title: The Health Action Process Approach as a motivational model for physical activity self-management for people with multiple sclerosis: a path analysis.
abstract: OBJECTIVE
  To evaluate the Health Action Process Approach (HAPA) as a motivational model for physical activity self-management for people with multiple sclerosis (MS).
  
  
  METHODS
  Quantitative descriptive research design using path analysis.
  
  
  METHODS
  One hundred ninety-five individuals with MS were recruited from the National Multiple Sclerosis Society and a neurology clinic at a university teaching hospital in the Midwest.
  
  
  METHODS
  Outcome was measured by the Physical Activity Stages of Change Instrument, along with measures for nine predictors (severity, action self-efficacy, outcome expectancy, risk perception, perceived barriers, intention, maintenance self-efficacy, action and coping planning, and recovery self-efficacy).
  
  
  RESULTS
  The respecified HAPA physical activity model fit the data relatively well (goodness-of-fit index = .92, normed fit index = .91, and comparative fit index = .93) explaining 38% of the variance in physical activity. Recovery self-efficacy, action and coping planning, and perceived barriers directly contributed to the prediction of physical activity. Outcome expectancy significantly influenced intention and the relationship between intention and physical activity is mediated by action and coping planning. Action self-efficacy, maintenance self-efficacy, and recovery self-efficacy directly or indirectly affected physical activity. Severity of MS and action self-efficacy had an inverse relationship with perceived barriers and perceived barriers influenced physical activity.
  
  
  CONCLUSIONS
  Empirical support was found for the proposed HAPA model of physical activity for people with MS. The HAPA model appears to provide useful information for clinical rehabilitation and health promotion interventions.
authors.affiliation: Department of Rehabilitation Counseling, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9088, USA. Chung-Yi.Chiu@UTSouthwestern.edu
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Chiu
authors.forename: Ruth T
authors.initials: RT
authors.lastname: Lynch
authors.forename: Fong
authors.initials: F
authors.lastname: Chan
authors.forename: Norman L
authors.initials: NL
authors.lastname: Berven
mesh_terms: D000328:Adult; D000368:Aged; D015444:Exercise / Q000523:psychology*; D005260:Female; D006293:Health Promotion; D006801:Humans; D033182:Intention; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D008960:Models, Psychological; D009042:Motivation; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D018570:Risk Assessment; D012648:Self Care / Q000523:psychology; D020377:Self Efficacy