Influence of functioning and contextual factors on activity-related travel behaviour in Multiple Sclerosis

Abstract

Objectives: Activity-related travel behaviour is a prerequisite for participation. Knowledge about key factors influencing activity-related travel behaviour is necessary, in order to define guidelines for interventions to optimize this behaviour. The present study 1. investigated to which degree the activity-related travel behaviour in Multiple Sclerosis (MS) does decrease with increasing ambulatory dysfunction and 2. assessed the impact of health condition and contextual factors on activity-related travel behaviour in MS. Methods: A convenience sample of 108 persons with MS was studied, distinguished in three disability subgroups based on Disease Steps (DS). Health condition was assessed by standardized clinical tests about physical, cognitive and psychosocial functioning. Contextual factors (personal and environmental) were collected. Activity-related travel diaries and GPS tracking devices were used to investigate activity-related travel behaviour in terms of number of trips and transport modes used. The influence of health condition measures and contextual factors with activityrelated travel behaviour measures was analyzed using Spearman correlations and multiple linear regressions. Results: 1. Activity-related travel behaviour in MS decreased significantly with increasing ambulatory dysfunction. Significant changes were found regarding travel modes, number, type and planning of activities. 2. Activity-related travel behaviour in MS correlated with both health condition measures and contextual factors. A limited number of standardized tests of health condition and contextual factors (driving ability, household size) can predict activity-related travel behaviour in MS. Conclusions: Both health condition (mostly physical functioning) and contextual factors are predictive for activity-related travel behaviour in MS. Multi-disciplinary teams should include counselling on living situation and on advice regarding environmental factors. Policy makers should be recommended to integrate medical and other services in the community.