Stages of Physical Activity Change, Self-Determination and Adults With Disabilities

Background/Purpose: Although the benefits of physical activity are well-documented, about 47% of adults with disabilities do not participate in any leisure-time physical activity compared with 27.7% of adults without disabilities (NHIS, 2011). Therefore, there is a call for action to understand physical activity motivational strategies among adults with disabilities (USDHHS, 2020). Integrating such theoretical frameworks as the self-determination theory and the stages of change may facilitate our understanding on physical activity promotion (Grodesky et al., 2006). Given the dearth of research in this area, and especially for people with disabilities, the purpose of this survey study was to explore differences in physical activity motivational orientations (from extrinsic to intrinsic) and psychological needs (autonomy, competence, relatedness) across the stages of change for adults with physical disabilities.

Method: Participants with mainly multiple sclerosis (46%) and spinal cord injury (39%) (n = 126; M age = 54.36 ± 10.27 years, females = 70%, Caucasian = 93%) completed online standardized self-report scales about their stages of change and self-determination constructs in physical activity. Specifically, the measures consisted of a new, validated, and conceptually improved stages-of-change scale (precontemplation, contemplation, preparation, and action [action = combination of action and maintenance]), psychological needs (autonomy, competence, relatedness), and motivational orientations (external regulation, introjected regulation, identified regulation, and intrinsic motivation).

Analysis/Results: Based on the first MANOVA, introjected regulation, identified regulation, and intrinsic motivation increased across the stages of change (F [12, 363] = 4.6; p < .01). The most important contributors to the stages of change were intrinsic motivation (r² = 29%), identified regulation (r² = 28%), and introjected regulation (r² = 10%). There were no differences in external regulation. Based on the second MANOVA, competence and autonomy significantly increased across the stages of change (F [9, 366] = 4.5; p < .01). Competence explained most of the variance in the stages of change (25%) followed by autonomy (14%).

Conclusions: Emphasizing such physical activity motivational strategies as enjoyable activities (intrinsic motivation) of increased value (identified regulation) may assist with physical activity promotion among adults with physical disabilities. Additionally, providing successful activity experiences (competence) and choices in activity programs (autonomy) can facilitate movement to the active stages of physical activity. Although social pressure to be active (introjected regulation) seems to be important to people in the action stage compared with those in precontemplation, it should be downplayed in physical activity promotion for increased physical activity adherence.