A comparison of barriers to physical activity faced by older and younger adults with mobility impairments

-----------------------------Vijay Vasudevan, MPH, PhD Candidate ------------------------------

Background and Purpose

Lower levels of physical activity have been associated with a higher risk of being obese. However, people with disabilities are less likely to engage in physical activity when compared to people without disabilities (25.6% vs 12.8% respectively). Some common barriers to physical activity include: cost of exercise program, lack of energy, transportation, and not knowing where to exercise. However, there are many additional barriers to physical activity that have yet to be measured. It is hypothesized that people with disabilities face more barriers to physical activity than older adults, ethnic/racial minorities, and the general population (fig. 1). The purpose of this study is to identify the differences in barriers to physical activity faced by older and younger adults with disabilities (age 50, versus < 50 and their relationship with physical activity. Fig. 1: Hypothesized comparison of barriers to physical activity

Methods
Participants were recruited from the Helen M. Galvin Health and Fitness Center, Access Living of Metropolitan Chicago, and the UIC medical center. Eligibility criteria included: 1) lived in Chicago, 2) had difficulty walking a quarter mile without using assistive device (eg, cane, walker, or wheelchair) OR had difficulty climbing 10 stairs, and 3) spoke English. Participants took part in in-person interviews. Barriers were assessed using the Barriers to Physical Activity Questionnaire (BPAQ) which assessed barriers that were experienced within the past three months and barrier magnitude on a five point Likert scale. Participants also completed the Physical Activity and Disability Survey and a demographic data questionnaire. Interviews lasted approximately 30-45 minutes.

Analysis
Independent sample t-tests were performed to compare older and younger adults with mobility impairments (age 50, versus < 50) and the barriers they faced. To assess the relationship between barriers experienced and physical activity, hierarchal multiple regression analysis was performed.

Results
Comparison of Barriers to Physical Activity faced by Older and Younger Adults Mean Confidence Interval Personal (-0.370, 0.943) Younger 1.13 Older 0.847 Social (-0.309, 0.517) Younger 0.378 Older 0.274 Organizational (-0.461, 0.497) Younger 0.325 Older 0.307 Community (-0.676, 0.668) Younger 0.633 Older 0.637 Linear Regression Predicting Physical Activity Model 1 () -0.042 -0.301 0.240 0.067 0.185 0.140 P-value 0.381

0.610

0.941

0.990

Gen Pop Increasing Barriers Ethnic/racial minorities Older adults People with Disabilities

Demographics (n=36)
Age (years) Body Mass Index (Kg/m2) Gender Male Female Race African American or Black White Hispanic Multiracial Education Did not complete high school Completed high school Some college College graduate Employment status Employed for wages Student Retired Social Security or disability Income $10,000 > $10,000 Mobility aid use Cane Walker Wheelchair Other Mean 52.72 31.11 n 17 19 28 5 2 1 1 10 15 10 3 3 8 23 11 25 20 12 14 6 SD 13.85 7.23 % 47.2 52.8 77.8 13.9 5.56 2.74 2.8 27.8 41.7 27.8 8.3 8.3 22.2 63.9 30.6 69.4 55.6 33.3 38.9 16.7

Age BMI Female At least some college Wheelchair user Personal Social Organizational Community R2 change # = p < 0.10, *= p < 0.05

Model 2 () 0.132 -0.378 0.341* 0.048 0.367# 0.658* 0.297 -0.056 -0.689# 0.331

Conceptual Model
Health Condition
(BMI)

Limitations and Conclusion

The preliminary results seem to indicate that the barriers that are experienced have a significant relationship with physical activity. Some counterintuitive results were that wheelchair users and people with greater personal barriers were more likely to be active. This might be because the wheelchair users have greater mobility and are capable of overcoming the personal barriers in their lives. The limitations of this preliminary study are that the population was primarily African American, active, and a small sample size. Future directions will include: 1) a larger sample size be 150, 2) greater racial diversity, and 3) include more physically inactive individuals. This will allow the BPAQ to be valid for both active and inactive individuals with disabilities across racial minorities., to better assess the relationship with physical activity participation.

Body Function & Structure

Activity

Participation
(Physical Activity)

Personal Barriers

Environmental Barriers

The International Classification of Functioning and Disability framework identifies the relationship between health condition(s) (obesity), participation in physical activity, and personal/environmental barriers. Understanding experienced barriers has the potential to develop interventions to increase physical activity.

This study is funded by the Midwest Roybal Center for Health Promotion and Translation.