Author ORCID Identifier

Date of Award

Summer 6-22-2021

Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Dr. Melissa Faulkner


Nonalcoholic fatty liver disease (NAFLD) is a progressive spectrum of disorders leading to hepatic steatosis is present with no secondary cause of liver disease. NAFLD is one of the leading cause of chronic liver disease in the United States and the prevalence of this chronic disease is increasing globally. Despite advances in science and treatment, providers rely on lifestyle choices and emphasis on physical activity as a main component of the treatment plan for NAFLD. Physical activity has been well documented in improving liver function tests and reduces the level of intrahepatic adipose tissue. Despite the known benefit, persons with NAFLD do not consistently participate in PA. To date, there are no known studies examining factors that influence level of physical activity in those with NAFLD. The purpose of this study was to examine fatigue, depression, perceived illness severity, exercise-self efficacy, and exercise benefits and barriers as potential factors that may predict level of physical activity in individuals with NAFLD. A cross-sectional, predictive, correlational study was performed. Ninety-eight study participants were recruited from a hepatology clinic in Atlanta, Georgia and data were analyzed to examine predictors of physical activity. Exercise benefits and barriers were found to be significant predictors of level of physical activity in those with NAFLD. Additionally, exercise self-efficacy demonstrated a mediator effect on the relationship between exercise benefits and physical activity. Overall, this research study further advances the understanding of symptom burden associated with NAFLD and factors that may influence level of physical activity.


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