A systematic review of the validity and reliability of sedentary behaviour measures used with children and adolescents

The aim of this review was to evaluate the reliability and validity of methods used to assess the multiple components of sedentary behaviour (i.e. screen time, sitting, not moving and existing at low energy expenditure) in children and adolescents. Twenty-six studies met our inclusion criteria and were reviewed. Thirteen studies reported the reliability of self- and proxy-report measures of sedentary behaviour and seven of these were found to have acceptable test–retest reliability. Evidence for the criterion validity of self- and proxy-report measures was examined in three studies with mixed results. Seven studies examined the reliability and/or validity of direct observation and the findings were generally positive. Five studies demonstrated the utility of accelerometers to accurately classify sedentary behaviour. Self-report measures provide reliable estimates of screen time, yet their validity remains largely untested. While accelerometers can accurately classify participants’ behaviour as sedentary, they do not provide information about type of sedentary behaviour or context. Studies utilizing measures of sedentary behaviour need to more adequately report on the validity and reliability of the measures used.We recommend the use of objective measures of sedentary behaviour such as accelerometers, in conjunction with subjective measures (e.g. self-report), to assess type and context of behaviour.

A validity-driven approach to the understanding of the personal and societal burden of low back pain : development of a conceptual and measurement model

Introduction: While the importance and magnitude of the burden of low back pain upon the individual is well recognized, a systematic understanding of the impact of the condition on individuals is currently hampered by the lack of an organized understanding of what aspects of a person’s life are affected and the lack of comprehensive measures for these effects. The aim of the present study was to develop a conceptual and measurement model of the overall burden of low back pain from the individual’s perspective using a validity-driven approach.
Methods: To define the breadth of low back pain burden we conducted three concept-mapping workshops to generate an item pool. Two face-to-face workshops (Australia) were conducted with people with low back pain and clinicians and policy-makers, respectively. A third workshop (USA) was held with international multidisciplinary experts. Multidimensional scaling, cluster analysis, participant input and thematic analyses organized participants’ ideas into clusters of ideas that then informed the conceptual model.
Results: One hundred and ninety-nine statements were generated. Considerable overlap was observed between groups, and four major clusters were observed - Psychosocial, Physical, Treatment and Employment - each with between two and six subclusters. Content analysis revealed that elements of the Psychosocial cluster were sufficiently distinct to be split into Psychological and Social, and a further cluster of elements termed Positive Effects also emerged. Finally, a hypothesized structure was proposed with six domains and 16 subdomains. New domains not previously considered in the back pain field emerged for psychometric verification: loss of independence, worry about the future, and negative or discriminatory actions by others.
Conclusions: Using a grounded approach, an explicit a priori and testable model of the overall burden of low back pain has been proposed that captures the full breadth of the burden experienced by patients and observed by experts.

Convergent validity of two visual motor integration tests

Background: Occupational therapists often assess visual motor integration (VMI) skills. It is, therefore, imperative that therapists use VMI tests with robust measurement properties.

Objective: This study examined the convergent validity of two VMI tests used to assess children, adolescents and adults.

Method: Three groups of healthy participants (n = 153) completed the Beery-Buktenica Developmental Test of Visual-Motor Integration (DTVMI) and the Full Range Test of Visual Motor Integration (FRTVMI). Seventy-three children aged 5-10 years (37 males and 36 females; mean age 7.5 years, SD = 2.20), 19 adolescents aged 11-17 years (8 males and 11 females; 13.1 years, SD = 2.16), and 61 adults (18 males and 43 females; mean age 31.82 years, SD = 11.20) completed the DTVMI and the FRTVMI. Spearman rho correlation coefficients were used to investigate whether each pair of the VMI test scores for each of the three participant age groups were associated.

Results: The Spearman rho correlation coefficients between all three versions of the DTVMI and FRTVMI were statistically significant. For the child group, the correlation coefficient was rho = 0.70 (p<0.000), while the correlation between the VMI scores obtained by the adolescent group on the two tests was rho = 0.77 (p<0.000). For the adult participant group, the correlation coefficient between the DTVMI and the FRTVMI was rho = 0.70 (p<0.000).

Conclusion: The VMI scores obtained by the three participant age groups on the DTVMI and the FRTVMI were all significantly correlated with each other. Overall, the DTVMI and the FRTVMI exhibited large levels of convergent validity with each other, indicating that the two tests appear to measure similar visual-motor integration constructs.

