Measurement properties of the CHAMPS physical activity questionnaire in a sample of older Australians

Background: The effective evaluation of physical activity interventions for older adults requires measurement instruments with acceptable psychometric properties that are sufficiently sensitive to detect changes in this population. Aim: To assess the measurement properties (reliability and validity) of the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire in a sample of older Australians. Methods: CHAMPS data were collected from 167 older adults (mean age 79.1 S.D. 6.3 years) and validated with tests of physical ability and the SF-12 measures of physical and mental health. Responses from a sub-sample of 43 older adults were used to assess 1-week test-retest reliability. Results: Approximately 25% of participants needed assistance to complete the CHAMPS questionnaire. There were low but significant correlations between the CHAMPS scores and the physical performance measures (rho=0.14-0.32) and the physical health scale of the SF-12 (rho=0.12-0.24). Reliability coefficients were highest for moderate-intensity (ICC=0.81-0.88) and lowest for vigorous-intensity physical activity (ICC=0.34-0.45). Agreement between test-retest estimates of sufficient physical activity for health benefits (>= 150 min and >= 5 sessions per week) was high (percent agreement = 88% and Cohen's kappa = 0.68). Conclusion: These findings suggest that the CHAMPS questionnaire has acceptable measurement properties, and is therefore suitable for use among older Australian adults, as long as adequate assistance is provided during administration. (c) 2006 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Beneficial associations of physical activity with 2-h but not fasting blood glucose in Australian adults

OBJECTIVE - We examined the associations of physical activity with fasting plasma glucose (FPG) and with 2-h postload plasma glucose (2-h PG) in men and women with low, moderate, and high waist circumference. RESEARCH DESIGN AND METHODS - The Australian Diabetes, Obesity and Lifestyle (AusDiab) study provided data on a population-based cross-sectional sample of 4,108 men and 5,106 women aged >= 25 years without known diabetes or health conditions that could affect physical activity. FPG and 2-h PG were obtained from an oral glucose tolerance test. Self-reported physical activity level was defined according to the current public health guidelines as active (>= 150 min/week across five or more sessions) or inactive (< 150 min/week and/or less than five sessions). Sex-specific quintiles of physical activity time were used to ascertain dose response. RESULTS - Being physically active and total physical activity time were independently and negatively associated with 2-h PG. When physical activity level was considered within each waist circumference category, 2-h PG was significantly lower in active high-waist circumference women (beta-0.30 [95% CI -0.59 to -0.01], P = 0.044) and active low-waist circumference men(beta-0.25 [-0.49 to -0.02],P = 0.036) compared with their inactive counterparts. Considered across physical activity and waist circumference categories, 2-h PG levels were not significantly different between active moderate-waist circumference participants and active low-waist circumference participants. Associations between physical activity and FPG were nonsignificant. CONCLUSIONS - There are important differences between 2-h PG and FPG related to physical activity. It appears that 2-h PG is more sensitive to the beneficial effects of physical activity, and these benefits occur across the waist circumference spectrum.

Does timing and sequencing of transitions to adulthood make a difference? Stress, smoking, and physical activity among young Australian women

The major changes of the transition to adulthood are argued to be stressful, and health-related behaviors such as smoking and physical activity may be adopted, consolidated, or abandoned at this time. On the other hand, research has suggested that the normative transitions of emerging adulthood, although involving considerable change, may be associated with low stress because they are perceived as both positive and normal at this life stage. This article examines relations between the timing and sequencing of life transitions and stress and health-related behaviors, focusing on the transition to young adulthood among Australian women. A total of 853 women aged 22 to 27 provided information about the timing and sequencing of 6 life transitions: moving out of home, stopping full-time education, starting full-time work, having the first live-in relationship, marriage, and motherhood-and stress, smoking, and physical activity. Most had moved out of home, stopped full-time education, and started full-time work, but only 14% had undertaken all 6 transitions. Overall, 70% of participants had made transitions in order Overall, the findings suggest that the relations between timing and sequencing of transitions, and indicators of health, are moderate for smoking, but small for stress and for physical activity. These effects remained after controlling for socioeconomic status of the participants' families of origin. Matching current social norms for the timing and sequencing of life changes may be of less importance for women's well-being than is commonly believed. Although the significant relations between early or out of order transitions and smoking are of concern, the smaller relations with stress and with sedentariness suggest that such transitions may have limited negative consequences, and support the view that individuals are active in choosing the life path that is appropriate for them and their circumstances.

