Examining Multilevel Environmental Correlates of Physical Activity Among Older Adults With Multiple Sclerosis

in Journal of Aging and Physical Activity
Restricted access

Purchase article

USD  $24.95

Student 1 year online subscription

USD  $77.00

1 year online subscription

USD  $103.00

Student 2 year online subscription

USD  $147.00

2 year online subscription

USD  $196.00

Three hundred and sixty-three older adults with multiple sclerosis completed a cross-sectional study examining hierarchical correlates of physical activity using a social cognitive theory perspective within a social ecological model (i.e., built environment, social environment, and individual social cognitive theory variables). Hierarchical linear regression analyses were conducted, wherein significant associations were noted for built environment (i.e., land-use mix diversity and aesthetics) and physical activity in Step 1 (R 2 = .09). Social and built environment were significant correlates in Step 2 (R 2 = .15). Finally in Step 3, individual social cognitive theory variables (i.e., self-efficacy and outcome expectations) were the only significant correlates of total physical activity (R 2 = .38). Results were comparable for health-promoting physical activity; however, self-efficacy was the only significant correlate in Step 3 (R 2 = .36). This study provides guidance for researchers and practitioners on relevant targets for tailoring interventions for older adults with multiple sclerosis and supports an emphasis on self-efficacy as a primary predictor of health behavior change.

Silveira, Baird, and Motl are with the Department of Physical Therapy, The University of Alabama at Birmingham, Birmingham, AL, USA. Baird and Motl are also with the Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA.

Silveira (ssilveira@uab.edu) is corresponding author.
  • Baird, J.F., Cederberg, K.L.J., Sikes, E.M., Silveira, S.L., Jeng, B., Sasaki, J.E., … Motl, R.W. (2019). Physical activity and walking performance across the lifespan among adults with multiple sclerosis. Multiple Sclerosis and Related Disorders, 35, 3641. PubMed ID: 31302502 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143164. PubMed ID: 15090118 doi:

  • Barnett, D.W., Barnett, A., Nathan, A., Van Cauwenberg, J., & Cerin, E. (2017). Built environmental correlates of older adults’ total physical activity and walking: A systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 103. PubMed ID: 28784183 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bollaert, R.E., & Motl, R.W. (2019). Physical and cognitive functions, physical activity, and sedentary behavior in older adults with multiple sclerosis. Journal of Geriatric Physical Therapy, 42(4), 304312. PubMed ID: 29200085 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bollaert, R.E., Sandroff, B.M., Stine-Morrow, E.A., Sutton, B.P., & Motl, R.W. (2019). The intersection of physical function, cognitive performance, aging, and multiple sclerosis: A cross-sectional comparative study. Cognitive And Behavioral Neurology, 32(1), 110. PubMed ID: 30896571 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bronfenbrenner, U. (1979). The ecology of human development. New York, NY: Harvard University Press.

  • Carlson, J.A., Sallis, J.F., Conway, T.L., Saelens, B.E., Frank, L.D., Kerr, J., … King, A.C. (2012). Interactions between psychosocial and built environment factors in explaining older adults’ physical activity. Preventive Medicine, 54(1), 6873. PubMed ID: 22027402 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cerin, E., Saelens, B.E., Sallis, J.F., Frank, L.D. (2006). Neighborhood environment walkability scale: Validity and development of a short form. Medicine & Science in Sports & Exercise, 38(9), 16821691. PubMed ID: 16960531 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cohen, J. (2013). Statistical power analysis for the behavioral sciences. New York: Routledge.

  • Fox, R.J., Bacon, T.E., Chamot, E., Salter, A.R., Cutter, G.R., Kalina, J.T., & Kister, I. (2015). Prevalence of multiple sclerosis symptoms across lifespan: Data from the NARCOMS Registry. Neurodegenerative Disease Management, 5(6, Suppl.), 310. PubMed ID: 26611264 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Godin, G., & Shephard, R. (1985). A simple method to assess exercise behavior in the community. Canadian Journal of Applied Sport Science, 10(3), 141146. PubMed ID: 4053261

