Date of Award

12-2025

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Jonathan C. Baker, Ph.D.

Second Advisor

Rodney Weir, Ph.D.

Third Advisor

Anthony DeFulio, Ph.D.

Fourth Advisor

Stephanie Peterson, Ph.D.

Keywords

Adherence, exercise, functional behavior assessment, physiotherapy

Abstract

Osteoarthritis (OA) is a chronic condition affecting over 33 million adults in the United States (Center for Disease Control and Prevention [CDC], 2024). While exercise is one of the leading, non-pharmacological treatments for OA (Zhang et al., 2008), patients often struggle to meet physical activity guidelines, increasing their risk of lifelong disability, falls, and dependence (Wallis et al., 2013). Researchers in physiotherapy have struggled to identify effective, individualized treatments to improve exercise adherence for patients with OA that maintain long-term effects (Ezzat et al., 2015); an area behavior analysts could offer insight and guidance. Behavior analysts have developed indirect functional assessments for behavioral deficits that could be adapted to exercise adherence (Feliciano et al., 2010; Carr et al., 2013). However, researchers must use best practice methods to assess validity and reliability of a new assessment tool during initial development (Ruel et al., 2016). Using a mixed-methods design, we developed an assessment tool to identify barriers to exercise for adults with OA using best practice methods. Results revealed that the tool adequately identified participants’ barriers to exercise and demonstrated moderate to strong reliability and evidence of validity. Additionally, participants provided feedback that will facilitate validation of the tool.

Access Setting

Dissertation-Open Access

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