was accomplished by the construction of a typology of problematic person-environment fit constellations, utilizing an existing methodology developed to assess and analyze accessibility problems in the built environment.MethodsBy means of qualitative review and statistical methods we classified the person-environment fit components covered by an existing application which targets housing accessibility: the Housing Enabler (HE) instrument. The International Classification of Functioning, Disability and Health (ICF) was used as a conceptual framework. Qualitative classification principles were based on conceptual similarities and for quantitative analysis of similarities, Principal Component Analysis was carried out.ResultsWe present a typology of problematic person-environment fit constellations classified along three dimensions: 1) accessibility problem range and severity 2) aspects of functioning 3) environmental context. As a result of the classification of the HE components, 48 typical person-environment fit constellations were recognised.ConclusionsThe main contribution of this study is the proposed typology of person-environment fit constellations. The typology provides a methodological platform for the identification and quantification of problematic person-environment fit constellations. Its link to the globally accepted ICF classification system facilitates communication within the scientific and health care practice communities. The typology also highlights how relations between aspects of functioning and physical environmental barriers generate typical accessibility problems, and thereby furnishes a reference point for research oriented to how the built environment may be designed to be supportive for activity, participation and health.

Experiences of mobility device use over time: A multiple case study among very old Latvian women

Aim: To explore the experiences over time of using mobility devices (MDs) among very old women in the context of everyday life in Latvia. Methods: This study utilized a multiple case-study design that employed an explanatory mixed-methods approach. A combination of quantitative survey data on home and health and qualitative interview data for each participant were used to create three narratives to describe the experiences of MD use in everyday life over time, followed by a cross-case analysis. Results: The three cases illustrate that very old women accept and use MDs due to walking difficulties and related needs. Over time, functional decline combined with physical environmental barriers and changes in their social networks limited the supportive role that available MDs could offer these women. Conclusions: The findings contribute to the understanding of the complexity of MD use in everyday life among very old women in Latvia and the need for different kinds of MDs. These findings illustrate the importance of considering the interaction between people’s everyday life situation and their physical environment for their optimal use of MDs. This is important information for policy-makers who can optimize the services for old people in Latvia and support the need for occupational therapists’ professional competence for the planning and development of MD provision.

Determinants of Perceived Physical Environment Barriers among Community-Dwelling Elderly in Taiwan.

To test the hypothesis that mobility, activities of daily living, and the interaction between them can play a key role in determining perceived physical environment barriers among community-dwelling elderly. Cross-sectional. Community. One hundred and ninety-seven community-dwelling elderly with more than 7 points on the Short Portable Mental State Questionnaire and less than 7 points on the Geriatric Depression Scale (15 items). None. Time Get-up and Go test (TUG), the subscales of basic activity of daily living (BADL)/instrumental activities of daily living (IADL) of the Hierarchy of Care Required (HCR), and the physical/structural subscale of the Craig Hospital Inventory of Environmental Factors in Community-dwelling Elderly in Taiwan were used to measure mobility, activities of daily living and perceived physical environment barriers, respectively. Hierarchical linear regression analyses were used to test the study hypothesis. Significant and positive relations were found to exist between perceived physical environment barriers and (1) the TUG time (β=.300, p<.05), and (2) the IADL score for the HCR (β=.322, p<.05), respectively. A significant and negative relation existed between perceived physical environment barriers and the interaction term (the TUG time and the IADL score for the HCR) (β=-.211, p<.05). Mobility, IADL and the interaction between them are found to be significant determinants of perceived physical environment barriers in the community-dwelling elderly under consideration. Strategies targeting the enhancement of mobility among community-dwelling elderly are suggested to lead to improvements in the degree to which physical environment barriers are perceived. This beneficial effect could be greater in the case of elderly individuals with better IADL function.

