Silveira Stephanie L, Motl Robert W
Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, USA.
Prev Med Rep. 2019 Jun 18;15:100921. doi: 10.1016/j.pmedr.2019.100921. eCollection 2019 Sep.
There is abundant evidence for the benefits of physical activity (PA) among persons with multiple sclerosis, however only 20% of persons with MS engage in sufficient PA. This cross-sectional study examined features of the built environment, social environment, and individual as hierarchical correlates of PA in persons with MS from a social-cognitive theory (SCT) perspective embedded within a social-ecological model (SEM). Five hundred eighty eight persons with MS completed an online survey between September 2018-January 2019 including: demographics, Patient Determined Disease Steps (PDDS), abbreviated Neighborhood Walkability Scale (NEWS-A), Social Provisions Scale (SPS), Exercise Self-Efficacy Scale (EXSE), and Godin Leisure-Time Exercise Questionnaire (GLTEQ). Correlation analyses were used to examine associations among NEWS-A subscales, SPS, EXSE, PDDS, Employment, Education and GLTEQ. We then conducted hierarchical, linear regression analysis whereby we regressed GLTEQ with PDDS, Education, and Employment (Step 1), NEWS-A subscales (Step 2), SPS (Step 3), and EXSE (Step 4) based on a SEM. Land-use mix diversity, land-use mix access, aesthetics, crime, SPS, EXSE, and PDDS correlated with GLTEQ. PDDS was a significant correlate of GLTEQ in Step 1 (β = -0.37;R = 0.15). Aesthetics (β = 0.08) and PDDS (β = -0.33) were significant correlates of GLTEQ in Step 2 (R = 0.18). SPS (β = 0.23) and PDDS (β = -0.30) were significant correlates of GLTEQ in Step 3 (R = 0.23). The final model in Step 4 identified PDDS (β = -0.11), aesthetics (β = 0.07), SPS (β = 0.09), and EXSE (β = 0.54) as correlates of GLTEQ (R = 0.43). Such results may inform the design of multi-level interventions that target environmental and individual correlates of PA consistent with the SEM framework and guided by SCT.
有大量证据表明体育活动（PA）对多发性硬化症患者有益，然而只有20%的多发性硬化症患者进行了足够的体育活动。这项横断面研究从社会生态模型（SEM）中嵌入的社会认知理论（SCT）角度，考察了建筑环境、社会环境和个体特征作为多发性硬化症患者体育活动的分层相关因素。588名多发性硬化症患者在2018年9月至2019年1月期间完成了一项在线调查，包括：人口统计学、患者确定的疾病阶段（PDDS）、简化的邻里步行能力量表（NEWS-A）、社会支持量表（SPS）、运动自我效能量表（EXSE）和戈丁休闲时间运动问卷（GLTEQ）。相关性分析用于检验NEWS-A子量表、SPS、EXSE、PDDS、就业、教育和GLTEQ之间的关联。然后，我们进行了分层线性回归分析，根据SEM，我们将GLTEQ与PDDS、教育和就业（步骤1）、NEWS-A子量表（步骤2）、SPS（步骤3）和EXSE（步骤4）进行回归。土地利用混合多样性、土地利用混合可达性、美观性、犯罪、SPS、EXSE和PDDS与GLTEQ相关。在步骤1中，PDDS是GLTEQ的显著相关因素（β = -0.37；R = 0.15）。在步骤2中，美观性（β = 0.08）和PDDS（β = -0.33）是GLTEQ的显著相关因素（R = 0.18）。在步骤3中，SPS（β = 0.23）和PDDS（β = -0.30）是GLTEQ的显著相关因素（R = 0.23）。步骤4中的最终模型确定PDDS（β = -0.11）、美观性（β = 0.07）、SPS（β = 0.09）和EXSE（β = 0.54）为GLTEQ的相关因素（R = 0.43）。这些结果可能为多层次干预措施的设计提供信息，这些干预措施针对与体育活动相关的环境和个体因素，符合SEM框架并以SCT为指导。