Physical activity patterns of Singaporean adolescents

The purpose of this study was to document the level of physical activity and sedentary behavior in a representative sample of Singaporean adolescents. A random sample of 1,827 secondary school students from six secondary schools (929 boys, 898 girls, mean age 14.9 +/- 1.2 yr) completed the Three-Day Physical Activity Recall (3DPAR) self-report instrument. Approximately 63% of Singaporean high school students met current guidelines requiring 60 min of moderate to vigorous physical activity daily. Just over half (51.6%) met the guideline calling for regular vigorous physical activity. Across all grade levels, boys were consistently more active than girls. More than 70% of Singaporean high school students exceeded the recommended 2 hours per day of electronic media use. Collectively, these findings suggest that a significant proportion of Singaporean adolescents are not sufficiently active and are in need of programs to promote physical activity and decrease sedentary behavior.

Physical activity and nutrition related variables in hispanic and non-hispanic college students

It has been estimated that one in four adults have sedentary lifestyles. In addition there appears to be an increase in obesity across the life span. It is of great importance to the health of this nation to understand how to promote more active lifestyles through the identification of lifestyle behaviors of active individuals and potential predictors of physical activity (PA). Seven hundred and seventy-seven college students were surveyed to investigate the relationship between nutrition related variables (i.e., dietary restraint, nutrition knowledge, food choice and body weight concerns) and PA. In this study, over half of the students reported doing 30 minutes of moderate intensity PA daily. Vigorously active males and females chose low fat foods more often than the less active group. Exercisers and non-exercisers had similar nutrition knowledge. The results of this study suggest that students who are more active are more conscience about making healthier food choices.

Physical activity in the school setting: cognitive performance is not affected by three different types of acute exercise

Recent studies indicate that a single bout of physical exercise can have immediatepositive effects on cognitive performance of children and adolescents. However, thetype of exercise that affects cognitive performance the most in young adolescents isnot fully understood. Therefore, this controlled study examined the acute effects ofthree types of 12-min classroom-based exercise sessions on information processingspeed and selective attention. The three conditions consisted of aerobic, coordination,and strength exercises, respectively. In particular, this study focused on the feasibilityand efficiency of introducing short bouts of exercise in the classroom. One hundredand ninety five students (5th and 6th grade; 10–13 years old) participated in a doublebaseline within-subjects design, with students acting as their own control. Exercise typewas randomly assigned to each class and acted as between-subject factor. Before andimmediately after both the control and the exercise session, students performed twocognitive tests that measured information processing speed (Letter Digit SubstitutionTest) and selective attention (d2 Test of Attention). The results revealed that exercisingat low to moderate intensity does not have an effect on the cognitive parameters testedin young adolescents. Furthermore, there were no differential effects of exercise type.The results of this study are discussed in terms of the caution which should be takenwhen conducting exercise sessions in a classroom setting aimed at improving cognitive performance.

