Validación de una versión reducida en español del instrumento Barriers to Physical Activity Questionnaire for People with Mobility Impairments

Socio-ecological Barriers to Leisure Time Physical Activity in Spanish Wheelchair Users With Spinal Cord Injury: Associations With Sociodemographic Characteristics and Functional Independence

OBJECTIVE

(1) To assess prevalence and severity of socio-ecological barriers to leisure time physical activity (LTPA) in a sample of adults with spinal cord injury (SCI); (2) to examine the association of these barriers with sociodemographic characteristics and functional independence (FI); and (3) to explore which socio-ecological levels of barriers might be associated with LTPA.

DESIGN

Cross-sectional study.

SETTING

Neurorehabilitation Hospital specialized in SCI.

PARTICIPANTS

207 wheelchair users with SCI living in the community who attended a comprehensive check-up (22.7% women, 47.5±10.7 mean age; N=207).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

The short version of the Barriers to Physical Activity Questionnaire for People with Mobility Impairments was used to measure socio-ecological barriers to LTPA. The Spinal Cord Independence Measure III was used to measure FI. The Physical Activity Recall Assessment for People with SCI was used to quantify LTPA. Several multiple linear regression models were computed to examine the associations between socio-ecological barriers and sociodemographic factors, LTPA and FI.

RESULTS

A high prevalence of barriers to LTPA was found. Seven of these barriers (2 intrapersonal, 3 organizational, and 2 community) were present for >60% of the participants. Intrapersonal and organizational barriers had a higher effect on participants with lower FI and women. Interpersonal barriers were higher for older participants and with lower FI, while community barriers were higher for unemployed participants. Finally, intrapersonal and interpersonal barriers were negatively associated with LTPA, and FI revealed as a moderator of the intrapersonal barriers-LTPA relation.

CONCLUSIONS

Given their high prevalence and their association with LTPA, the development of interventions targeting socio-ecological barriers to LTPA in people with SCI becomes crucial. The associations of these barriers with FI and sociodemographic characteristics should also be considered for these interventions to be as specific and effective as possible.

Validity and Reliability of the Persian Version of Barriers to Physical Activity Questionnaire for People With Mobility Impairments

BACKGROUND

Although physical activity (PA) is an important determinant of health, physically disabled individuals tend to have a sedentary lifestyle. The Barriers to Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI) is a self-report instrument evaluating PA barriers. This study was intended to evaluate the validity and reliability of the Persian version of BPAQ-MI (P-BPAQ-MI) and to report the prevalence and severity of PA barriers among Persian-speaking individuals.

METHODS

The translation and back translation of the BPAQ-MI was conducted according to an internationally accepted guideline and tested on 163 participants to assess its reliability and validity. Internal consistency and test-retest reliability were analyzed using Cronbach alpha and Spearman correlation coefficient. Convergent construct validity was established by comparing the scores of P-BPAQ-MI and The Baecke Habitual Physical Activity Questionnaire. Known-groups construct validity was assessed with regard to type of assistive device and sex of the individual. Prevalence and severity of the barriers were reported by computing the percentage and means of "yes" answers.

RESULTS

The P-BPAQ-MI domains demonstrated very good internal consistency (Cronbach alpha of .77-.95) and excellent test-retest reliability (Spearman rho of .73-.96) with a significant inverse small correlation with Baecke Habitual Physical Activity Questionnaire indexes. The P-BPAQ-MI successfully discriminated between individuals with different assistive devices and sex. Community Built Environment barriers were the most prevalent and severe.

CONCLUSIONS

The P-BPAQ-MI is a valid and reliable instrument to assess the PA barriers of people with physical disability. The community barriers were the most frequently reported obstacles to PA.

Predicting physical activity in university students with disabilities: The role of social ecological barriers in the theory of planned behaviour

BACKGROUND

Even though university students with disabilities are less active than their peers without disabilities, there is scarce knowledge on the predictors of physical activity (PA) in this population.

OBJECTIVES

To predict PA in Spanish university students with disabilities using the Theory of Planned Behaviour (TPB) and to examine the role of social ecological barriers within this theoretical framework.

METHODS

Participants (N = 1079; Mean age = 40.12) for this cross-sectional study were recruited through the disability care services of 55 Spanish universities. The TPB constructs were assessed using a questionnaire. The Spanish short form of the International Physical Activity Questionnaire was used to measure PA and the reduced Spanish version of the Barriers to Physical Activity for People with Mobility Impairments was used to measure social ecological barriers.

RESULTS

Two different models were computed through path analysis. Model 1 included the traditional TPB constructs and model 2 added a social ecological barriers variable. In both models, attitudes (β = 0.152; β = 0.152), subjective norms (β = 0.114; β = 0.115) and self-efficacy (β = 0.657; β = 0.659) each predicted PA intentions. PA intentions (β = 0.118; β = 0.122), self-efficacy (β = 0.225; β = 0.207) and controllability (β = 0.098; β = 0.075) predicted PA. In model 2, social ecological barriers predicted PA (β = 0.099). Regression analyses revealed intrapersonal barriers as a significant predictor of self-efficacy (β = -0.441). Controllability was predicted by intrapersonal barriers (β = -0.265), community barriers (β = -0.100) and organizational barriers (β = -0.095).

CONCLUSIONS

Future PA behaviour change interventions should target intentions, self-efficacy and controllability, since they directly predicted PA. These interventions would benefit from considering social ecological barriers to PA.

Barriers to physical activity in university students with disabilities: Differences by sociodemographic variables

BACKGROUND

Despite the positive effects of regular physical activity (PA), university students with disabilities are less active than their able-bodied peers, which could be due to the wide range of barriers to PA that these individuals face across all social ecological levels.

OBJECTIVE

To identify the barriers to PA experienced by university students with disabilities at the different social ecological levels and to examine the differences in these barriers by sociodemographic variables.

METHODS

The reduced Spanish version of the Barriers to Physical Activity Questionnaire for People with Mobility Impairments was administered to a sample of 1219 Spanish university students with disabilities. Non-parametric tests were performed to examine the differences in the barriers experienced by sociodemographic variables.

RESULTS

The most important barriers were intrapersonal (e.g. fatigue, pain, lack of motivation), followed by organizational ones (e.g. lack of adapted programs, economic cost). At the interpersonal level, the inactivity of friends and family were the main barriers. Potholes in the streets or other public spaces were found to be the most important barriers at the community level. Significant differences were found in barriers by sex, age, disability grade, congenital-acquired disability and disability type. The groups most affected by the barriers were, in general, those with multiple disabilities and higher disability grade.

CONCLUSIONS

The results indicate the need for PA promotion programs to be implemented for university students with disabilities addressing the most important barriers found at each social ecological level, as well as the differences identified by sociodemographic variables.