Disability Inclusion in Primary Health Care in Nepal: An Explorative Study of Perceived Barriers to Access Governmental Health Services

Purpose: Persons with disabilities face additional barriers in accessing primary healthcare services, especially in developing countries. Consequently the prevalence of secondary health conditions is higher among this population. This study aims to explore the perceived barriers to access primary healthcare services by persons with disabilities in the Western region of Nepal. Methods: 10 primary healthcare providers and 11 persons with disabilities (physically or visually impaired) were selected by non-governmental organisations from the hilly and lower areas. Based on the International Classification of Functioning and the health accessibility model of Institute of Medicine, semi-structured interviews were conducted and analysed using analytical induction. Results: In general, healthcare providers and persons with disabilities reported similar barriers. Transportation and the attitude of family members and the community were the main environmental barriers . Even with assistive devices, people still depend on their families. Financial barriers were mainly reported, such as lack of funds for health expenses, problems in generating an income by persons with disabilities themselves, and the low socio-economic status of their families. Personal barriers, which affect help-seeking behaviour in a major way, were most often mentioned in relation to financial and socio-environmental barriers. Low self-esteem of the person with disability determines the family’s attitude and the motivation to seek out healthcare. Lastly, poor public awareness about the needs of persons with disabilities was reported. Conclusions: Besides the known physical environmental barriers, this study found several environmental, financial and personal barriers that also affect access to primary healthcare. In particular, the attitudes of families and poor financial conditions seem to be interrelated and greatly influence help-seeking behaviour. Implications: There is a definite need to educate primary healthcare providers who work at the community level about disability-related health conditions, and train them to diminish barriers to access health services. In addition, the government support system for persons with disabilities should be revised and implemented accordingly. Lastly, further research is needed to understand the interaction between the reported barriers that influence the inclusion of persons with disabilities in healthcare.

Correlates of participation in meaningful activities among people with multiple sclerosis.

To explore the associations between impairments, self-management self-efficacy, self-management behaviors, and environmental factors and their role in predicting participation in meaningful activities among people with multiple sclerosis. Online cross-sectional survey. Randomly selected individuals (n = 335) from a large multiple sclerosis patient registry. Participation in activities that are meaningful to the individual was measured with Community Participation Indicators (CPI), the dependent variable. Independent variables included symptom severity, activities of daily living limitations, cognitive problems, stages of change for physical activity, nutritional behaviors, self-efficacy, and environmental barriers. A backwards selection regression analysis was used to compare the relative contributions of independent variables in predicting the CPI. A path analysis was conducted to explore the associations between independent variables and their direct and indirect effects on the CPI. The final regression model included self-management self-efficacy (β = 0.12), environmental barriers (β = -0.16), cognitive problems (β = -0.22), and stages of change for physical activity (β = 0.12). Path analysis indicated that impairments and environmental barriers might negatively influence self-management self-efficacy. Self-management self-efficacy might have indirect effects on the CPI via engagement in self-management behaviors. Future research should explore whether interventions that promote self-management self-efficacy can facilitate participation in meaningful activities.

Physical Environmental Barriers to Community Mobility in Older and Younger Wheelchair Users

For those who rely on wheeled mobility devices for many or all of their mobility needs, barriers in the physical environment can pose significant obstacles in everyday life. Current Americans With Disabilities Act Accessibility Guidelines standards do not address barriers at the level of specificity necessary to ensure accessibility for wheelchair use. This project developed a Web-based survey to capture differences in the level of difficulty of 50 barriers that persons who use wheelchairs routinely encounter in their communities. Results showed that among the 385 people who completed the survey, the most significant differences were between older and younger manual wheelchair users and suggest that Americans With Disabilities Act Accessibility Guidelines specifications should be revised to be more sensitive to the needs of older wheelchair users.

Understanding neighborhood environment related to Hong Kong children's physical activity: a qualitative study using nominal group technique.

BackgroundRelationships between the neighborhood environment and children’s physical activity have been well documented in Western countries but are less investigated in ultra-dense Asian cities. The aim of this study was to identify the environmental facilitators and barriers of physical activity behaviors among Hong Kong Chinese children using nominal group technique.MethodsFive nominal groups were conducted among 34 children aged 10–11 years from four types of neighborhoods varying in socio-economic status and walkability in Hong Kong. Environmental factors were generated by children in response to the question “What neighborhood environments do you think would increase or decrease your willingness to do physical activity?” Factors were prioritized in order of their importance to children’s physical activity.ResultsSixteen unique environmental factors, which were perceived as the most important to children’s physical activity, were identified. Factors perceived as physical activity-facilitators included “Sufficient lighting”, “Bridge or tunnel”, “Few cars on roads”, “Convenient transportation”, “Subway station”, “Recreation grounds”, “Shopping malls with air conditioning”, “Fresh air”, “Interesting animals”, and “Perfume shop”. Factors perceived as physical activity-barriers included “People who make me feel unsafe”, “Crimes nearby”, “Afraid of being taken or hurt at night”, “Hard to find toilet in shopping mall”, “Too much noise”, and “Too many people in recreation grounds”.ConclusionsSpecific physical activity-related environmental facilitators and barriers, which are unique in an ultra-dense city, were identified by Hong Kong children. These initial findings can inform future examinations of the physical activity-environment relationship among children in Hong Kong and similar Asian cities.