Understanding and validating accelerometry as a measure of physical activity in children with intellectual disabilities

Background Physical activity in children with intellectual disabilities is a neglected area of study, which is most apparent in relation to physical activity measurement research. Although objective measures, specifically accelerometers, are widely used in research involving children with intellectual disabilities, existing research is based on measurement methods and data interpretation techniques generalised from typically developing children. However, due to physiological and biomechanical differences between these populations, questions have been raised in the existing literature on the validity of generalising data interpretation techniques from typically developing children to children with intellectual disabilities. Therefore, there is a need to conduct population-specific measurement research for children with intellectual disabilities and develop valid methods to interpret accelerometer data, which will increase our understanding of physical activity in this population. Methods Study 1: A systematic review was initially conducted to increase the knowledge base on how accelerometers were used within existing physical activity research involving children with intellectual disabilities and to identify important areas for future research. A systematic search strategy was used to identify relevant articles which used accelerometry-based monitors to quantify activity levels in ambulatory children with intellectual disabilities. Based on best practice guidelines, a novel form was developed to extract data based on 17 research components of accelerometer use. Accelerometer use in relation to best practice guidelines was calculated using percentage scores on a study-by-study and component-by-component basis. Study 2: To investigate the effect of data interpretation methods on the estimation of physical activity intensity in children with intellectual disabilities, a secondary data analysis was conducted. Nine existing sets of child-specific ActiGraph intensity cut points were applied to accelerometer data collected from 10 children with intellectual disabilities during an activity session. Four one-way repeated measures ANOVAs were used to examine differences in estimated time spent in sedentary, moderate, vigorous, and moderate to vigorous intensity activity. Post-hoc pairwise comparisons with Bonferroni adjustments were additionally used to identify where significant differences occurred. Study 3: The feasibility on a laboratory-based calibration protocol developed for typically developing children was investigated in children with intellectual disabilities. Specifically, the feasibility of activities, measurements, and recruitment was investigated. Five children with intellectual disabilities and five typically developing children participated in 14 treadmill-based and free-living activities. In addition, resting energy expenditure was measured and a treadmill-based graded exercise test was used to assess cardiorespiratory fitness. Breath-by-breath respiratory gas exchange and accelerometry were continually measured during all activities. Feasibility was assessed using observations, activity completion rates, and respiratory data. Study 4: Thirty-six children with intellectual disabilities participated in a semi-structured school-based physical activity session to calibrate accelerometry for the estimation of physical activity intensity. Participants wore a hip-mounted ActiGraph wGT3X+ accelerometer, with direct observation (SOFIT) used as the criterion measure. Receiver operating characteristic curve analyses were conducted to determine the optimal accelerometer cut points for sedentary, moderate, and vigorous intensity physical activity. Study 5: To cross-validate the calibrated cut points and compare classification accuracy with existing cut points developed in typically developing children, a sub-sample of 14 children with intellectual disabilities who participated in the school-based sessions, as described in Study 4, were included in this study. To examine the validity, classification agreement was investigated between the criterion measure of SOFIT and each set of cut points using sensitivity, specificity, total agreement, and Cohen’s kappa scores. Results Study 1: Ten full text articles were included in this review. The percentage of review criteria met ranged from 12%−47%. Various methods of accelerometer use were reported, with most use decisions not based on population-specific research. A lack of measurement research, specifically the calibration/validation of accelerometers for children with intellectual disabilities, is limiting the ability of researchers to make appropriate and valid accelerometer use decisions. Study 2: The choice of cut points had significant and clinically meaningful effects on the estimation of physical activity intensity and sedentary behaviour. For the 71-minute session, estimations for time spent in each intensity between cut points ranged from: sedentary = 9.50 (± 4.97) to 31.90 (± 6.77) minutes; moderate = 8.10 (± 4.07) to 40.40 (± 5.74) minutes; vigorous = 0.00 (± .00) to 17.40 (± 6.54) minutes; and moderate to vigorous = 8.80 (± 4.64) to 46.50 (± 6.02) minutes. Study 3: All typically developing participants and one participant with intellectual disabilities completed the protocol. No participant met the maximal criteria for the graded exercise test or attained a steady state during the resting measurements. Limitations were identified with the usability of respiratory gas exchange equipment and the validity of measurements. The school-based recruitment strategy was not effective, with a participation rate of 6%. Therefore, a laboratory-based calibration protocol was not feasible for children with intellectual disabilities. Study 4: The optimal vertical axis cut points (cpm) were ≤ 507 (sedentary), 1008−2300 (moderate), and ≥ 2301 (vigorous). Sensitivity scores ranged from 81−88%, specificity 81−85%, and AUC .87−.94. The optimal vector magnitude cut points (cpm) were ≤ 1863 (sedentary), ≥ 2610 (moderate) and ≥ 4215 (vigorous). Sensitivity scores ranged from 80−86%, specificity 77−82%, and AUC .86−.92. Therefore, the vertical axis cut points provide a higher level of accuracy in comparison to the vector magnitude cut points. Study 5: Substantial to excellent classification agreement was found for the calibrated cut points. The calibrated sedentary cut point (ĸ =.66) provided comparable classification agreement with existing cut points (ĸ =.55−.67). However, the existing moderate and vigorous cut points demonstrated low sensitivity (0.33−33.33% and 1.33−53.00%, respectively) and disproportionately high specificity (75.44−.98.12% and 94.61−100.00%, respectively), indicating that cut points developed in typically developing children are too high to accurately classify physical activity intensity in children with intellectual disabilities. Conclusions The studies reported in this thesis are the first to calibrate and validate accelerometry for the estimation of physical activity intensity in children with intellectual disabilities. In comparison with typically developing children, children with intellectual disabilities require lower cut points for the classification of moderate and vigorous intensity activity. Therefore, generalising existing cut points to children with intellectual disabilities will underestimate physical activity and introduce systematic measurement error, which could be a contributing factor to the low levels of physical activity reported for children with intellectual disabilities in previous research.