    • Search Google Scholar
    • Export Citation
  • Klaren, R.E., Sebastiao, E., Chiu, C.-Y., Kinnett-Hopkins, D., McAuley, E., & Motl, R.W. (2016). Levels and rates of physical activity in older adults with multiple sclerosis. Aging and Disease, 7(3), 278. PubMed ID: 27330842 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Konopack, J.F., & McAuley, E. (2012). Efficacy-mediated effects of spirituality and physical activity on quality of life: A path analysis. Health and Quality of Life Outcomes, 10(1), 57. PubMed ID: 22642832 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Learmonth, Y.C., Motl, R.W., Sandroff, B.M., Pula, J.H., & Cadavid, D. (2013). Validation of patient determined disease steps (PDDS) scale scores in persons with multiple sclerosis. BMC Neurology, 13(1), 37. PubMed ID: 23617555 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McAuley, E., Jerome, G.J., Marquez, D.X., Elavsky, S., & Blissmer, B. (2003). Exercise self-efficacy in older adults: Social, affective, and behavioral influences. Annals of Behavioral Medicine, 25(1), 17. PubMed ID: 12581930 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McAuley, E., Motl, R.W., White, S.M., & Wojcicki, T.R. (2010). Validation of the multidimensional outcome expectations for exercise scale in ambulatory, symptom-free persons with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 91(1), 100105. PubMed ID: 20103403 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Motl, R.W., Arnett, P.A., Smith, M.M., Barwick, F.H., Ahlstrom, B., & Stover, E.J. (2008). Worsening of symptoms is associated with lower physical activity levels in individuals with multiple sclerosis. Multiple Sclerosis Journal, 14(1), 140142. PubMed ID: 18089672 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Motl, R.W., McAuley, E., Snook, E.M., Gliottoni, R.C. (2009). Physical activity and quality of life in multiple sclerosis: Intermediary roles of disability, fatigue, mood, pain, self-efficacy and social support. Psychology, Health, & Medicine, 14(1), 111124. PubMed ID: 19085318 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Motl, R.W., Pekmezi, D., & Wingo, B.C. (2018). Promotion of physical activity and exercise in multiple sclerosis: Importance of behavioral science and theory. Multiple Sclerosis Journal—Experimental, Translational and Clinical, 4(3), 2055217318786745. PubMed ID: 30090642 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Motl, R.W., & Pilutti, L.A. (2012). The benefits of exercise training in multiple sclerosis. Nature Reviews Neurology, 8(9), 487. PubMed ID: 22825702 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Motl, R.W., Snook, E.M., McAuley, E., Scott, J.A., & Douglass, M.L. (2006). Correlates of physical activity among individuals with multiple sclerosis. Annals of Behavioral Medicine, 32(2), 154161. PubMed ID: 16972813 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rao, S.M., Leo, G.J., Bernardin, L., & Unverzagt, F. (1991). Cognitive dysfunction in multiple sclerosis.: I. Frequency, patterns, and prediction. Neurology, 41(5), 685691. PubMed ID: 2027484 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sikes, E.M., Richardson, E.V., Cederberg, K.J., Sasaki, J.E., Sandroff, B.M., Motl, R.W. (2018). Use of the Godin leisure-time exercise questionnaire in multiple sclerosis research: A comprehensive narrative review. Disability and Rehabilitation, 41(11), 12431267. PubMed ID: 29343122 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Silveira, S.L., & Motl, R.W. (2019a). Environmental correlates of health-promoting leisure physical activity in persons with multiple sclerosis using a social cognitive perspective embedded within social ecological model. Preventive Medicine Reports, 15, 100921. PubMed ID: 31304080 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Silveira, S.L., & Motl, R.W. (2019b). Do social cognitive theory constructs explain response heterogeneity with a physical activity behavioral intervention in multiple sclerosis? Contemporary Clinical Trials Communication, 15, 100366. PubMed ID: 31193266 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Silveira, S.L., & Motl, R.W. (in press). Validation of neighborhood environment walkability scale scores in persons with multiple sclerosis. Journal of Transport and Health.

    • Search Google Scholar
    • Export Citation
  • Suh, Y., Joshi, I., Olsen, C., & Motl, R.W. (2014). Social cognitive predictors of physical activity in relapsing-remitting multiple sclerosis. International Journal of Behavioral Medicine, 21(6), 891898. PubMed ID: 24407400 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Uszynski, M.K., Casey, B., Hayes, S., Gallagher, S., Purtill, H., Motl, R.W., & Coote, S. (2018). Social cognitive theory correlates of physical activity in inactive adults with multiple sclerosis. International Journal of MS Care, 20(3), 129135. PubMed ID: 29896049 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wallin, M.T., Culpepper, W.J., Campbell, J.D., Nelson, L.M., Langer-Gould, A., Marrie, R.A., … LaRocca, N.G. (2019). The prevalence of MS in the United States: A population-based estimate using health claims data. Neurology, 92(10), e1029e1040. PubMed ID: 30770430 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • White, S.M., Wójcicki, T.R., & McAuley, E. (2011). Social cognitive influences on physical activity behavior in middle-aged and older adults. The Journals of Gerontology, Serics B: Psychological Sciences & Social Sciences, 67(1), 1826. PubMed ID: 21743038 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Winett, R.A., Williams, D.M., & Davy, B.M. (2009). Initiating and maintaining resistance training in older adults: A social cognitive theory-based approach. British Journal of Sports Medicine, 43(2), 114119. PubMed ID: 18628361 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wojcicki, T.R., White, S.M., & McAuley, E. (2009). Assessing outcome expectations in older adults: The multidimensional outcome expectations for exercise scale. The Journals of Gerontology, Serics B: Psychological Sciences & Social Sciences, 64(1), 3340. PubMed ID: 19181688 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 135 135 40
Full Text Views 3 3 0
PDF Downloads 5 5 1