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Maria Hagströmer, Barbara E. Ainsworth, Lydia Kwak and Heather R. Bowles

Context:

The quality of methodological papers assessing physical activity instruments depends upon the rigor of a study’s design.

Objectives:

We present a checklist to assess key criteria for instrument validation studies.

Process:

A Medline/PubMed search was performed to identify guidelines for evaluating the methodological quality of instrument validation studies. Based upon the literature, a pilot version of a checklist was developed consisting of 21 items with 3 subscales: 1) quality of the reported data (9 items: assess whether the reported information is sufficient to make an unbiased assessment of the findings); 2) external validity of the results (3 items: assess the extent to which the findings are generalizable); 3) internal validity of the study (9 items: assess the rigor of the study design). The checklist was tested for interrater reliability and feasibility with 6 raters.

Findings:

Raters viewed the checklist as helpful for reviewing studies. They suggested minor wording changes for 8 items to clarify intent. One item was divided into 2 items for a total of 22 items.

Discussion:

Checklists may be useful to assess the quality of studies designed to validate physical activity instruments. Future research should test checklist internal consistency, test-retest reliability, and criterion validity.

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Elva M. Arredondo, Tamar Mendelson, Christina Holub, Nancy Espinoza and Simon Marshall

Context:

The validity of physical activity (PA) self-report measures can be a problem when using these measures with target populations that differ from the population for which the measures were originally developed.

Objectives:

Describe an approach to further tailor PA self-report measures to a target community, and report on focus group and cognitive interview findings.

Process:

Topics relevant to culturally tailoring measures are discussed, including translation, focus groups, and cognitive interviews. We describe examples from our own work, including focus groups and cognitive interviews conducted to assess Latinos’ interpretations of PA questions derived from various epidemiological surveys that were developed in White communities.

Findings:

Findings from focus groups and cognitive interviews provide valuable information about the comprehension, interpretation, and cultural relevance of the PA questions to Latino communities.

Conclusions:

It is recommended that investigators collect formative data to better assess the equivalence of items being applied to a different cultural group. Guidelines for cultural attunement of self-report instruments are described to promote more uniform and rigorous processes of adaptation and facilitate cross-cultural investigations.

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Kelley K. Pettee Gabriel, James R. Morrow Jr. and Anne-Lorraine T. Woolsey

Context:

The selection of the most psychometrically appropriate self-report tool(s) to measure specific physical activity constructs has been a challenge for researchers, public health practitioners, and clinicians, alike. The lack of a reasonable gold standard measure and inconsistent use of established and evolving terminology have contributed to these challenges. The variation of self-report measures and quality of the derived summary estimates could be attributed to the absence of a standardized conceptual framework for physical activity.

Objective:

To present a conceptual framework for physical activity as a complex and multidimensional behavior that differentiates behavioral and physiological constructs of human movement.

Process:

The development of a conceptual framework can provide the basic foundation from which to standardize definitions, guide design and development of self-report measures, and provide consistency during instrument selection.

Conclusions:

Based on our proposed conceptual framework for physical activity, we suggest that physical activity is more clearly defined as the behavior that involves human movement, resulting in physiological attributes including increased energy expenditure and improved physical fitness. Utilization of the proposed conceptual framework can result in better instrument choices and consistency in methods used to assess physical activity and sedentary behaviors across research and public health practice.

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Sarah M. Nusser, Nicholas K. Beyler, Gregory J. Welk, Alicia L. Carriquiry, Wayne A. Fuller and Benjamin M.N. King

Background:

Physical activity recall instruments provide an inexpensive method of collecting physical activity patterns on a sample of individuals, but they are subject to systematic and random measurement error. Statistical models can be used to estimate measurement error in activity recalls and provide more accurate estimates of usual activity parameters for a population.