Prevalence of physical activity in European adults — Compliance with the World Health Organization's physical activity guidelines

Background. Adults are recommended to engage in at least 150 min/week of moderate-to-vigorous physical activity (PA). Purpose. This study aimed to examine the level of compliance with PA recommendations among European adults. Methods. Using data from European Social Survey round 6, PA self-report data was collected from 52,936 European adults from 29 countries in 2012. Meeting PA guidelines was assessed usingWorld Health Organization criteria. Results. 61.47% (60.77% male, 62.05% female) of European adults reported to be engaged in moderate to vigorous PA at least 30 min on 5 or more days per week. The likelihood of achieving the PA recommended levels was higher among respondents older than 18–24. For those aged 45–64 years the likelihood increased 65% (OR = 1.65, 95% CI: 1.51–1.82, p b 0.001) and 112% (OR = 2.12, 95% CI: 1.94–2.32, p b 0.001) for males and females, respectively. Those who were high school graduates were more likely to report achieving the recommended PA levels than those with less than high school education (males: OR = 1.19, 95% CI: 1.12–1.27, p b 0.001; females: OR = 1.13, 95% CI: 1.06–1.20, p b 0.001). Conclusion. Although about 60% of European adults reported achieving the recommended levels of PA, there is much room for improvement among European adults, particularly among relatively inactive subgroups.

Youth-Physical Activity Towards Health: evidence and background to the development of the Y-PATH physical activity intervention for adolescents

Background: Despite known benefits of regular physical activity for health and well-being, many studies suggest that levels of physical activity in young people are low, and decline dramatically during adolescence. The purpose of the current research was to gather data on adolescent youth in order to inform the development of a targeted physical activity intervention. Methods: Cross-sectional data on physical activity levels (using self report and accelerometry), psychological correlates of physical activity, anthropometic characteristics, and the fundamental movement skill proficiency of 256 youth (53% male, 12.40 ± 0.51 years) were collected. A subsample (n = 59) participated in focus group interviews to explore their perceptions of health and identify barriers and motivators to participation in physical activity. Results: Findings indicate that the majority of youth (67%) were not accumulating the minimum 60 minutes of physical activity recommended daily for health, and that 99.5% did not achieve the fundamental movement skill proficiency expected for their age. Body mass index data showed that 25% of youth were classified as overweight or obese. Self-efficacy and physical activity attitude scores were significantly different (p < 0.05) between low, moderate and high active participants. Active and inactive youth reported differences in their perceived understanding of health and their barriers to physical activity participation, with active youth relating nutrition, exercise, energy and sports with the definition of ‘being healthy’, and inactive youth attributing primarily nutritional concepts to ‘being healthy’. Conclusions: Data show a need for targeting low levels of physical activity in youth through addressing poor health related activity knowledge and low fundamental movement skill proficiency. The Y-PATH intervention was developed in accordance with the present study findings; details of the intervention format are presented.