Fifteen-minute consultation: a structured approach to the diagnosis of idiopathic orbital inflammation

48 BSPAR157 FIFTEEN-MINUTE CONSULTATION: A STRUCTURED APPROACH TO THE DIAGNOSIS OF IDIOPATHIC ORBITAL INFLAMMATION E. Oliver, E. Mosley and S. Rangaraj Nottingham Children’s Hospital, University Hospitals Nottingham, UK Correspondence to: E. Oliver. E-mail: emma_oliver05@hotmail.com Introduction: Idiopathic orbital inflammation (IOI) also known as orbital pseudotumour was first noted in 1905 by Birch Hirchfield. IOI is the third most common condition to affect the orbit. Aims: Sclerosing IOI is a rare subdivision of IOI, causing 5% of all orbital inflammation. Oral corticosteroids, immunosuppression, radiotherapy and surgery have been successful in a number of cases; however, there remains to be a consensus on treatment. Results: We present two cases which failed to respond to oral corticosteroids and were subsequently successfully treated with i.v. pulsed methylprednisolone. Case 1, a 13-year old boy presented with a painless diplopia, ptosis, proptosis and right eyelid swelling. Initial treatment with i.v. antibiotics failed. Investigations for autoimmune and infective causes were negative. Imaging revealed a 3 x 1 cm extraocular mass overlying the right globe. Biopsy was consistent with an inflammatory lesion. Oral corticosteroid failed to improve the clinical picture. Pulsed i.v. methylprednisolone weaned over a 9 month period resulted in resolution of the lesion. Case 2, a 10-year-old girl presented with peri-orbital oedema, ptosis, proptosis and diplopia of the left eye. Treatment for orbital cellulitis resulted in resolution of erythema only. Imaging revealed a left ocular mass in the left lacrimal gland. Histopathology was consistent with sclerosing idiopathic orbital inflammation. Oral steroids resulted in limited improvement. Subsequent pulsed i.v. methylprednisolone for 5 months resulted in resolution of the lesion. Conclusion: We report two cases successfully treated with pulsed methylprednisolone. We propose pulsed methylprednisolone as first line treatment for IOI. Disclosure statement: The authors have declared no conflicts of interest. ABSTRACT 49 BSPAR158 PHYSICAL ACTIVITY, SELF-EFFICACY AND PERCEPTIONS OF ILLNESS IN ADOLESCENTS WITH CHRONIC MUSCULOSKELETAL DISEASE W. Williamson, A. Doherty, C. Foster, E. Kendall, E. Parsons, J. Sheehan, J. Dwyer and N. Wilkinson BHF Health Promotion Research Group, University of Oxford, OxPARC Oxford University Hospitals Trusts, Oxford, UK and University of Guelph, Canada Correspondence to: W. Williamson. E-mail: wilby.williamson@dph.ox.ac.uk Introduction: Moderate-to-vigorous physical activity (MVPA) is essential for growth, well-being and reducing cardio-metabolic risk. Promoting activity in adolescent disease groups requires understanding of baseline behaviour. Aims: Survey MVPA of adolescents attending a regional rheumatology clinic and identify associations been health beliefs and self-efficacy measures that may explain MVPA behaviour. Method: Three validated questionnaires covering physical activity, sedentary behaviour, self-efficacy to overcome barriers to activity and illness perceptions, were distributed over six consecutive clinics. Results: Questionnaires were completed by 42 patients [mean age 15 (range 11–21) years; 25 with JIA and 26 females]. Activity profiles: 17% inactive (zero days 60 min MVPA), 36% low-active (1–2 days 60 min MVPA), 33% moderately active (3–4 days 60 min MVPA) 14% active (>5 days 60 min MVPA). Sedentary profile: 55% report 4 or more h daily TV viewing and digital recreation. Illness-perception responses: 1 in 3 report severe symptoms, restricted lives and limited activity, 1 in 2 report negative emotional well-being. Positive illness perceptions for illness duration, concern, understanding and emotional response tended towards significant for being active (P1⁄4 0.054–0.073). MVPA self-efficacy responses did not correlate significantly with activity. The majority were confident overcoming harassment and physical environment barriers and somewhat confident overcoming internal, social and symptom barriers. TV viewing (OR 0.18 P1⁄4 0.05) and being on a sports teams (OR 9.7 P1⁄40.01) are strong correlates of inactivity/ activity. Reporting lots of opportunity for activity positively correlated with MVPA (r1⁄4 0.5, P1⁄40.03). Conclusion: Adolescents with musculoskeletal disease are less active than the general population. Reducing screen-time and promoting social sports are potential targets for MVPA promotion. A larger sample with repeated measures is required to explore correlation of self-efficacy and illness-perceptions with MVPA. Disclosure statement: The authors have declared no conflicts of interest. ABSTRACT 50 BSPAR15950 BSPAR159 PAEDIATRIC SARCOIDOSIS: A SINGLE CENTRE PAEDIATRIC RHEUMATOLOGY EXPERIENCE E. Mosley, M. Yiallorides and S. Rangaraj Nottingham Children’s Hospital, University Hospitals Nottingham, UK Correspondence to: E. Mosley. E-mail: EllenMosley@doctors.org.uk Introduction: Sarcoidosis is a rare chronic multisystem granulomatous disease. We present two cases highlighting the varied clinical presentation in children. Aims: Case 1, a 6-year-old girl, with a 4-month history of parotid swelling, unresponsive to antibiotic treatment. Paediatric referral and subsequent multisystem investigations revealed raised ACE level, elevated calcium, Schirmer’s test showed 2 mm of wetting after 5 min, punctate epithelial erosions on the cornea, pan uveitis. Renal investigations revealed hypertension, raised calcium, renal impairment POSTER PRESENTATIONS iii17

