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Barbara Resnick, Kathleen Michael, Marianne Shaughnessy, Eun Shim Nahm, Susan Kopunek, John Sorkin, Denise Orwig, Andrew Goldberg and Richard F. Macko

Background:

Self-report measures of physical activity have well-known drawbacks, and physiologic measures alone do not account for behavioral variables important in the perception and performance of physical activity. Therefore, we considered multiple measures to quantify physical activity in community-dwelling men and women with chronic stroke.

Methods:

This analysis included data from a volunteer sample of 87 individuals at least 6 months poststroke. Physical activity was measured using self-report questionnaires, step activity monitors, self-efficacy expectations related to exercise, and VO2peak from treadmill testing, and a model of physical activity was tested.

Results:

Most of the variance in objective physical activity was explained by VO2peak, and most of the variance in subjective physical activity was explained by self-efficacy expectations. There were significant discrepancies between subjective and objective findings.

Conclusion:

This study helps to understand the perspective of stroke survivors with regard to physical activity.

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Athanasios Papaioannou

This study examined the relationship among goal orientations, perceived motivation climate, self-reported discipline, reasons for discipline, and perceived teacher’s strategies to sustain discipline in physical education lessons. Six hundred and seventy-four students responded on questionnaires assessing the aforementioned variables. Task orientation was positively associated with self-determined reasons for discipline. The perception of a task-involving climate was positively related to perceptions of teaching strategies promoting reasons for discipline determined by the students. Task-involvement and self-determined reasons for being disciplined corresponded to students’ reported discipline in the lesson. On the contrary, the perception of an ego-involving climate was linked with perceived teaching strategies promoting an external locus of causality in the lesson. The results imply that teachers who try to strengthen the task orientation of students and help them adopt more self-determined reasons for being disciplined will have more orderly classes.

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Jennifer A. Beamer and Joonkoo Yun

With an increase in the presence of students with autism spectrum disorder (ASD) in the general physical education (GPE) classroom, understanding the current state of GPE teachers’ beliefs and behaviors for including these students is warranted. The current study aimed to examine the beliefs and self-reported behaviors of GPE teachers’ inclusion of students with ASD. In addition, the study examined potential factors affecting their inclusion behaviors. Using a national stratified random sample, participants were 142 current GPE teachers who submitted surveys anonymously online. Results from a regression analysis indicate that teachers’ experience, graduate coursework in adapted physical education (APE), and perceptions of strength in undergraduate training in APE significantly predicted their self-reported behavior for including students with ASD. Although the participant response rate is considerably low, this study provides some support toward the importance of teacher education programs for inclusion training.

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Catrine Tudor-Locke and Sandra A. Ham

Background:

We report walking for shopping, exercise, transportation, and walking the dog, among other sources captured in the 2003 to 2005 American Time Use Survey (ATUS).

Methods:

We extracted and analyzed 8 walking behaviors (by sex, age, education level, and race/ethnicity) from 24 hours of activities recalled by telephone interview for 15,175 males and 19,518 females age ≥15 years.

Results:

On any given day in 2003 to 2005, 45.8% of Americans participated in a median of 45 minutes of any walking activities; 31.6% walked for shopping purposes, 12.5% walked for transportation, 4.8% walked for exercise, and 2.5% walked the dog. College-educated respondents more commonly reported walking while shopping, walking for exercise, and dog walking. Those with less than a high school education more commonly reported walking for transportation.

Conclusions:

Despite limitations identified in imputing explicit and implicit performance of walking behaviors in the ATUS, Americans engage in a wide variety of walking behaviors that are not well represented by surveys focused only on leisure-time behaviors. Public health implications include increased availability of multiple and varied opportunities for walking, especially through environmental shifts toward more walkable places and destinations and policy shifts that support walking behaviors over competing transportation modes.

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Brent Hutto, Patricia A. Sharpe, Michelle L. Granner, Cheryl L. Addy and Steven Hooker

Background:

Question order might affect self-reported regular physical activity (PA) measured with items from the Behavioral Risk Factor Surveillance System (BRFSS) PA module.

