Social Cognitive Theory Variables Research Articles

Physical Activity Levels and Social Cognitive Theory Correlates among Adults with Crohn's Disease: Preliminary Results from a Cross-Sectional Analysis.

There is increasing research and clinical interest in physical activity (PA) as an adjuvant therapy for improving health outcomes among persons with Crohn's disease. To date, little is known regarding PA behavior and its cognitive and behavioral correlates in Crohn's disease. Thus, we assessed self-reported PA and its social cognitive theory (SCT) correlates in a sample of persons with Crohn's disease. Data on demographic and clinical characteristics, disease activity, leisure-time PA, and SCT variables were collected from 30 participants with Crohn's disease (90% White, 60% female) through an online survey. SCT variables assessed included exercise self-efficacy, social support, outcome expectations, goal setting, and planning. Analyses involved comparing PA levels and SCT survey scores using independent sample t-tests and non-parametric bivariate correlations. The majority of participants were in clinical remission (60%) and over half (57%) were classified as physically active, yet the mean PA level was lower than normative values for adults. Females (n = 18) and participants who reported previous surgery for Crohn's disease (n = 18) were almost twice as physically active as male participants and those without a history of Crohn's disease-related surgery, respectively (p's < 0.05). Overall, participants who reported greater exercise goal setting behaviors had higher levels of PA (rs = 0.34; p < 0.05). These findings highlight lower overall levels of PA in persons with Crohn's disease, and exercise goal setting represents a potential target of behavior change interventions for increasing PA in this population.

PHYSICAL ACTIVITY AND SOCIAL COGNITIVE THEORY CORRELATES AMONG POSTOPERATIVE PERSONS WITH CROHN'S DISEASE: PRELIMINARY RESULTS FROM A CROSS-SECTIONAL ANALYSIS

Abstract INTRODUCTION There is increasing research and clinical interest in physical activity (PA) behavior among persons with Crohn's disease (CD), but little is known regarding PA and its correlates among postoperative persons with CD. This is important as most patients with CD will require surgery within 10 years of diagnosis which may drastically alter PA levels and its benefits for CD. As found in past studies with other patient populations (e.g., colorectal cancer survivors), understanding the cognitive and behavioral factors associated with PA engagement among postoperative adults with CD is useful for informing the development of PA behavior change interventions for this population. This cross-sectional study examined self-reported PA levels and its associations with social cognitive theory (SCT) variables among postoperative persons with CD. METHODS Participants included 30 persons with CD who completed an online survey between November 2022 and June 2023. Of those participants, 18 reported a history of CD-related surgery. The survey assessed demographic and clinical characteristics, disease activity (Harvey-Bradshaw Index), leisure time exercise (Godin Leisure-Time Exercise Questionnaire and International Physical Activity Questionnaire), and related SCT variables (exercise self-efficacy, social support, outcome expectations, goal setting, and planning). Analyses included independent sample t-tests and non-parametric bivariate correlations (rs) for comparing PA levels and SCT survey scores among participants with and without a history of surgery. RESULTS There were differences in PA and SCT variables based on surgical history. Postoperative participants engaged in significantly more PA (t = 2.17, p = 0.04) and reported greater outcome expectations (t = 2.45, p = 0.02) and goal setting (t = 2.22, p = 0.04) scores compared with CD participants without a history of surgery. Among postoperative participants, only exercise goal setting was significantly correlated with PA (rs = .53, p = 0.03) such that postoperative participants with greater exercise goal setting behaviors reported higher levels of PA. None of the SCT variables were significantly associated with PA in the sample of participants without a history of surgery. CONCLUSIONS This study yielded novel findings regarding PA behavior and its SCT correlates in a small sample of postoperative persons with CD. The results suggest the need for further research into exercise goal setting as a potential target of behavior change interventions for increasing PA among postoperative persons with CD.

