Physical environmental correlates of self-reported and objectively assessed physical activity in Belgian type 2 diabetes patients.

Despite the well-known beneficial effects of physical activity (PA) on the long-term outcomes of type 2 diabetes patients, the majority of this patient group remains inactive. Therefore, it is necessary to understand the most important PA determinants in type 2 diabetes patients in order to develop efficacious interventions to increase PA participation. The main aim of this study was to investigate the associations of physical environmental factors with objectively assessed and self-reported PA in type 2 diabetes patients. A total of 133 type 2 diabetes patients participated in this cross-sectional study (response rate: 43.3%). All participants completed the long International PA Questionnaire and two validated questionnaires to measure physical environmental perceptions and psychosocial factors. They also wore an accelerometer and a pedometer to measure PA objectively. Selection criteria were age 35-80, BMI 25-35 kg m(-²), treated for type 2 diabetes and no PA limitations. Data were collected in 2007. Physical environmental factors contributed significantly to the explained variance of all objective and self-reported PA measures (explained variance from 4% to 18%) after controlling for sociodemographic variables. Home PA equipment, walkability, aesthetics and convenience of PA facilities were the most consistent environmental correlates. The contribution of physical environmental factors remained significant for most PA measures after taking into account the variance explained by psychosocial factors (explained variance from 4% to 10%), except for step counts and recreational walking. Physical environmental factors could be important correlates of PA in type 2 diabetes patients, even beyond the contribution of sociodemographic and psychosocial variables, but additional research is needed. Nevertheless, sociodemographic and psychosocial factors remain very important and when developing future interventions, all these multidimensional correlates should be kept in mind.