Factors Influencing Participant Use of an Internet-Based Physical Activity Program for Adults with Physical Disabilities

Carolyn Lullo, AUCD/CDC Fellow, PhD Candidate University of Illinois at Chicago

Introduction
Background: Internet programs have shown initial success at increasing physical activity (PA) in the general population; but concerns about program engagement and questions about program design remain.1 The internet is a promising delivery mode for PA programs for people with disabilities because it addresses many of the most commonly reported barriers, but research in this area is limited. 2 Research question: What factors do participants with disabilities perceive to influence their use of an internet-based program? Last Week Visited (n=241)
# of Participants
100 80 60 40 20 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14

Results
Engagement Variables (n=162) Weeks visited Total visits Pages viewed Total minutes MeanSD 4.693.83 9.7312.13 152.50153.56 131.32147.30

The Program
Program goal: Promote participation in physical activity by people with physical disabilities Primary delivery modes: Website and email Duration: 14 weeks of content; updated weekly Primary content: Motivational/instructional resources; individually tailored exercise videos; interactive logs; email reminders; coaching; social networking

Week of Program

Factors Influencing Program Registration

Match between personal goals/needs and program characteristics I know this is totally bizarre, but I had prayed, God, why dont they come out with some kind of exercise program that disabled people can do? I just want something for us. And heres this thing comes popping up on Facebook within a couple of hours of my prayer. I was thinking that I ought to do something in terms of, you know, being better. And then I was trying to also get my boyfriend involved in physical activity. The idea that we could do something sort of together. Then not really being sure, with my abilities, what the best way to do sort of things I should do, things that I could adapt I think that was the biggest thing. Theres transportation issues. You cant always get to an appointment when you think you should be there. They cant meet your needs at that time just things happen. Being able to find a program where you could use it at home. I think thats what made the program right for me.

Methods
Design: Portion of a mixed methods program evaluation Eligibility: 18+ years old, physical disability, not regularly active, registered for the program Program use electronically monitored Responses to open-ended survey questions collected at baseline (n=241), mid-point (n=148), post (n=141), and 4-week follow-up (n=147) Semi-structured phone interviews conducted from midpoint to post, targeting infrequent and frequent visitors Infrequent visitors (n=24): 2 or less visits Frequent visitors (n=23): 4 or less missed weeks Analysis: Content analysis using an inductive category and theme development approach was used Two stages of use were explored separately: Initial consideration of the program (registration) Use once the program had started (engagement) Participant baseline characteristics: Age: 48.4211.61 years
% %

Implications
Initial interest in the program was high. Many participants expressed how this is something they had been actively looking for but unable to find previously. Thus, there is a need and demand for internet-based physical activity programs for this population. Participants provided many insights into what influenced their engagement that should be incorporated into future programs for this population. They highlighted the importance of convenience, ease of use, individual tailoring, and social connection.

Factors Influencing Program Engagement

Exogenous factors Probably my chronic pain and fatigue just, you know, I get to the end of the day and I would have nothing left. And, you know, it just, I wanted to, but my body said, No way! Ive had some hardware issues. My sound card went out and its triggered all kinds of other problems. Its obviously a conflict and Ive been trying to trace it down, but I havent. Program should be easy, convenient, and supportive of me personally The exercises show people doing the exercise with whatever their limitation is. And watching all these other workout videos on TV, they are always showing the person who is in perfect shape. So, it really caught my attention and made an impression as to who you had in the videos. It said I would have to wait until Monday to start. I dont have a Monday through Friday job. My days that I was off, and I was motivated, I had to wait. And then when I finally got started, I need somebody to say, You need to do this exercise this many times and I will work with you. It has a lot to do with not always being on the internet and forgetting the exercises. But now we found a way that we can actually download the videos so I have them right on my computer. I think one of the first things is that you have to remember to go to this website. So something that came up in your email every week or even every day that came up Google alert style. Connecting with other participants If youre talking with someone who is doing the program too, you can motivate each other and share and that might be a way of reminding the participants and reconnecting with the program. I like seeing other peoples stories and their frustrations too, because everything doesnt work for everybody. It gave me a little solace when it came to me wanting to just jump off the deep end.

References & Acknowledgements

1 van

Female White some college Income $24,999

81.7 78.7 91.7 31.9

Unemployed or retired Suburban area Wheelchair-user No physical activity

59.0 53.5 33.6 48.9

den Berg, M., Schoones, J., & Vliet Vlieland, T. (2007). Internetbased physical activity interventions: A systematic review of the literature. Journal of Medical Internet Research, 9(3). 2 Motl, R., Dlugonski, D., Wojcicki, T., McAuley, E., & Mohr, D. (2011). Internet intervention for increasing physical activity in persons with multiple sclerosis. Multiple Sclerosis Journal, 17(1), 116-128. This poster has been developed by the Association of University Centers on Disability in collaboration with the Centers for Disease Control and Prevention (CDC)'s National Center on Birth Defects and Developmental Disabilities (NCBDDD), Division of Human Development and Disability as an activity within the AUCD-NCBDDD/CDC Cooperative Agreement # DD07-003 Grant # 231-5. The project was also conducted in partnership with the National Center on Health, Physical Activity, and Disability. NCHPAD is a part of the University of Alabama at Birmingham /Lakeshore Research Collaborative and is supported by Grant/Cooperative Agreement Number U59DD000906 from the CDC. The contents are solely the responsibility of the author and do not represent the official views of AUCD, NCHPAD, or CDC.