Social Cognitive Theory Variables as Correlates of Physical Activity Behavior Among Hispanics With Multiple Sclerosis

ObjectiveTo examine the association between social cognitive theory (SCT) variables and physical activity (PA) behavior in Hispanic adults with multiple sclerosis (MS). DesignObservational, survey study. SettingGeneral community. ParticipantsInclusion criteria: (a) age 18 years or older, (b) self-identify as Hispanic or Latino, (c) diagnosis of MS, and (d) English or Spanish as primary language. Two hundred forty-three individuals opened the survey, 24 individuals did not meet inclusion criteria, and 66 individuals were excluded due to not completing any of the SCT variable measures (N=153). InterventionsNot applicable. Main Outcome Measure(s)PA was measured using the Godin Leisure Time Exercise Questionnaire (GLTEQ) total and Health Contribution Scores (HCS). SCT variables included standard measures of exercise self-efficacy, planning, goal setting, outcome expectations, social support, and functional impairment. ResultsThe final sample included 153 participants with a mean (SD) age of 43 (11) years, 78% identified as women, 57% were employed, and 63% had a college degree or higher. The mean (SD) MS disease duration was 11 (9) years, 74% of participants reported relapsing remitting MS, and median (interquartile range) Patient Determined Disease Steps (PDDS) score was 3.0 (3.0). Significant correlations were observed between all SCT variables and both GLTEQ total and GLTEQ HCS scores (P<.001). Forward stepwise regression with Akaike's Information Criterion (AICC) identified PDDS, age, exercise planning, exercise self-efficacy, and exercise goal setting as the most appropriate covariates and SCT variables to include in a multivariable model examining independent contributions on GLTEQ HCS scores. The multivariable, linear regression analysis indicated that PDDS (Standardized B=-.280, P<.001), exercise planning (Standardized B=.214, P<.05), and exercise self-efficacy (Standardized B=.183, P<.05) explained 42.4% of variance in GLTEQ HCS scores. ConclusionsThis study provides a contribution to the literature by identifying SCT variables that correlate with PA behavior among Hispanics with MS that may guide the creation of culturally appropriate PA programs.

Randomized controlled trial of the behavioral intervention for physical activity in multiple sclerosis project: Social cognitive theory variables as mediators.

We recently reported in a phase-III, randomized controlled trial that a behavioral intervention based on social cognitive theory (SCT) and delivered through the Internet using e-learning approaches increased device-measured minutes/day of moderate-to-vigorous physical activity (MVPA) over a 6-month period among persons with multiple sclerosis (MS). This planned tertiary outcome paper examined SCT variables as mediators of the behavioral intervention effect on change in device-measured minutes/day of MVPA. Persons with MS (N=318) were randomized into behavioral intervention (n=159) or attention/social contact control (n=159) conditions. The conditions were administered over a 6-month period via an Internet website and supported with behavioral coaching by persons who were uninvolved in screening, recruitment, random assignment, and outcome assessments. We collected MVPA and SCT data before and after the 6-month period. The data analysis involved linear mixed modeling on MVPA and SCT outcomes followed by latent change score modeling for examining SCT variables as mediators of the intervention effect on change in MVPA. The linear mixed model indicated statistically significant group by time interactions on device-measured minutes/day of MVPA and scores from SCT measures of exercise self-efficacy, barriers self-efficacy, goal setting, and planning. The effect of the intervention on device-measured minutes/day of MVPA was mediated by the SCT variable of exercise self-efficacy based on the statistical significance of the Wald z-score for the indirect effect in the latent change score model. This study provides evidence for exercise self-efficacy as a SCT mediator of the behavioral intervention effect on device-measured minutes/day of MVPA in persons with MS.