Methods:

We develop a measurement error model for a short-term activity recall that describes the relationship between the recall and an individual’s usual activity over a long period of time. The model includes terms for systematic and random measurement errors. To estimate model parameters, the design should include replicate observations of a concurrent activity recall and an objective monitor measurement on a subsample of respondents.

Results:

We illustrate the approach with preliminary data from the Iowa Physical Activity Measurement Study. In this dataset, recalls tend to overestimate actual activity, and measurement errors greatly increase the variance of recalls relative to the person-to-person variation in usual activity. Statistical adjustments are used to remove bias and extraneous variation in estimating the usual activity distribution.

Conclusions:

Modeling measurement error in recall data can be used to provide more accurate estimates of long-term activity behavior.

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William L. Haskell

For the scientific domain of physical activity and public health research to advance its agenda of health promotion and disease prevention continued development of measurement methodologies is essential. Over the past 50 years most data supporting a favorable relationship between habitual physical activity and chronic disease morbidity and mortality have been obtained using self-report methods, including questionnaires, logs, recalls, and diaries. Many of these instruments have been shown to have reasonable validity and reliability for determining general type, amount, intensity, and bout duration, but typically do better for groups than individuals with some instruments lacking the sensitivity to detect change in activity. During the past decade the objective assessment of physical activity using accelerometer-based devices has demonstrated substantial potential, especially in documenting the pattern of light-, moderate-, and vigorous-intensity activity throughout the day. However, these devices do not provide information on activity type, location or context. Research that combines the strengths of both self-report and objective measures has the potential to provide new insights into the benefits of physical activity and how to implement successful interventions.

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Steven P. Hooker, Janet Fulton and Lanay M. Mudd

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Barbara E. Ainsworth, Carl J. Caspersen, Charles E. Matthews, Louise C. Mâsse, Tom Baranowski and Weimo Zhu

Context:

Assessment of physical activity using self-report has the potential for measurement error that can lead to incorrect inferences about physical activity behaviors and bias study results.

Objective:

To provide recommendations to improve the accuracy of physical activity derived from self report.

Process:

We provide an overview of presentations and a compilation of perspectives shared by the authors of this paper and workgroup members.

Findings:

We identified a conceptual framework for reducing errors using physical activity self-report questionnaires. The framework identifies 6 steps to reduce error: 1) identifying the need to measure physical activity, 2) selecting an instrument, 3) collecting data, 4) analyzing data, 5) developing a summary score, and 6) interpreting data. Underlying the first 4 steps are behavioral parameters of type, intensity, frequency, and duration of physical activities performed, activity domains, and the location where activities are performed. We identified ways to reduce measurement error at each step and made recommendations for practitioners, researchers, and organizational units to reduce error in questionnaire assessment of physical activity.

Conclusions:

Self-report measures of physical activity have a prominent role in research and practice settings. Measurement error may be reduced by applying the framework discussed in this paper.

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Richard P. Troiano, Kelley K. Pettee Gabriel, Gregory J. Welk, Neville Owen and Barbara Sternfeld

Context:

Advances in device-based measures have led researchers to question the value of reported measures of physical activity or sedentary behavior. The premise of the Workshop on Measurement of Active and Sedentary Behaviors: Closing the Gaps in Self-Report Methods, held in July 2010, was that assessment of behavior by self-report is a valuable approach.

Objective:

To provide suggestions to optimize the value of reported physical activity and sedentary behavior, we 1) discuss the constructs that devices and reports of behavior can measure, 2) develop a framework to help guide decision-making about the best approach to physical activity and sedentary behavior assessment in a given situation, and 3) address the potential for combining reported behavior methods with device-based monitoring to enhance both approaches.

Process:

After participation in a workshop breakout session, coauthors summarized the ideas presented and reached consensus on the material presented here.

Conclusions:

To select appropriate physical activity assessment methods and correctly interpret the measures obtained, researchers should carefully consider the purpose for assessment, physical activity constructs of interest, characteristics of the population and measurement tool, and the theoretical link between the exposure and outcome of interest.