Development and Psychometric Evaluation of an Instrument to Assess Physical Activity Participation Behavior Among Chinese Patients with Chronic Obstructive Pulmonary Disease.

Purpose: This study aimed to develop and evaluate a psychometrically reliable tool specifically designed to assess physical activity participation behavior in COPD patients in China.

Patients and methods: Using the Motivation-Opportunity-Ability (MOA) model as a framework, a scale was developed and evaluated through literature and guideline reviews, qualitative research, interdisciplinary expert consultations (n=21), and a pilot trial (n=50). A sample of COPD patients diagnosed over a year was randomly divided into two groups for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to test the factor structure. The scale's content validity, internal consistency and test-retest reliability were further assessed.

Results: 433 COPD patients from four hospitals in a city in China participated in this study. The final scale included 32 items and demonstrated good internal consistency, with a Cronbach's α of 0.956 and a test-retest reliability of 0.777. The EFA identified four dimensions, with factor loadings ranging from 0.530 to 0.799, explaining 60.338% of the total variance: Motivation (5 items), Opportunity (12 items), Ability (9 items), and Behavior (6 items). The CFA confirmed that the four-dimensional model fit the data well: χ²/df = 1.891, standardized root mean residual (SRMR) = 0.0497, root mean square error of approximation (RMSEA) = 0.064, comparative fit index (CFI) = 0.927, Tucker-Lewis index (TLI) = 0.921.

Conclusion: The Physical Activity Participation Behavior Scale for COPD patients demonstrated good reliability and validity and can be used to assess physical activity participation in individuals with COPD.