Increasing Physical Activity Among North American Sexual/Gender Diverse Adults: A Socioecological Approach

Background: Sexual and/or gender diverse (nonheterosexual, non-cisgender; SGD) adults continue to report high rates of chronic condition incidence and prevalence, and reduced rates of physical activity (PA). However, interventions tailored to SGD individuals remain limited. This study sought to determine the effect of each level of socioecological model (SEM), (eg, individual, social, community/institution, environment) associated with meeting PA guidelines to inform intervention approaches. Methods: Participants across North America (N = 300, non-Hispanic White [69.7%], cis-gendered women [40.7%], queer [38.3%], 18–34 y old [70.7%]) self-reported their current PA levels and PA correlates at each level of the SEM using multiple validated survey instruments via an online, anonymous survey. SEM level-specific survey instruments were combined to create a composite score for analyses. A hierarchical logistic regression was used to predict likelihood of meeting PA guidelines with each additional step adding a level of the SEM. Race/ethnicity, gender identity, sexual orientation, and income served as confounders. Results: Each step in the model was significant; the level-specific correlates were significant predictors of meeting PA guidelines. In the final model (χ²[16] = 74.13, P < .001, R² = .303), and across each model, general (B = 0.148, P < .001, odds ratio = 1.16) correlates at the individual level were significant predictors of higher odds of meeting PA guidelines. Conclusion: Tailored PA interventions should emphasize individual correlates of PA, in tandem with other SEM levels of influence to promote effective behavior change. Without intervention, SGD individuals may continue to experience chronic conditions at a higher rate compared with their peers.