Methods:

A telephone survey was conducted using 2 forms (N = 1004, N = 212) with varying PA question order. The standard form presented moderate-PA, vigorous-PA, and walking questions, in that order, whereas the alternate form presented walking questions, followed by moderate-PA, and then vigorous-PA questions. Weighted, adjusted rates of vigorous PA, walking, meeting the Centers for Disease Control and Prevention (CDC) recommendation for moderate or vigorous PA, and moderate PA from each form were compared.

Results:

Vigorous PA and walking were similar regardless of question order. Meeting the CDC recommendation for moderate or vigorous PA was reported less often with the alternate form among 18- to 34-year-olds. Less moderate PA was reported with the alternate form overall and among 18- to 34-year-olds, women, whites, and those with a high school education or less.

Conclusion:

Estimating PA and walking across sociodemographic strata with differing patterns of PA requires asking moderate-PA and vigorous-PA questions before walking questions. Asking walking questions first might lead to bias, especially for moderate PA. Walking, added to a survey with BRFSS moderate and vigorous PA items, should be placed after moderate and vigorous PA. Walking questions first may cause bias, especially for moderate PA.

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Heather K. Neilson, Ruth Ullman, Paula J. Robson, Christine M. Friedenreich and Ilona Csizmadi

Purpose:

The qualitative attributes and quantitative measurement properties of physical activity questionnaires are equally important considerations in questionnaire appraisal, yet fundamental aspects such as question comprehension are not often described in the literature. Here we describe the use of cognitive interviewing to evaluate the Sedentary Time and Activity Reporting Questionnaire (STAR-Q), a self-administered questionnaire designed to assess overall activity energy expenditure and sedentary behavior.

Methods:

Several rounds of one-on-one interviews were conducted by an interviewer trained in qualitative research methods. Interviewees included a convenience sample of volunteers and participants in the Tomorrow Project, a large cohort study in Alberta, Canada. Following each round of interviews the STAR-Q was revised and cognitively tested until saturation was achieved.

Results:

Six rounds of cognitive interviewing in 22 adults (5 males, 17 females) age 23−74 years, led to revisions involving 1) use of recall aids; 2) ambiguous terms; and 3) specific tasks, such as averaging across multiple routines, reporting time asleep and self-care, and reporting by activity domain.

Conclusions:

Cognitive interviewing is a critical step in questionnaire development. Knowledge gained in this study led to revisions that improved respondent acceptability and comprehension of the STAR-Q and will complement ongoing validity testing.

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Bethany Barone Gibbs, Wendy C. King, Kelliann K. Davis, Amy D. Rickman, Renee J. Rogers, Abdus Wahed, Steven H. Belle and John Jakicic

Background:

Sedentary behavior (SED) has been measured almost exclusively by self-reported total SED or television time in longitudinal studies. This manuscript aimed to compare self-reported vs. objectively measured SED.

Methods:

Among overweight and obese young adults enrolled in a weight loss trial, baseline SED was assessed by 3 methods: 1) a questionnaire assessing 8 common SEDs (SEDQ), 2) 1 question assessing SED from the Global Physical Activity Questionnaire (SEDGPAQ), and 3) a monitor worn on the arm (SEDOBJ). In addition, television time (SEDTV) was isolated from the SEDQ. SED measures were compared using Spearman’s correlations, signed-rank tests, and Bland-Altman plots.

Results:

In 448 participants, SEDQ and SEDGPAQ were only weakly associated with SEDOBJ (rs = 0.21; P < .001, rs = 0.32; P < .001, respectively). Compared with SEDOBJ, SEDQ more often overestimated SEDOBJ (median difference: 1.1 hours/day; P < .001), while SEDGPAQ more often underestimated SEDOBJ (median difference: –0.7 hours/day; P < .001). The correlation between SEDTV and SEDOBJ was not significantly different from 0 (rs = 0.08; P = .08).

Conclusions:

SEDQ and SEDGPAQ were weakly correlated with, and significantly different from, SEDOBJ in overweight and obese young adults. SEDTV was not related to SEDOBJ. The poor associations of self-reported and objectively measured SED could affect interpretation and comparison across studies relating SED to adverse health outcomes.

