All ETDs from UAB

Advisory Committee Chair

Robert Motl

Advisory Committee Members

Elizabeth Barstow

Donald H Lein Jr

David Morris

John R Rinker II

Document Type

Dissertation

Date of Award

2023

Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions

Abstract

Multiple sclerosis (MS) is a prevalent immune-mediated, neurodegenerative disorder, affecting approximately 1 million people in the United States. MS onset is commonly between 20 and 40 years of age, and persons with MS often live a long life with the disease resulting from the early initiation of disease-modifying therapies and comorbidity-managing approaches. Notably, physical activity is promising for disease modification and symptoms and comorbidity management in MS. Yet, physical activity has been initiated quite late during the disease course. Further, early MS could be a “window of opportunity” for initiating physical activity to maximize its health benefits for symptom management and progression prevention. However, little is known about physical activity behavior and behavior change interventions for promoting physical activity in early MS. This dissertation described the current literature regarding the theory-based physical activity behavior change interventions in MS and participant characteristic, namely disease duration, examined potential determinants of physical activity among persons newly with MS (i.e., disease duration ≤ 2 years) based on the Capability-Opportunity-Motivation-Behavior (COM-B) model using two different approaches, and examined the feasibility and initial efficacy of a 12-week COM-B-based intervention for promoting physical activity in persons newly diagnosed with MS. Results are presented through four single study chapters. Briefly, the existing theory-based physical activity behavior change interventions have not targeted persons newly iv diagnosed with MS. This underscores the need for more effective theory-based interventions targeting physical activity in this MS subpopulation. Further, the COM-B determinants, including intention, action control and planning, self-efficacies, outcome expectation, goal setting, fatigue, knowledge regarding appropriate physical activity approaches, environmental resources, social support, role/identity, reinforcement, emotions, may be important targets for future interventions to promote physical activity change in persons newly diagnosed with MS. Lastly, the 12-week COM-B-based behavior change intervention provided novel and promising evidence on the feasibility and positive effects on increasing self-reported and device-measured physical activity and health-related quality of life in this MS subpopulation. This dissertation provides novel evidence and fundamental understanding regarding physical activity in persons newly diagnosed with MS and precise guidance for designing future comprehensive theory-based interventions targeting physical activity in persons newly diagnosed with MS.

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