Analysis of Social Cognitive Theory in predicting Physical Activity Among Adolescents in Depok City, West Java Province, Indonesia: Structural Equation Modeling Approach

Introduction: The proportion lack of physical activity (PA) among adolescents worldwide is increasing. Many studies have analyzed the behavioral determinants of PA among adolescents, but research that analyzes the relationship of all determinants in a conceptual framework is still limited. Social Cognitive Theory (SCT) is one of the concepts that is used as the basis for developing interventions to increase PA in the population. The purpose of this study was to examine the direct and indirect effect of SCT constructs on PA among adolescents in Depok City. Methods: A cross sectional study was conducted. A total of 351 high-school students (aged 14-19 years) completed the questionnaire. The PA level was measured using the Three-Day PA Recall (3DPAR) questionnaire and the data obtained were converted into METs using the Youth Compendium of Physical Activities. Structural Equation Modelling (SEM) was applied to analyze the relationship between SCT variables and PA in adolescents. Results: Self-efficacy had positive effects on outcome expectation (ρ=0.880, P-value 0.000), self-regulation (ρ= 0.243, P-value 0.000), social support (ρ=0.910, P-value 0.000) and PA (ρ=0.489, P-value 0.000). Self-efficacy had negative effect on perceived barriers (ρ=-0.919, P-value 0.000), Outcome expectation had positive effects on PA (ρ=0.919, P-value 0.000) and self-regulation (ρ=0.137, P-value 0.026). Self-regulation had positive effect on PA (ρ=0.188, P-value 0.004). Social support had positive effect on self-regulation (ρ=0.320, P-value 0.000). Perceived barriers had negative effect on self-regulation (ρ=-0.248, P value 0.003). Conclusion: Self-efficacy had the strongest effect on PA, but did not have indirect effect on PA through outcome expectations and self-regulation.

Physical activity and social cognitive theory variables among persons with multiple sclerosis and elevated anxiety

Purpose/objectiveAnxiety is prevalent and poorly managed among persons with multiple sclerosis (MS). Physical activity (PA) may reduce anxiety, yet little is known about PA and its theory-based correlates in persons with MS who report elevated anxiety. Such research is important for the design and delivery of behavioral interventions targeting PA for the treatment of anxiety in MS. This study examined PA and social cognitive theory (SCT) variables (i.e., self-efficacy, barriers, outcome expectations, goal-setting/planning, social support, and functional limitations) in persons with MS who report elevated anxiety. Research method/design324 participants with MS (aged 48.5[9.5] years) completed SCT, anxiety, and PA measures, and wore accelerometers for 7 days as a device-measure of PA. The sample was categorized into subsamples with non-elevated (n = 218) and elevated anxiety (n = 106) based on the cut-off score of 8 for the Hospital Anxiety Depression Scale Anxiety subscale. We examined levels of PA and SCT variables between the two subsamples. ResultsThere were no differences in PA levels between the subsamples when controlling for group differences in age, education, and disease duration. Social support was lower and perceived functional limitations were higher in those with elevated anxiety and were significantly associated with PA. Regression analyses identified planning, social support, and perceived functional limitations as correlates of PA in those with elevated anxiety. Conclusions/ImplicationsThis study may guide research on SCT-based behavioral interventions for increasing PA as an approach for reduced anxiety among persons with MS and elevated anxiety by targeting exercise planning, social support, and perception of functional limitations.

Application of Bandura's social cognitive theory to predict cigarette butt-littering behavior in male smokers: a case study in the parks in Tehran, Iran.

Cigarette butt-littering behavior is common among most smokers. The present study aimed to determine the predictors of butt-littering behavior in a sample of Iranian male current smokers based on the Bandura's social cognitive theory variables. In this cross-sectional study, 291 smokers who throw their cigarette butts in public parks in Tehran city, Iran were selected and completed the study instrument. Finally, the data were analyzed. The average number of butts littered daily by the participants was 8.59 (± 8.661). The results of multiple Poisson regression showed that knowledge, perceived self-efficacy, positive and negative outcome expectations, self-regulation, and observational learning variables were statistically significant predictors of butt-littering behavior among the participants. It is concluded that Bandura's social cognitive theory is a suitable theoretical framework for predicting butt-littering behavior and might be used to develop theory-based environmental education efforts in this field.

