Psychosocial Factors of Physical Activity among People with Disabilities: Prospective Cohort Study

Brandenbarg, P., Krops, L.A., Seves, B.L., Hoekstra, T., Hettinga, Florentina, Twisk, J.W.R., van der Woude, L.H.V., Dekker, R. and Hoekstra, F. (2023) Psychosocial Factors of Physical Activity among People with Disabilities: Prospective Cohort Study. Rehabilitation Psychology, 68 (2). pp. 164-173. ISSN 0090-5550

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Abstract

Purpose/Objective: This study aimed to (a) explore the associations between psychosocial factors and physical activity behavior in people with physical disabilities and/or chronic diseases, both between and within persons over time; and (b) examine whether these associations differ for people initiating and people maintaining physical activity behavior.

Research Method/Design: Data of 1,256 adults with physical disabilities and/or chronic diseases enrolled in the prospective cohort study Rehabilitation, Sports, and Active lifestyle (ReSpAct) were analyzed. Self-reported physical activity and four main psychosocial factors (i.e., self-efficacy, attitude, motivation, social support) were measured with questionnaires 3–6 weeks before discharge (T0) and 14 (T1), 33 (T2), and 52 (T3) weeks after discharge from rehabilitation. Hybrid multilevel regression models (corrected for age, sex, education level, diagnosis, counseling support) were used.

Results: Multivariable significant between-subject associations were found for self-efficacy (std β = .094; 95% CI [0.035, 0.153]) and intrinsic motivation (std β = .114; [0.036, 0.192]). Multivariable significant within-subject associations were found for identified regulation (std β = −.038; [−0.072, −0.005]) and intrinsic motivation (std β = .049; [0.016, 0.082]). Effect modification of initiating or maintaining physical activity was found for the between-subject association of attitude (p = .035). No significant associations were found for social support, amotivation, external regulation, and introjected regulation.

Conclusion/Implications: This study is the first that explored the between- and within-subject associations between psychosocial factors and physical activity over time in a large cohort of adults with physical disabilities and/or chronic diseases. The findings indicate the importance of intrinsic motivation, identified regulation, and self-efficacy in initiating and maintaining physical activity behavior.

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