Home and health in people ageing with Parkinson's disease: study protocol for a prospective longitudinal cohort survey study.

BackgroundWith an increased life expectancy for the general population as well as for those ageing with chronic diseases, there are major challenges to the affected individuals and their families, but also to health care and societal planning. Most important, an increasing proportion of older people remain living in their ordinary homes despite health decline and disability. However, little is known about the home and health situation of people ageing with Parkinson’s disease (PD), and older people are often excluded from PD-research.Methods/designThe overall aim of the present project is to generate knowledge on home and health dynamics in people with PD, with an explicit attention to PD-specific symptomatology. We will concentrate on aspects of home and health captured by state-of-the-art methodology from gerontology as well as PD-research, health science and rehabilitation. This study protocol describes a longitudinal cohort survey study that includes a baseline data collection and a 3-year follow-up. Both data collection waves include self-administered questionnaires, structured interviews, clinical assessments and observations during home visits effectuated by research staff with project-specific training. In order to arrive at a follow-up sample of N=160, 250 participants identified by PD specialist nurses are being recruited from three hospitals in southern Sweden. With no lower or upper age limit, only those diagnosed with PD since at least one year were included. The exclusion criteria were: difficulties in understanding or speaking Swedish and/or cognitive difficulties/other reasons making the individual unable to give informed consent or to take part in the majority of the data collection. The data collection targets environmental factors such as assistive devices, social support, physical environmental barriers, accessibility problems and perceived aspects of home. A broad variety of instruments tap PD-specific problems (e.g. freezing of gait, fear of falling) and health-related issues such as general self-efficacy, body functions, activities and participation.DiscussionThis project will produce knowledge to the benefit of the development of health care and societal planning that targets people ageing with PD, ultimately promoting activity and participation and an increase of the number of healthy life years for this sub-group of the population.