Relationships between Obesity, Exercise Preferences, and Related Social Cognitive Theory Variables among Breast Cancer Survivors.

Breast cancer survivors with obesity have an increased risk of cancer recurrence, second malignancy, and comorbidities. Though physical activity (PA) interventions are needed, investigation of the relationships between obesity and factors influencing PA program aspects among cancer survivors remain understudied. Thus, we conducted a cross-sectional study examining associations amongst baseline body mass index (BMI), PA program preferences, PA, cardiorespiratory fitness, and related social cognitive theory variables (self-efficacy, exercise barriers interference, social support, positive and negative outcome expectations) from a randomized controlled PA trial with 320 post-treatment breast cancer survivors. BMI was significantly correlated with exercise barriers interference (r = 0.131, p = 0.019). Higher BMI was significantly associated with preference to exercise at a facility (p = 0.038), lower cardiorespiratory fitness (p < 0.001), lower walking self-efficacy (p < 0.001), and higher negative outcome expectations (p = 0.024), independent of covariates (comorbidity score, Western Ontario and McMaster Universities osteoarthritis index score, income, race, education). Those with class I/II obesity reported a higher negative outcome expectations score compared with class III. Location, walking self-efficacy, barriers, negative outcome expectations, and fitness should be considered when designing future PA programs among breast cancer survivors with obesity.

Sequential mediation path from moderate exercise to weight loss through social cognitive theory variables

Sequential mediation path from moderate exercise to weight loss through social cognitive theory variables

Predictors Of Breakfast Consumption Among Iranian Students: Applying Social Cognitive Theory

Background — Despite the known significance of regular breakfast consumption, skipping or inadequate consumption of breakfast is common among students. Social cognitive theory (SCT) is one of the most effective theories in predicting nutritional behaviors, especially breakfast-related behaviors Objective — This study aimed to determine the factors related to breakfast consumption based on SCT among students of Islamic Azad University Kermanshah Branch. Methods — In this cross-sectional study, 206 students of Islamic Azad University Kermanshah Branch were selected based on availability sampling. An online questionnaire consisting of demographic information scales, SCT variables and breakfast consumption behavior was sent to student groups. Data were analyzed using descriptive statistical tests, chi-square test, linear regression and correlation analysis in SPSS software version 16. Results — On average, students consume breakfast 4.39 times a week. Overall, 17.6% of students had completely ignored breakfast and 42.4% of them ate breakfast irregularly between one and six times a week. Among the components of social cognitive theory, self-efficacy and observational learning predicted 55.7% of changes in breakfast consumption among students (P&lt;0.001). Conclusions — It seems that social cognitive theory is a useful framework for predicting breakfast consumption behavior among young people, and it is possible to improve breakfast consumption behavior by designing and implementing appropriate educational interventions based on this theory.

Social cognitive correlates of device-measured and self-reported physical activity in Black and White individuals with multiple sclerosis

BackgroundThere is increasing research interest regarding physical activity behavior among persons with multiple sclerosis (MS), yet there is little known about physical activity and its correlates in Black persons with MS. ObjectiveThis cross-sectional study assessed associations among social cognitive theory (SCT) variables and device-measured and self-reported physical activity in samples of Black and White persons with MS. MethodsParticipants included 67 Black and 141 White persons with MS who wore an ActiGraph accelerometer on a belt around the waist measuring moderate-to-vigorous physical activity (MVPA) for seven days and completed a battery of questionnaires. Questionnaires included demographic and clinical characteristics, leisure-time exercise, exercise self-efficacy, overcoming barriers self-efficacy, function, social support, exercise outcome expectations, and goal setting and planning. ResultsBlack participants with MS engaged in significantly less MVPA, but not sedentary behavior or light physical activity, than the White participants with MS. Black participants further had significantly lower levels of exercise self-efficacy and outcome expectations than the White sample. All SCT correlates were significantly correlated with self-reported physical activity, but only exercise and barriers self-efficacy, perceived function, and exercise goal setting were associated with device-measured MVPA. The difference in physical activity between Black and White participants with MS was accounted for by differences in exercise self-efficacy and outcome expectations. ConclusionsResearchers should consider developing behavioral interventions that target exercise self-efficacy and outcome expectations as SCT variables for increasing physical activity in Black persons with MS.