The long-term predictive validity of the consumers' need for uniqueness scale

This research examines the long-term ability of the consumers’ need for uniqueness measure to predict consumers’ valued possessions, shopping behaviors, and experiences. Consumers’ need for uniqueness reflects individual differences in counterconformity motivation (i.e., the pursuit of differentness relative to others) that is manifest in consumer responses. This research reports on 2 longitudinal assessments of the scale's predictive validity using data collected at 4 stages from a consumer mail-survey sample. One year following initial responses to the trait measure, respondents participated in a second survey in which they photographed and rank ordered their valued possessions. In a third survey, the photographs served as cues to obtain responses to ratings of possession benefits and to questions regarding acquisition of the possession. Overall, the results support a number of hypotheses regarding the relation of consumers’ need for uniqueness to salient possession benefits, types of goods comprising consumers’ valued possessions, and shopping behaviors associated with acquiring valued possessions. Two years following initial responses to the trait measure, members of the consumer mail panel completed a fourth survey, indicating their participation in various uniqueness-enhancing consumer activities. Results support the stability and predictive validity of the measure over the 2-year period. Because the design of possessions and endorsed uniqueness-enhancing activities considered in the consumer mail panel studies varied across individuals, an additional study was conducted that demonstrated the scale's ability to predict individuals’ counterconformity responses to the same choice situation.

Reliability and validity of psychosocial and environmental correlates measures of physical activity and screen-based behaviors among Chinese children in Hong Kong

Background : Insufficient participation in physical activity and excessive screen time have been observed among Chinese children. The role of social and environmental factors in shaping physical activity and sedentary behaviors among Chinese children is under-investigated. The purpose of the present study was to assess the reliability and validity of a questionnaire to measure child- and parent-reported psychosocial and environmental correlates of physical activity and screen-based behaviors among Chinese children in Hong Kong.

Methods : A total of 303 schoolchildren aged 9-14 years and their parents volunteered to participate in this study and 160 of them completed the questionnaire twice within an interval of 10 days. Intraclass correlation coefficients (ICCs), kappa statistics, and percent agreement were performed to evaluate test-retest reliability of the continuous and categorical variables, respectively. Exploratory factor analyses (EFAs) were conducted to assess convergent validity of the emergent scales. Cronbach's alpha and ICCs were performed to assess internal and test-retest reliability of the emergent scales. Criterion validity was assessed by correlating psychosocial and environmental measures with self-reported physical activity and screen-based behaviors, measured by a validated questionnaire.

Results : Reliability statistics for both child- and parent-reported continuous variables showed acceptable consistency for all of the ICC values greater than 0.70. Kappa statistics showed fair to perfect test-retest reliability for the categorical items. Adequate internal consistency and test-retest reliability were observed in most of the emergent scales. Criterion validity assessed by correlating psychosocial and environmental measures with child-reported physical activity found associations with physical activity in the self-efficacy scale (r = 0.25, P < 0.05), the peer support for physical activity scale (r = 0.25, P < 0.05) and home physical activity environmental (r = 0.14, P < 0.05). Children's screen-based behaviors were associated with the family support for physical activity scale (r = -0.22, P < 0.05) and parental role modeling of TV (r = 0.12, P = 0.053).

Conclusions : The findings provide psychometric support for using this questionnaire for examining psychosocial and environmental correlates of physical activity and screen-based behaviors among Chinese children in Hong Kong. Further research is needed to develop more robust measures based on the current questionnaire, especially for peer influence on physical activity and parental rules on screen-based behaviors.

Reliability and validity of the modified Chinese version of the children's leisure activities study survey (CLASS) questionnaire in assessing physical activity among Hong Kong children

This study aimed to examine the reliability and validity of the modified Children’s Leisure Activities Study Survey (CLASS) Chinese-version questionnaire in assessing physical activity among Hong Kong Chinese Children. Test-retest reliability was examined in 84 boys and 136 girls aged 9–12 years by comparing data from two administrations of the survey conducted one week apart. Validity was determined by comparing data from the second administration with accelerometer estimates. The results suggested that the questionnaire provided reliable and valid estimates in overall physical activity patterns in Hong Kong Chinese children. However, substantial overestimation was observed in vigorous activity.

Reliability and validity of a reactive agility test for Australian football

Purpose: The aim of this study was to test the reliability and construct validity of a reactive agility test (RAT), designed for Australian Football (AF).

Methods: Study I tested the reliability of the RAT, with 20 elite junior AF players (17.44 ± 0.55 y) completing the test on two occasions separated by 1 wk. Study II tested its construct validity by comparing the performance of 60 participants (16.60 ± 0.50 y) spread over three aged-matched population groups: 20 athletes participating in a State Under-18 AF league who had represented their state at national competitions (elite), 20 athletes participating in the same league who had not represented their state (subelite), and 20 healthy males who did not play AF (controls).

Results: Test-retest reliability reported a strong correlation (0.91), with no significant difference (P = .22) between the mean results (1.74 ± 0.07 s and 1.76 ± 0.07 s) obtained (split 2+3). Nonparametric tests (Kruskal-Wallis and Mann-Whitney) revealed both AF groups performed significantly faster on all measures than the control group (ranging from P = .001 to .005), with significant differences also reported between the two AF groups (ranging from P = .001 to .046). Stepwise discriminant analyses found total time discriminated between the groups, correctly classifying 75% of the participants.

