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Assessment bias: Physical activity questionnaire assessment inadvertently influences patients’ desire to be ‘more physically active’
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Thursday 1 November Papers / Journal of Science and Medicine in Sport 15 (2013) S34–S126
298
299
Assessment bias: Physical activity questionnaire assessment inadvertently influences patients’ desire to be ‘more physically active’
Concurrent validity evidence of physical activity measures for Korean adults: A preliminary study
S. McPhail 1,2,∗ , M. Schippers 1,2 , A. Marshall 2
M. Lee ∗ Kookmin University
1
Centre for Functioning and Health Research, Queensland Health 2 School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology
Introduction: Evaluating physical activity is important for public health population research and evaluating lifestyle interventions among targeted groups. Self-reported questionnaires are frequently used to evaluate physical activity in a variety of contexts where resource or pragmatic limitations prohibit the use of more sophisticated approaches. However, prior research in the use of other patient reported outcomes in healthcare settings has highlighted that simply completing a questionnaire may change a patients’ behaviour or responses to subsequent questions. This methodology study aimed to examine whether completing a standard physical activity questionnaire altered patients responses to two related questions a) whether they are ‘sufficiently physically active’ and b) whether they desire ‘to be more physically active.’ Methods: A convenience sample of patients (n = 224) attending a hospital outpatient clinic for musculoskeletal conditions completed a customized survey at a single assessment point. Participants were asked whether they consider themselves to be a) sufficiently physically active (yes/no), and b) whether they would like to be more physically active (yes/no). Patients then completed the Active Australia Survey (AAS) before repeating questions a) and b). The number (percentage) of respondents who changed their response was calculated. McNemar’s (Chi2) tests were used to examine whether differences between questions a) pre and post AAS completion and b) pre and post AAS completion were due to chance alone. Results: All participants had complete data and were included in analysis. Before completing the AAS, 114 (50.9%) participants considered themselves to be sufficiently active, of these participants 43 (37.7%) changed their response to indicate they did not consider themselves to be sufficiently physically active after completing the AAS (McNemar’s-Chi2 p < 0.001). Similarly 33 (14.7%) did not desire to be more physically active before completing the AAS, of these participants 16 (48.5%) changed their response to indicate they desired to be more physically active after completing the AAS (McNemar’s-Chi2 p < 0.001). Discussion: The act of completing a physical activity questionnaire altered patients’ responses to a) whether they consider themselves to be physically active, and b) whether they desired to be more physically active. These findings are consistent with methodology research in other fields of healthcare and highlight that a simple self-reported physical activity assessment may lead to a chain of cognitive events influencing responses to subsequent questions, or possibly future physical activity behaviours. This unintended source of influence has potential to invalidate population based questionnaire research or randomized trials dependent on self-reported outcome measures. Mitigating potential bias from physical activity assessments must be considered when planning physical activity research. http://dx.doi.org/10.1016/j.jsams.2012.11.301
Introduction: Due to the lack of validated physical activity measures for Korean, it has been limited to determine the impact of daily physical activity on health accurately. The purpose of this study was to validate frequently employed physical activity measures and to investigate the validity evidence of the measures for Korean adults. Methods: A total of 42 adults (23 males: 23.26 ± 2.72yrs & BMI 23.30 ± 3.23 vs 19 females: 20.74 ± 2.10yrs & BMI 19.88 ± 1.96) were participated in study. As a criterion measure, indirect calorimetry (K4b2, Italy) was employed to measure VO2 ml/kg, heart rate (HR), MET value, and energy expenditure (Kcal). Also, the hand-tally counts of walking steps was employed as the criterion measure of step counts. Accuracy of the various field measures was determined to measure physical activity levels, which were including an accelerometer (Actigraph GT3X, USA), a pedometer (Omron Pedometer HJ-720ITC, Japan), and OMNI-Walk/Run Scale of Perceived Exertion (Utter et al., 2004). The selected physical activities of the validation protocol based on the scientific evidences were including sitting, standing, walking (slow, natural, & fast), running (slow & fast), moving objects, and stair up and down. To determine the concurrent validity of the physical activity field measures, descriptive analysis was applied, and the coefficients of Pearson product moment correlation (r) and the percent of the error (%error) were calculated, respectively, using SPSS 19.0 (␣=.05). Results: The calculated MET value from the criterion measure showed moderately correlated with HR (r = .696), Actigraph (r = .788), and OMNI scale (r = .589), respectively. The walking steps measured by the pedometer showed high correlations with the steps measured by hand-tally counts (left r = .977 & right r = .985). The total %error of walking steps between tally counts and pedometers was -1.62(±4.35)%, which is relatively low. Discussion: Accuracy of the physical activity field measures such as an accelerometer, perceived scale, HR, and pedometer was acceptable to estimate the physical activity levels (METs and steps taken) for Korean adults in the laboratory settings. The validity evidence of the field measures to estimate physical activity levels in free-living should be examined with a larger sample size. This work was supported by the National Research Foundation of Korea[NRF] grant funded by the Korea government [MEST] [No. NRF-2011-0013871]. http://dx.doi.org/10.1016/j.jsams.2012.11.302 300 SIT: Sedentary behaviour International Taxonomy. Expert concensus project and folksonomy S. Chastin ∗ , D. Skelto Glasgow Caledonian University Introduction: Evidence, from both cross sectional and longitudinal studies, has shown that sedentary behaviour is associated with poor health and wellbeing outcomes. This has led to several countries including Canada, UK, Ireland, New Zealand, France, Denmark, Finland and USA to issue national recommendations to limit sedentary time at all ages. The next phase of research is to refine these guidelines, but currently sedentary behaviour is an