Factors affecting the implementation of soil conservation practices among Iranian farmers

As soil is the basis for agriculture, soil erosion is one of the major threats to food security in arid and semi-arid regions across the world. Therefore, soil conservation is an important step to increase productivity and ensure sustainability in agriculture. To implement soil conservation measures, farmers must voluntarily adopt soil conservation behaviors. Therefore, it may be important to understand the psychological and social factors that influence farmers' environmental sustainability. Thus, in this study, social cognitive theory (SCT) was used as a theoretical framework to investigate the factors influencing Iranian farmers' soil conservation behaviors (SCBs). The results showed that SCT was a successful theory in this area as it could explain 0.662 and 0.537 percent of behavioral intentions (BI) and SCBs, respectively. Moreover, the two components of self-efficacy (SE) and outcome expectancies (OE) were the strongest SCT variables that influenced SCBs. Overall, our results may provide new insights for policymakers in the agricultural sector to reduce soil erosion.

Social cognitive theory variables are stronger correlates of moderate-to-vigorous physical activity than light physical activity in older adults with multiple sclerosis

Social cognitive theory variables are stronger correlates of moderate-to-vigorous physical activity than light physical activity in older adults with multiple sclerosis

Social Cognitive Theory variables as correlates of physical activity in fatigued persons with multiple sclerosis

BackgroundThere is interest in the application of behavioral interventions based on theory for increasing physical activity among adults with multiple sclerosis (MS). To date, researchers have applied theory such as Social Cognitive Theory (SCT) for identifying correlates of physical activity that can then inform the design and delivery of behavioral interventions. Such research often has been conducted in heterogeneous samples of persons with MS without a focus on those with a specific symptom, such as fatigue, that may be targeted by physical activity behavioral interventions. To that end, this study examined SCT variables (i.e., self-efficacy, barriers, outcome expectations, goal-setting, planning, social support, and functional limitations) as correlates of physical activity in persons with MS who self-reported elevated fatigue. MethodsPersons with MS (N=210; aged 49.6[13.2] years) who ambulated with or without assistance participated in the study. Participants completed self-report measures of fatigue, physical activity, and SCT variables and wore an ActiGraph GT3X+ accelerometer on a belt around the waist for 7 days. The accelerometer data were processed and delineated into time spent in light and moderate-to-vigorous physical activity (MVPA) based on MS-specific cut-points. We generated groups of fatigued (n=134) and non-fatigued (n=76) persons with MS based on the cut-off score of 4 for the Fatigue Severity Scale. ResultsThere were differences in physical activity and SCT variables between fatigued and non-fatigued persons with MS. Among those with fatigue, functional limitations (ρ=0.52), self-efficacy (ρ=0.31), and goal-setting (ρ=0.25) were associated with device-measured MVPA, and all SCT variables except outcome expectations were associated with self-reported physical activity. The regression analyses indicated self-efficacy, functional limitations, and goal-setting as significant correlates of MVPA in those with fatigue. ConclusionSelf-efficacy, goal-setting, and social support may be important targets of SCT-based behavioral interventions for increasing physical activity among persons with MS who have fatigue.