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Robert Carter III, Samuel N. Cheuvront and Michael N. Sawka

Objectives:

We report our observations on one soldier with abnormal hyperthermia during exercise in the heat compared with prior exercise and following acute local (non-febrile) infection. Also, we report on 994 heat stroke hospitalizations in the U.S. Army. It is known that prior infection is a risk factor for heat illness and some of the 37 heat stroke deaths cited infections (eg, pneumonia, influenza) in the medical records.

Results:

This case report illustrates complete recovery from abnormal hyperthermia, which occurred in a laboratory setting during mild, low intensity exercise. In a field setting, this case may have resulted in serious heat illness. As with most of the heat stroke cases, rapid medical attention (ie, cooling and rehydration) and the age group (19 to 26) that represents majority of the heatstroke cases in U.S. Army are likely factors that contribute successful treatment of heatstroke in the field environment.

Conclusions:

We conclude that acute inflammatory response can augment the hyperthermia of exercise and possibly increase heat illness susceptibility. Furthermore, it is important for health care providers of soldiers and athletes to monitor acute local infections due to the potential thermoregulatory consequences during exercise in the heat.

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Jarmo Liukkonen, Timo Jaakkola, Sami Kokko, Arto Gråstén, Sami Yli-Piipari, Pasi Koski, Jorma Tynjälä, Anne Soini, Timo Ståhl and Tuija Tammelin

The Finnish 2014 Report Card on Physical Activity (PA) for Children and Youth is the first assessment of Finland’s efforts in promoting and facilitating PA opportunities for children and youth using the Active Healthy Kids Canada grading system. The Report Card relies primarily on research findings from 6 Research Institutes, coordinated by the University of Jyväskylä. The Research Work Group convened to evaluate the aggregated evidence and assign grades for each of the 9 PA indicators, following the Canadian Report Card protocol. Grades from A (highest) to F (lowest) varied in Finland as follows: 1) Overall physical activity—fulfillment of recommendations (D), 2) Organized sport participation (C), 3) Active play (D), 4) Active transportation (B), 5) Sedentary behaviors (D), 6) Family and peers (C), 7) School (B), 8) Community and the built environment (B), and 9) Government (B). This comprehensive summary and assessment of indicators related to PA in Finnish children and youth indicates that Finland still has many challenges to promote a physically active life style for youth.

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Britni R. Belcher, Richard P. Moser, Kevin W. Dodd, Audie Atienza, Rachel Ballard-Barbash and David Berrigan

Background:

Discrepancies in self-report and accelerometer-measured moderate-to-vigorous physical activity (MVPA) may influence relationships with obesity-related biomarkers in youth.

Methods:

Data came from 2003–2006 National Health and Nutrition Examination Surveys (NHANES) for 2174 youth ages 12 to 19. Biomarkers were: body mass index (BMI, kg/m2), BMI percentile, height and waist circumference (WC, cm), triceps and subscapular skinfolds (mm), systolic & diastolic blood pressure (BP, mmHg), high-density lipoprotein (HDL, mg/dL), total cholesterol (mg/dL), triglycerides (mg/dL), insulin (μU/ml), C-reactive protein (mg/dL), and glycohemoglobin (%). In separate sex-stratified models, each biomarker was regressed on accelerometer variables [mean MVPA (min/day), nonsedentary counts, and MVPA bouts (mean min/day)] and self-reported MVPA. Covariates were age, race/ethnicity, SES, physical limitations, and asthma.

Results:

In boys, correlations between self-report and accelerometer MVPA were stronger (boys: r = 0.14−0.21; girls: r = 0.07−0.11; P < .010) and there were significant associations with BMI, WC, triceps skinfold, and SBP and accelerometer MVPA (P < .01). In girls, there were no significant associations between biomarkers and any measures of physical activity.

Conclusions:

Physical activity measures should be selected based on the outcome of interest and study population; however, associations between PA and these biomarkers appear to be weak regardless of the measure used.