Responsiveness to Change of Self-Report and Device-Based Physical Activity Measures in the Living Well With Diabetes Trial

in Journal of Physical Activity and Health
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This study evaluated the responsiveness to change in physical activity of 2 self-report measures and an accelerometer in the context of a weight loss intervention trial.


302 participants (aged 20 to 75 years) with type 2 diabetes were randomized into telephone counseling (n = 151) or usual care (n = 151) groups. Physical activity (minutes/week) was assessed at baseline and 6-months using the Active Australia Survey (AAS), the United States National Health Interview Survey (USNHIS) walking for exercise items, and accelerometer (Actigraph GT1M; ≥1952 counts/minute). Responsiveness to change was calculated as responsiveness index (RI), Cohen’s d (postscores) and Cohen’s d (change-scores).


All instruments showed significant improvement in the intervention group (P < .001) and no significant change for usual care (P > .05). Accelerometer consistently ranked as the most responsive instrument while the least responsive was the USHNIS (responsiveness index) or AAS (Cohen’s d). RIs for AAS, USNHIS and accelerometer did not differ significantly and were, respectively: 0.45 (95% CI: 0.26–0.65); 0.38 (95% CI: 0.20–0.56); and, 0.49 (95% CI: 0.23–0.74).


Accelerometer tended to have the highest responsiveness but differences were small and not statistically significant. Consideration of factors, such as validity, feasibility and cost, in addition to responsiveness, is important for instrument selection in future trials

The authors are with the Cancer Prevention Research Centre, School of Public Health, University of Queensland, Brisbane, Queensland, Australia.

Reeves ( is corresponding author.