An Exploration of the Use of an Internet-based Physical Activity Program by Adults with Disabilities

The use of the internet to deliver physical activity promotion programs continues to grow rapidly, but our understanding of the use of internet-based physical activity programs among people with disabilities is limited. This study was an exploratory evaluation of a 14-week internet-based physical activity promotion program for adults with disabilities with an analytic focus on examining factors associated with program use and engagement, analyzing the relationship of engagement to program outcomes, and profiling participant perceptions of the program. A mixed methods approach was used: (1) program engagement was electronically monitored, (2) physical activity levels, sociodemographic and psychosocial (stage of change, self-efficacy, outcome expectations, and physical activity enjoyment) characteristics, and experiences in the program were measured through internet-based surveys at baseline, mid-point, end of program, and four week follow-up, and (3) factors related to program use and perceptions of program effectiveness were further explored through phone interviews. Study participants (n=241) had a mean age of 48.42 years (SD=11.61) and were largely female, white, well-educated, frequent internet-users with only a physical disability. Findings demonstrated a demand for internet-based physical activity programs among people with disabilities because of the way they can surmount many barriers to physical activity experienced by this population. Participants who used a wheelchair (p=0.000) and participants who were inactive at baseline were (p=0.048) more engaged in the program than their counterparts. Those who were more engaged in the program showed greater improvements in physical activity (p=0.013) and other targeted outcomes, affirming the need to better understand the process and parameters of engagement. Together, the survey and interview findings suggested improvements in participant physical activity levels and other health outcomes. The following program characteristics were particularly important to facilitate program engagement: flexibility to accommodate other priorities, materials targeted and tailored to individual differences, and social interactions with other participants. Future efforts would benefit from incorporating study findings in both program and study design in order to achieve the population-level health status changes that are greatly needed for people with disabilities.