Correlates of Physical Activity Among Adults with Type 2 Diabetes

Background: A majority of adults with type 2 diabetes are not meeting the minimum physical activity guidelines. Promoting physical activity in this population is critical for successful disease management. In order to effectively develop evidence-based health promotion programs, it is important to identify the correlates of physical activity among individuals with type 2 diabetes. Purpose: To conduct a systematic review to identify the demographic/biological, psychosocial, and environmental factors associated with physical activity behavior among adults with type 2 diabetes. Methods: Research articles were selected meeting the following criteria: sample was adults (> 18 years) with type 2 diabetes, physical activity was the dependent variable, and identified correlates of physical activity. Correlates of physical activity were categorized into three groups: demographic/biological, psychosocial, and environmental. Results: Eighteen articles met the review criteria. A majority of the studies were cross-sectional, two were qualitative, and three were prospective. The rates of physical activity varied across study samples. Self-report measures of physical activity estimated that approximately 36-50% of individuals engaged in regular physical activity. Among the biological factors BMI, female gender, and disease severity were negatively associated with physical activity. Education level and income were positively associated with physical activity. Among psychosocial factors, self-efficacy, perceived behavioral control, and attitude were positively associated with physical activity. Perceived barriers were negatively related to activity levels. There was no relationship between knowledge and physical activity. Support for environmental factors included; high levels of social support, suitable weather, and having access to facilities to be positively associated with physical activity. Conclusion: A set of demographic/biological, psychosocial, and environmental correlates of physical activity has emerged among adults with type 2 diabetes that can be used to direct future research and be incorporated in health promotion programs. Health educators can use these correlates to design programs that target modifiable factors to positively promote physical activity adoption and maintenance. For example, programs may be designed specifically by age or gender. Educators should also emphasize problem solving and skill development to overcome barriers and develop self-efficacy and perceived behavioral control. Future research should move beyond cross-sectional research, and determine if these associations persevere over time. Intervention research should focus on strategies to enhance physical activity correlates to determine if they are causally linked to increased rates of physical activity.