Thursday 1 November Papers / Journal of Science and Medicine in Sport 15 (2013) S34–S126
298
299
Assessment bias: Physical activity questionnaire assessment inadvertently influences patients’ desire to be ‘more physically active’
Concurrent validity evidence of physical activity measures for Korean adults: A preliminary study
S. McPhail 1,2,∗ , M. Schippers 1,2 , A. Marshall 2
M. Lee ∗ Kookmin University
1
Centre for Functioning and Health Research, Queensland Health 2 School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology
Introduction: Evaluating physical activity is important for public health population research and evaluating lifestyle interventions among targeted groups. Self-reported questionnaires are frequently used to evaluate physical activity in a variety of contexts where resource or pragmatic limitations prohibit the use of more sophisticated approaches. However, prior research in the use of other patient reported outcomes in healthcare settings has highlighted that simply completing a questionnaire may change a patients’ behaviour or responses to subsequent questions. This methodology study aimed to examine whether completing a standard physical activity questionnaire altered patients responses to two related questions a) whether they are ‘sufficiently physically active’ and b) whether they desire ‘to be more physically active.’ Methods: A convenience sample of patients (n = 224) attending a hospital outpatient clinic for musculoskeletal conditions completed a customized survey at a single assessment point. Participants were asked whether they consider themselves to be a) sufficiently physically active (yes/no), and b) whether they would like to be more physically active (yes/no). Patients then completed the Active Australia Survey (AAS) before repeating questions a) and b). The number (percentage) of respondents who changed their response was calculated. McNemar’s (Chi2) tests were used to examine whether differences between questions a) pre and post AAS completion and b) pre and post AAS completion were due to chance alone. Results: All participants had complete data and were included in analysis. Before completing the AAS, 114 (50.9%) participants considered themselves to be sufficiently active, of these participants 43 (37.7%) changed their response to indicate they did not consider themselves to be sufficiently physically active after completing the AAS (McNemar’s-Chi2 p < 0.001). Similarly 33 (14.7%) did not desire to be more physically active before completing the AAS, of these participants 16 (48.5%) changed their response to indicate they desired to be more physically active after completing the AAS (McNemar’s-Chi2 p < 0.001). Discussion: The act of completing a physical activity questionnaire altered patients’ responses to a) whether they consider themselves to be physically active, and b) whether they desired to be more physically active. These findings are consistent with methodology research in other fields of healthcare and highlight that a simple self-reported physical activity assessment may lead to a chain of cognitive events influencing responses to subsequent questions, or possibly future physical activity behaviours. This unintended source of influence has potential to invalidate population based questionnaire research or randomized trials dependent on self-reported outcome measures. Mitigating potential bias from physical activity assessments must be considered when planning physical activity research. http://dx.doi.org/10.1016/j.jsams.2012.11.301
Introduction: Due to the lack of validated physical activity measures for Korean, it has been limited to determine the impact of daily physical activity on health accurately. The purpose of this study was to validate frequently employed physical activity measures and to investigate the validity evidence of the measures for Korean adults. Methods: A total of 42 adults (23 males: 23.26 ± 2.72yrs & BMI 23.30 ± 3.23 vs 19 females: 20.74 ± 2.10yrs & BMI 19.88 ± 1.96) were participated in study. As a criterion measure, indirect calorimetry (K4b2, Italy) was employed to measure VO2 ml/kg, heart rate (HR), MET value, and energy expenditure (Kcal). Also, the hand-tally counts of walking steps was employed as the criterion measure of step counts. Accuracy of the various field measures was determined to measure physical activity levels, which were including an accelerometer (Actigraph GT3X, USA), a pedometer (Omron Pedometer HJ-720ITC, Japan), and OMNI-Walk/Run Scale of Perceived Exertion (Utter et al., 2004). The selected physical activities of the validation protocol based on the scientific evidences were including sitting, standing, walking (slow, natural, & fast), running (slow & fast), moving objects, and stair up and down. To determine the concurrent validity of the physical activity field measures, descriptive analysis was applied, and the coefficients of Pearson product moment correlation (r) and the percent of the error (%error) were calculated, respectively, using SPSS 19.0 (␣=.05). Results: The calculated MET value from the criterion measure showed moderately correlated with HR (r = .696), Actigraph (r = .788), and OMNI scale (r = .589), respectively. The walking steps measured by the pedometer showed high correlations with the steps measured by hand-tally counts (left r = .977 & right r = .985). The total %error of walking steps between tally counts and pedometers was -1.62(±4.35)%, which is relatively low. Discussion: Accuracy of the physical activity field measures such as an accelerometer, perceived scale, HR, and pedometer was acceptable to estimate the physical activity levels (METs and steps taken) for Korean adults in the laboratory settings. The validity evidence of the field measures to estimate physical activity levels in free-living should be examined with a larger sample size. This work was supported by the National Research Foundation of Korea[NRF] grant funded by the Korea government [MEST] [No. NRF-2011-0013871]. http://dx.doi.org/10.1016/j.jsams.2012.11.302 300 SIT: Sedentary behaviour International Taxonomy. Expert concensus project and folksonomy S. Chastin ∗ , D. Skelto Glasgow Caledonian University Introduction: Evidence, from both cross sectional and longitudinal studies, has shown that sedentary behaviour is associated with poor health and wellbeing outcomes. This has led to several countries including Canada, UK, Ireland, New Zealand, France, Denmark, Finland and USA to issue national recommendations to limit sedentary time at all ages. The next phase of research is to refine these guidelines, but currently sedentary behaviour is an