Conclusions: The RAT used within this study demonstrates evidence of reliability and construct validity. It further suggests the ability of a reactive component within agility test designs to discriminate among athletes of different competition levels, highlighting its importance within training activities.

The content validity of the behaviour support plan quality evaluation tool (BSP-QEII) and its potential application in accommodation and day-support services for adults with intellectual disability

Background The quality of support provided to people with disability who show challenging behaviour could be influenced by the quality of the behaviour support plans (BSPs) on which staff rely for direction. This study investigated the content validity of the Behaviour Support Plan Quality Evaluation tool (BSP-QEII), originally developed to guide the development of BSPs for children in school settings, and evaluated its application for use in accommodation and day-support services for adults with intellectual disability.

Method A three-round Delphi study involving a purposive sample of experienced behaviour support practitioners (n = 30) was conducted over an 8-week period. The analyses included deductive content analysis and descriptive statistics.

Results The 12 quality domains of the BSP-QEII were affirmed as valid for application in adult accommodation and day-support service settings. Two additional quality domains were suggested, relating to the provision of detailed background on the client and the need for plans to reflect contemporary service philosophy. Furthermore, the results suggest that some issues previously identified in the literature as being important for inclusion in BSPs might not currently be a priority for practitioners. These included: the importance of specifying replacement or alternative behaviours to be taught, descriptions of teaching strategies to be used, reinforcers, and the specification of objective goals against which to evaluate the success of the intervention programme.

Conclusions The BSP-QEII provides a potentially useful framework to guide and evaluate the development of BSPs in services for adults with intellectual disability. Further research is warranted to investigate why practitioners are potentially giving greater attention to some areas of intervention practice than others, even where research has demonstrated these others areas of practice could be important to achieving quality outcomes.

Content validity of visual analog scales to assess symptom severity of acute angioedema attacks in adults with hereditary angioedema : an interview study

Background: Hereditary angioedema (HAE) is a rare, debilitating, potentially life-threatening condition characterized by recurrent acute attacks of edema of the skin, face/upper airway, and gastrointestinal and urogenital tracts. During a laryngeal attack, people with HAE may be at risk of suffocation, while other attacks are often associated with intense pain, disfigurement, disability, and/or vomiting. The intensity of some symptoms is known only to the person experiencing them. Thus, interview studies are needed to explore such experience and patient-reported outcome measures (PROMs) are required for systematic assessment of symptoms in the clinical setting and in clinical trials of treatments for acute HAE attacks.

Objective: The aim of this interview study was to assess the content validity and suitability of four visual analog scale (VAS) instruments for use in clinical studies. The VAS instruments were designed to assess symptoms at abdominal, oro-facial-pharyngeal-laryngeal, peripheral, and urogenital attack locations. This is the first known study to report qualitative data about the patient's experience of the rare disorder, HAE.

Methods: Semi-structured exploratory and cognitive debriefing interviews were conducted with 27 adults with a confirmed clinical/laboratory diagnosis of HAE (baseline plasma level of functional plasma protein C1 esterase inhibitor [C1INH] <50% of normal without evidence for acquired angioedema). There were 17 participants from the US and 10 from Italy, with mean age 42.5 (SD 14.5) years, range 18–72 years, mean HAE duration 21.3 (SD 14.1) years, range 1–45 years, 67% female, and 44% VAS-naïve. Experience of acute angioedema attacks was first explored, noting spontaneous mentions by participants of HAE symptomatology. Cognitive debriefing of the VAS instruments was undertaken to assess the suitability, comprehensibility, and relevance of the VAS items. Asymptomatic participants completed the VAS instruments relevant to their angioedema experience, reporting as if they were experiencing an acute angioedema attack at the time. Interviews were conducted in the clinic setting in the US and Italy over an 8-month period.

Results: Participants mentioned spontaneously almost all aspects of acute angioedema attacks covered by the four VAS instruments, thus providing strong support for inclusion of nearly all VAS items, with no important symptoms missing. Predominant symptoms found to be associated with acute angioedema attacks were edema and pain, and there was evidence of varying degrees of disruption to everyday activities supporting the inclusion of an overall severity item reflecting the disabling effects of HAE symptoms. VAS item wording was understood by participants.

Conclusion: This interview study explored and reported the patient experience of HAE attacks. It demonstrated the content validity of the four anatomical location HAE VAS instruments and their suitability for use in clinical trials of recombinant human C1INH (rhC1INH) treatment for ascertaining trial participants' assessments of the severity of acute angioedema symptoms.