Social cognitive variables and physical activity during chemotherapy for breast cancer: An intensive longitudinal examination

Although physical activity is associated with better health outcomes in breast cancer survivors (BCS), activity often declines during cancer treatment. Social cognitive theory (SCT) constructs have been associated with physical activity in post-treatment BCS, but little is known about the relation between these constructs and physical activity during chemotherapy. BCS (n=67; Mage =48.6 [SD=10.3]) undergoing chemotherapy wore accelerometers and completed prompts in the morning and at night assessing same-day and next-day exercise self-efficacy, physical and psychological outcome expectations, and goal-setting for 10 consecutive days (3 days pre-, day of, and 6 days post-chemotherapy dose) at three time points (beginning, middle, and end of chemotherapy). Separate mixed models assessed between- and within-person associations of each of the SCT constructs associations with same- and next-day moderate to vigorous physical activity (MVPA) and light physical activity (LPA), independently. Within-person differences in all SCT variables were statistically significantly related to same-day MVPA (p's<0.001) and LPA (p's<0.001). Every one-point increase in SCT construct related to an increase in MVPA ranging from (a) 3.70 (self-efficacy) to 8.02 (physical outcome expectations) minute increase in MVPA and (b) 12.72 (self-efficacy) to 20.38 (physical outcome expectations) increase in LPA that day. No same-day between-person effects nor any next-day effects were significant. MVPA and LPA were related to same-day within-person differences in SCT variables. Interventions targeted at increasing or mitigating chemotherapy-related declines in daily within-person changes in SCT constructs could help to increase physical activity among BCS during chemotherapy.

Additional Effects of Reduced Emotional Eating on Associations of Weight Loss via Changes in Social Cognitive Theory Variables.

Improvements in the theory-based psychosocial variables of eating self-regulation, mood, and self-efficacy for controlled eating significantly predicted weight loss in community-based obesity treatments. However, in women, additional effects from reductions in emotional eating, and age and race/ethnicity are unclear. Women (N = 130) participating in a community-based cognitive-behavioral obesity treatment were assessed on changes in theory-based psychosocial variables and weight. Treatment-associated improvements in self-regulation, mood, and self-efficacy over 3months significantly predicted 6-month weight loss (R2 = 0.26), with self-regulation change being the strongest individual predictor. Entry of change in emotional eating into the prediction model significantly added to the variance in weight change explained. Age and race/ethnicity did not further improve the predictive strength. In addition to targeting self-regulation skill development and, to a lesser extent addressing mood and self-efficacy improvements, behavioral obesity treatments should focus on emotional eating to maximize their large-scale effects on excess weight.

Social Cognitive Correlates of Physical Activity among Chinese University Employees: A Cross-Sectional Study.

Despite the well-documented benefits of leisure time physical activity, university employees are often reported to be at high risk of physical inactivity and low fitness levels. However, few efforts have been made to identify modifiable correlates of physical activity among this population. From the perspective of Social Cognitive Theory (SCT), the current study aims to examine the relationship between physical activity and a series of demographic variables (e.g., age, gender, income, education), self-reported fitness, and social cognitive variables. Data were collected through mail-based surveys from a convenience sample consisting of 116 Chinese university employees (age = 36.59 ± 8.7 y). An array of SCT variables, namely, exercise self-efficacy (r = 0.55, p < 0.01), barrier self-efficacy (r = 0.35, p < 0.01), exercise social support (r = 0.37, p < 0.01), importance of physical self (r = 0.30, p < 0.01), outcome expectations (r = 0.24, p < 0.05), and satisfaction with health(r = 0.32, p < 0.01) were found to be positively correlated with physical activity in Chinese faculty and staff, and most of the correlations were moderate to large in magnitude. Further regression analyses indicate that exercise self-efficacy (β = 0.29, p < 0.01) and exercise social support from friends (β = 0.70, p < 0.01) emerge as significant predictors of physical activity after controlling for age, gender, occupation (faculty or staff), and self-reported fitness. It is concluded that these SCT variables are important correlates of university employees’ physical activity behavior. Future physical activity promotion interventions in this population should incorporate strategies to improve one’s confidence in maintaining regular physical activity and enhance social support from friends, which are likely to increase the effectiveness of these programs.

Do physical activity and social cognitive theory variable scores differ across symptom cluster severity groups in multiple sclerosis?