Perceived physical activity barriers related to body weight status and sociodemographic factors among Malaysian men in Klang Valley

BackgroundPhysical inactivity has been acknowledged as a public health issue and has received increasing attention in recent years. This cross-sectional study was conducted to determine the barriers to physical activity among Malaysian men. These barriers were analyzed with regards to sociodemographic factors, physical activity level, BMI and waist circumference.MethodsSubjects in this study included 308 Malay men and 422 Chinese men aged 20 years and older. Subjects completed the International Physical Activity Questionnaire (IPAQ) and a questionnaire on barriers to physical activity, categorized into personal and psychological, physical and social environment barriers. Weight, height and waist circumference were also measured and BMI was calculated.ResultsDescriptive analyses showed that 79.3% of subjects were married, 52.1% had secondary educational level, 68.8% were still working, and 39.7% had household income between RM1500 to RM3500. The perception that other recreational activities with family and friends were more fun was the most frequently reported barrier, followed by weather, lack of discipline, lack of free time, lack of money, and lack of friends. Marriage status, educational level, household income, BMI, and physical activity status were shown to be associated with perceived barriers.ConclusionsTo increase participation in physical activity, policy makers should consider significant personal, social and environmental barriers when developing appropriate intervention programmes. Health-promoting strategies that increase awareness, knowledge, skills and motivation related to physical activity are required.

Housing and Health: Very Old People with Self-Reported Parkinson's Disease versus Controls.

Objectives. To explore whether aspects of housing and health among very old people with self-reported Parkinson's disease (PD) differ from matched controls. Methods. Data from the ENABLE-AGE Survey Study were used to identify people with self-reported PD (n = 20) and three matched controls/individual (n = 60). The matching criteria were age (mean = 82 years), sex, country, and type of housing. The analyses targeted problems in activities of daily living, objective and perceived aspects of housing, for example, number of environmental barriers, accessibility (i.e., person-environment fit), and usability. Results. The number of physical environmental barriers did not differ (P = 0.727) between the samples. The PD sample had more (P < 0.001) accessibility problems than controls and perceived their homes as less (P = 0.003) usable in relation to activities. They were less independent and had more functional limitations (median 5 versus 2; P < 0.001), and 70% experienced loss of stamina or poor balance. Conclusions. Due to the fact that they have more functional limitations than very old people in general, those with self-reported PD live in housing with more accessibility problems. This explorative study has implications for rehabilitation as well as societal planning, but larger studies including people with a confirmed PD diagnosis are needed.

Adolescents‘ Self-Efficacy to Overcome Barriers to Physical Activity Scale

This paper describes a revised measure of self-efficacy to overcome barriers to moderate and vigorous physical activity in a sample of 484 high school students in Toronto, Ontario. The students had a mean age of 15.3 years. Principal axis factoring with oblique rotation yielded five factors: self-efficacy to overcome internal, harassment, physical environment, social environment, and responsibilities barriers. Two problematic items were removed, which resulted in a 22-item measure. Subsequent analyses were conducted on responses to this shortened measure. Confirmatory factor analysis supported the five-factor model and demonstrated age- and sexinvariance. The subscales had good internal consistency reliability. Structural regressions demonstrated a strong relationship between the resulting factors and a physical activity measure (energy expenditure), showing predictive validity.

Factors associated with physical activity levels in African–American women with type 2 diabetes

To examine how family/friend social support, exercise self-efficacy, physical environment, sense of community, social issues and roles, socioeconomic status, and body image discrepancy influence physical activity levels in African American females with type 2 diabetes. A sample of 50 African American females with type 2 diabetes was recruited from a Midwest diabetes center for this descriptive, cross-sectional, correlational study. A series of self-report instruments were administered to examine the relationships between the independent study variables and physical activity levels. Results of the study suggested that higher levels of exercise self-efficacy, family social support for exercise, and a decrease in physical environmental barriers may serve to increase physical activity levels in this population. No significant relationships were observed between the other study variables and physical activity levels. Nurse practitioners working with African American females with type 2 diabetes need to assess family social support, exercise self-efficacy, and physical environmental barriers and plan interventions that incorporate family support and the principles of self-efficacy while minimizing environmental barriers. Further exploration is warranted to examine the relationship between body image discrepancy and physical activity in this population.