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Gregory Knell, Deborah Salvo, Kerem Shuval, Casey Durand, Harold W. Kohl III, and Kelley P. Gabriel

Recent technological advances allow for field-based data collection of accelerometers in community-based studies. Mail-based administration can markedly reduce the cost and logistic challenges and burden associated with in-person data collection. It necessitates, however, other resources, such as phone calls and mailed reminder prompts, to increase protocol compliance and data recovery. Additionally, lost accelerometers can impact the study’s budget and its internal validity due to missing data. In this article, we present an applied methodological approach used to define thresholds (or cutoff points) at which pursuing unreturned accelerometers is a worthwhile versus futile pursuit. This methodological approach was designed, specifically, to maximize scalability across multiple sectors. We used data from an on-going study that administered accelerometers through the mail to illustrate and encourage investigators to replicate the approach for use in their own studies. In heterogeneous study samples, investigators might consider repeating this approach by study-relevant strata to refine thresholds and improve the return percentages of data collection instruments, minimize the potential missing data, and optimize study staff time and resources.

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Casey P. Durand, Kelley K. Pettee Gabriel, Deanna M. Hoelscher, and Harold W. Kohl III

Background:

The potential for adults to accrue significant physical activity through public transit use is a topic of interest. However, there are no data on analogous questions among children. The goal of this analysis was to quantify patterns of transit use and correlates of transit-related physical activity among children aged 5 to 17 years.

Methods:

Data for this cross-sectional study came from the 2012 California Household Travel Survey. Probit regressions modeled the probability of transit use; negative binomial regressions modeled minutes/day in transit-related active travel.

Results:

Public transit use accounted for 3% of trips in California in 2012. Older Hispanic youth and those residing in areas with greater housing density and county size had a higher probability of transit use. Driver licensure, home ownership, household income, and vehicles in household were negatively correlated with public transit use. Race/ethnicity, income, and transit type were correlated with time spent in active travel to/from transit.

Conclusions:

Given its importance as a source of physical activity for some children, researchers should consider assessment of public transit-related activity in physical activity measurement instruments. Efforts to encourage active travel should consider how to incorporate transit-related activity, both from a measurement perspective and as an intervention strategy.

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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.

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Gregory Knell, Henry S. Brown, Kelley P. Gabriel, Casey P. Durand, Kerem Shuval, Deborah Salvo, and Harold W. Kohl III

Background: Improving sidewalks may encourage physical activity by providing safe, defined, and connected walking spaces. However, it is unknown if reduced health care expenditures assumed by increased physical activity offset the investment for sidewalk improvements. Methods: This cost-effectiveness analysis of sidewalk improvements in Houston, TX, was among adults enrolled in the Houston Travel-Related Activity in Neighborhoods Study, 2013–2017 . The 1-year change in physical activity was measured using self-report (n = 430) and accelerometry (n = 228) and expressed in metabolic equivalent (MET) hours per year (MET·h·y−1). Cost-effectiveness ratios were calculated by comparing annualized sidewalk improvement costs (per person) with 1-year changes in physical activity. Results: The estimated cost-effectiveness ratio were $0.01 and −$0.46 per MET·h·y−1 for self-reported and accelerometer-derived physical activity, respectively. The cost-effectiveness benchmark was $0.18 (95% confidence interval, $0.06–$0.43) per MET·h·y−1 gained based on the volume of physical activity necessary to avoid health care costs. Conclusions: Improving sidewalks was cost-effective based on self-reported physical activity, but not cost-effective based on accelerometry. Study findings suggest that improving sidewalks may not be a sufficient catalyst for changing total physical activity; however, other benefits of making sidewalks more walkable should be considered when deciding to invest in sidewalk improvements.

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Joowon Lee, Baojiang Chen, Harold W. Kohl III, Carolyn E. Barlow, Chong Do Lee, Nina B. Radford, Laura F. DeFina, and Kelley P. Gabriel

The purpose of the current investigation was to examine the cross-sectional associations of participation in muscle-strengthening activities (MSAs) with carotid intima–media thickness (CIMT) among older adults. The data are from 2,557 older adult participants enrolled in an observational cohort who reported no history of cardiovascular disease. MSA was determined using a questionnaire. Carotid ultrasound was performed to measure the CIMT of the common carotid artery bilaterally. Logistic regression models were constructed to estimate the association of MSA with CIMT after adjustment for potential confounders. The participants were aged 68.6 ± 7.0 years, and the majority were male (71.7%) and White (96.5%); 18% had abnormal CIMT. Meeting the physical activity guidelines for MSA was inversely associated with abnormal CIMT after adjustment for age and sex. However, this observed inverse relation became statistically null after further adjustment for cardiovascular disease risk factors, including aerobic physical activity.

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Joowon Lee, Baojiang Chen, Harold W. Kohl III, Carolyn E. Barlow, Chong do Lee, Nina B. Radford, Laura F. DeFina, and Kelley P. Gabriel

The purpose of this study was to examine the association between self-reported physical activity (PA) and mean common carotid artery intima–media thickness (CCA IMT) among older adults. The data are from 1,811 Cooper Center Longitudinal Study participants, who were aged ≥60 years, with no history of cardiovascular disease. A medical history questionnaire was used to assess PA. Carotid ultrasound was performed to measure CCA IMT and the presence of plaque and stenosis. Logistic regression models were constructed to estimate the association between PA and CCA IMT after adjustment for covariates. The participants were aged 69.2 ± 5.9 years, and the majority were male (73.3%) and White (96.7%). The odds ratio of abnormal thickening of CCA IMT was 0.72 (95% confidence interval [0.54, 0.96]) in physically active participants (≥500 metabolic equivalent·min/week) after adjustment for covariates. In the current study, meeting PA guidelines in older adulthood was associated with lower odds of abnormal thickening of CCA IMT.