BackgroundPersons with multiple sclerosis (MS) experience co-occurring symptoms termed “symptom clusters” that can be distinguished based on mild, moderate, or severe symptom severity termed “symptom cluster severity.” Physical activity (PA) may be an approach for improving co-occurring symptoms. ObjectiveTo examined if PA and social cognitive theory (SCT) variables differed by symptom cluster groups, and if associations between SCT variables and PA were moderated by symptom cluster groups. MethodsSecondary analysis of participants with MS (N = 205) enrolled in a cross-sectional study. Trend analyses were conducted to determine if device-measured and self-reported PA and SCT variables (i.e., social support, self-efficacy, outcome expectations, goal setting, planning, and impediments) decreased with increased symptom cluster severity. Spearman rho rank-order correlations were conducted between PA measures and SCT variables within each symptom cluster group. ResultsLinear trend analyses indicated that self-reported PA declined with increased symptom cluster severity groups (F = 4.90,p = 0.03). Linear trend analyses indicated significant differences among symptom cluster severity groups in social support (F = 31.43,p = 0.001), exercise self-efficacy (F = 22.55,p = 0.001), barrier self-efficacy (F = 11.48,p = 0.001), outcome expectations (F = 6.98,p = 0.009), and impediments (F = 34.41,p = 0.001). There were differential associations of moderate magnitude in correlations, such that three SCT variables were associated with PA in the mild group (i.e., self-efficacy, goal setting and planning), two in the moderate group (i.e., social support and goal setting), and four in the severe group (i.e., self-efficacy, outcome expectations, planning, and social support). ConclusionsFurther research is warranted examining the use of SCT-based behavior change techniques for promoting PA and improving symptom clusters in persons with MS.

Examining Multilevel Environmental Correlates of Physical Activity Among Older Adults With Multiple Sclerosis

Three hundred and sixty-three older adults with multiple sclerosis completed a cross-sectional study examining hierarchical correlates of physical activity using a social cognitive theory perspective within a social ecological model (i.e.,built environment, social environment, and individual social cognitive theory variables). Hierarchical linear regression analyses were conducted, wherein significant associations were noted for built environment (i.e.,land-use mix diversity and aesthetics) and physical activity in Step 1 (R2 = .09). Social and built environment were significant correlates in Step 2 (R2 = .15). Finally in Step 3, individual social cognitive theory variables (i.e.,self-efficacy and outcome expectations) were the only significant correlates of total physical activity (R2 = .38). Results were comparable for health-promoting physical activity; however, self-efficacy was the only significant correlate in Step 3 (R2 = .36). This study provides guidance for researchers and practitioners on relevant targets for tailoring interventions for older adults with multiple sclerosis and supports an emphasis on self-efficacy as a primary predictor of health behavior change.

Social cognitive theory as a guide for exercise engagement in persons with multiple sclerosis who use wheelchairs for mobility.

Multiple sclerosis (MS) is an immune-mediated neurodegenerative disease of the brain, optic nerves and spinal cord. Among persons with MS, 30% experience significant mobility impairment that requires use of a wheelchair for mobility. Exercise is an evidence-based second-line therapy that can improve mobility; however, little research has focused on individuals that use wheelchairs for mobility. Framed by social cognitive theory (SCT), we conducted a formative qualitative study examining exercise status and perceptions among 20 persons with MS who use wheelchairs for mobility. Using deductive, semantic thematic analysis, we coded for SCT variables (i.e. self-efficacy, knowledge, outcome expectations, barriers and facilitators) and identified participants as regular or inconsistent exercisers. In total, 12 participants were classified as regular exercisers and 8 inconsistent exercisers. Regular exercisers more frequently reported high self-efficacy, consistent exercise knowledge and numerous facilitators. All participants reported some positive outcome expectations and several barriers and facilitators. These findings can inform future intervention studies supporting exercise behavior change through SCT. Strategies such as increasing self-efficacy, imparting instructional materials, shaping realistic outcome expectations and providing tools directed toward overcoming barriers and identifying facilitators may work to support the exercise endeavor of persons with MS who use wheelchairs for mobility.