All ETDs from UAB

Advisory Committee Chair

Diane M Grimley

Advisory Committee Members

Jamy D Ard

Monica L Baskin

Retta R Evans

Jane Roy

Scott W Snyder

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Public Health


Fear-avoidance beliefs have been correlated with disability and physical function in populations with pain, but research has primarily focused on the impact of these beliefs on daily functioning, not leisure time physical activity. Current screening tools focus on a specific type or source of pain, making them inadequate for assessing fear of exercise-induced pain. The purpose of this study was to develop and establish preliminary validity of a scale to measure fear of physical response to exercise among overweight and obese adults. Additionally, the study sought to assess the relationships between scale responses and body mass index, physical activity level and daily pain. The study employed a two-phase design. The first phase of the study employed formative methods including focus groups, expert reviews and cognitive interviews to gather data and cultivate an item pool which was used to develop a quantitative scale. This phase of the study resulted in a 16-item scale, designed to measure weight-specific, musculoskeletal and cardio-respiratory fears. The second phase of the study consisted of administering the scale and validation measures to weight loss participants (n=125). Validation measures included questions assessing physical activity, pain, medical conditions and demographic information. Principle component analysis was conducted and a two-factor solution offered the best fit of the items: weight-specific fears and cardio-respiratory fears accounted for 34.5% and 30% of the variance in scale scores. Additional analysis indicated there were significant differences in cardio-respiratory subscale scores based on physical activity level (p=.006). Body mass index was a significant predictor of total scale score (p=.002) and weight-specific subscale scores (p=.001). Pain, as measured by the Pain Disability Index, was a significant predictor of total scale scores (p=.000), as well as scores on the weight-specific subscale (p=.001) and the cardio-respiratory subscale (p=.007). The results of this study suggest that there may be a relationship between weight and fear-avoidance beliefs related to exercise. More work is needed, however to examine how the beliefs of overweight and obese individuals differ from those of sedentary, normal-weight individuals. Additionally, more research is needed to explore how medical conditions influence fear-avoidance beliefs among overweight and obese individuals.

Included in

Public Health Commons



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.