Jessica L.J. Greenwood, Elizabeth A. Joy and Joseph B. Stanford
Only 25% of US adults achieve adequate physical activity (PA). Obtaining a PA history is an appropriate first step when evaluating this behavior. The Physical Activity Vital Sign (PAVS) is a clinical tool designed to screen for PA in adults.
To determine how responses to the PAVS questions associate with BMI, overweight, and obesity, we performed a cross-sectional study utilizing the PAVS, and measured height and weight. Data were collected from adults at 2 clinics within the Utah Health Research Network.
Adjusting for demographic factors, BMI decreased 0.91 units for every reported day of PA during a typical week (P < .001), and the odds of obesity was significantly decreased by 0.73 for every day of PA reported in a typical week, (P = .001).
Response to the PAVS question of typical behavior is highly correlated with BMI. Although response to the PAVS question of behavior last week is not correlated, this question may prompt accurate recall to the typical week question and help guide patient counseling. Our results support the construct validity for the use of the PAVS as a clinical screening tool and suggest the need for additional research to characterize the properties of the PAVS.
Trever J. Ball, Elizabeth A. Joy, Lisa H. Gren, Ruthann Cunningham and Janet M. Shaw
Few have examined predictive relationships between physical activity (PA) and health using electronic health records (EHRs) of patient-reported PA.
Assess initial predictive validity of the Physical Activity “Vital Sign” (PAVS) recorded in EHRs with BMI and disease burden.
EHRs were from November 2011 to November 2013 (n = 34,712). Differences in not meeting Physical Activity Guidelines (PAG) were tested using chi-square analysis between being normal weight versus overweight/obese, and scoring below versus above the 50th percentile of the Charlson Comorbidity Index (CCI). Repeated measures logistic regression was used to determine odds of BMI and CCI classifications according to responses to the PAVS as not meeting PAG.
Patients who did not meet PAG according to the PAVS were more likely than normal weight patients to have a higher BMI (BMI 25.0–29.9, OR = 1.19, P = .001; BMI 30.0–34.9, OR = 1.39, P < .0001; BMI 35.0–39.9, OR = 2.42, P < .0001; BMI ≥ 40, OR = 3.7, P < .0001) and also higher disease burden (above 50th percentile for CCI, OR = 1.8, P < .0001).
The strong association of the PAVS found with patient BMI and moderately-strong association with disease burden supports initial predictive validity of the PAVS recorded in EHRs. PA recorded in EHRs may be vastly useful for assessing patient disease and cost burdens attributed independently to PA behavior.