Abstract written by Maureen Wagner

Purpose:
Research in this article is geared toward finding out how behavioral, cognitive, and environmental factors differentially associated with the stage of change (transtheoretical model of behavior change) for exercise behavior among adults with physical disabilities. In the general population, self-efficacy and the behavioral change process appear to be important parts of the stages of exercise behavior; it is hypothesized that the same is true for people with physical disabilities.

Participants:
The subjects for this study were 322 adults in the U.S. with a variety of physical disabilities. Most (84.3%) used some form of assistive device, were female (62.1%), and were Caucasian (91.9%). The mean age of participants was 52.5 years of age.

Method:
A national cross-sectional survey of adults with physical disabilities was conducted. Self reported questionnaires were used to estimate the degree to which the process of change, self-efficacy, decisional balance, and exercise barriers were associated with the stage of exercise change. Participants of the study completed and returned surveys for each of the transtheoretical model constructs along with exercise barrier measures. Subjects were asked to indicate their level of activity and from the response were categorized into the pre-contemplative, contemplative, active, or maintenance stages. The process of change was assessed through a questionnaire which consisted of 20 behavioral process questions and 20 cognitive process questions. In addition, subjects were asked to answer questions on self-efficacy and decisional balance, as well as identify exercise barriers and how often they encountered those barriers.

Results:
The results showed that in a univariate analysis of the data, all of the constructs tested were statistically significant.

Discussion:
The results demonstrate that the transtheoretical model behavioral change is a reliable tool to assess the exercise behavior of people with physical disabilities as well as the general population. The results support the hypothesis that the behavioral process of change along with self-efficacy improved in a linear sequence from pre-contemplative to maintenance and that self-efficacy and the stages of behavioral change were the most important concomitants.