Development of a valid and reliable barriers to physical activity questionnaire for people with mobility disabilities

Background/Purpose: While the benefits of physical activity is well established, people with mobility disabilities are less likely to participate in adequate physical activity levels. The purpose of this study was to develop a valid and reliable Barriers to Physical Activity Questionnaire (BPAQ) for people with mobility disabilities using an ecological framework (personal, social, organizational, and community).

Methods: BPAQ items were developed using a three round Delphi. The items were subsequently refined or removed using cognitive interview. To test the reliability and validity of the BPAQ, 120 people with mobility disabilities completed the BPAQ, the Physical Activity and Disability Survey, and a demographic questionnaire. Exploratory factor analysis (EFA) was performed within each ecological framework. Internal consistency was calculated. A rasch analysis was also performed using Hierarchal Linear Modeling (HLM). Analysis of variance was used to assess discriminant validity.

Results: After completing the EFA, three factors were extracted from each of the four domains of the ecological framework. Cronbach alpha ranged from 0.707 to 0.948 (health care provider and fitness center built environment respectively). When controlling for age, gender, and race, HLM analysis identified significant personal and socio-environmental barriers. Personal barriers were significantly more likely to be of greater magnitude than barriers from other ecological domains. Stroke survivors were significantly more likely to experience psychosocial barriers, when compared to other disability types (F=4.149, p<0.05).

Implication: To improve the BPAW's validity, the psychometric qualities should be assessed in rural communities. By understanding barriers, appropriate interventions can be developed to increase physical activity participation.