Development of a Barriers To Physical Activity Questionnaire for People with Mobility Impairments

The purpose of this study was to develop a questionnaire that measures barriers to physical activity for people with mobility disabilities that incorporated items from an ecological perspective and that used Item Response and Classical Test theories. By incorporating an ecological perspective, researchers can have a better understanding of the complex relationship across domains. Using a combination of classical and item response theories provides researchers an opportunity to understand barriers both at the item level and at a subscale level. There are four phases to the development of the questionnaire: item development, item refinement, field testing, and psychometric analysis.;A Delphi panel and cognitive interviews were conducted to develop and refine the questionnaire items. Delphi panelists had experience with physical activity promotion for people with disabilities or developing barrier questionnaires for people with disabilities. The purpose of the Delphi panel was to identify missing items, combine similar items, and remove unnecessary items. Panelists identified a total of 115 items with near-equal weight across the four domains. The purpose of cognitive interviews was to identify items that needed rewording and to remove unnecessary items. Cognitive interview participants were primarily African American females. Participants stated that they wanted further clarifications on items by providing examples.;One-hundred fifty field test participants were recruited from a large, metropolitan independent living center, a universally-accessible fitness center, and an outpatient clinic at the University of Illinois at Chicago. Participants completed the Physical Activity and Disability Survey, Barriers to Physical Activity Questionnaire (BPAQ), and demographic variables were collected through in-person interviews. A random sample of 30 out of the 150 field test participants completed the BPAQ twice over a seven to ten day period to calculate test-retest reliability.;Field test participants were mostly African American females. Exploratory factor analysis revealed the BPAQ was comprised of eight subscales or factors. The underlying factors were health, beliefs and attitudes, family, friends, fitness center built environment, staff and policy, community built environment, and safety. The health subscale had the highest mean. The BPAQ demonstrated moderate to very good reliability and validity. The BPAQ showed significant associations with physical activity levels. Item Response Theory analysis revealed that the health factor had the most "difficult" items. Other subscales had items that ranged from very easy to difficult. Some items behaved differently for people of certain demographic variables. For example, some items were more difficult if the participant has a particular disability diagnosis, such as lymphedema. The BPAQ has the potential to assist researchers in understanding the complex relationship between barriers and ultimately develop physical activity interventions that address these barriers.