Exploring the relationship between patterns of physical activity, sedentary behaviour and cardiometabolic health in middle-aged Irish adults

Background and Study Rationale Being physically active is a major contributor to both physical and mental health. More specifically, being physically active lowers risk of coronary heart disease, high blood pressure, stroke, metabolic syndrome (MetS), diabetes, certain cancers and depression, and increases cognitive function and wellbeing. The physiological mechanisms that occur in response to physical activity and the impact of total physical activity and sedentary behaviour on cardiometabolic health have been extensively studied. In contrast, limited data evaluating the specific effects of daily and weekly patterns of physical behaviour on cardiometabolic health exist. Additionally, no other study has examined interrelated patterns and minute-by-minute accumulation of physical behaviour throughout the day across week days in middle-aged adults. Study Aims The overarching aims of this thesis are firstly to describe patterns of behaviour throughout the day and week, and secondly to explore associations between these patterns and cardiometabolic health in a middle-aged population. The specific objectives are to: 1 Compare agreement between the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and GENEActiv accelerometer-derived moderate-to-vigorous (MVPA) activity and secondly to compare their associations with a range of cardiometabolic and inflammatory markers in middle-aged adults. 2 Determine a suitable monitoring frame needed to reliably capture weekly, accelerometer-measured, activity in our population. 3 Identify groups of participants who have similar weekly patterns of physical behaviour, and determine if underlying patterns of cardiometabolic profiles exist among these groups. 4 Explore the variation of physical behaviour throughout the day to identify whether daily patterns of physical behaviour vary by cardiometabolic health. Methods All results in this thesis are based on data from a subsample of the Mitchelstown Cohort; 475 (46.1% males; mean aged 59.7±5.5 years) middle-aged Irish adults. Subjective physical activity levels were assessed using the IPAQ-SF. Participants wore the wrist GENEActiv accelerometer for 7 consecutive days. Data was collected at 100Hz and summarised into a signal magnitude vector using 60s epochs. Each time interval was categorised based on validated cut-offs. Data on cardiometabolic and inflammatory markers was collected according to standard protocol. Cardiometabolic outcomes (obesity, diabetes, hypertension and MetS) were defined according to internationally recognised definitions by World Health Organisation (WHO) and Irish Diabetes Federation (IDF). Results The results of the first chapter suggest that the IPAQ-SF lacks the sensitivity to assess patterning of activity and guideline adherence and assessing the relationship with cardiometabolic and inflammatory markers. Furthermore, GENEActiv accelerometer-derived MVPA appears to be better at detecting relationships with cardiometabolic and inflammatory markers. The second chapter examined variations in day-to-day physical behaviour levels between- and within-subjects. The main findings were that Sunday differed from all other days in the week for sedentary behaviour and light activity and that a large within-subject variation across days of the week for vigorous activity exists. Our data indicate that six days of monitoring, four weekdays plus Saturday and Sunday, are required to reliably estimate weekly habitual activity in all activity intensities. In the next chapter, latent profile analysis of weekly, interrelated patterns of physical behaviour identified four distinct physical behaviour patterns; Sedentary Group (15.9%), Sedentary; Lower Activity Group (28%), Sedentary; Higher Activity Group (44.2%) and a Physically Active Group (11.9%). Overall the Sedentary Group had poorer outcomes, characterised by unfavourable cardiometabolic and inflammatory profiles. The remaining classes were characterised by healthier cardiometabolic profiles with lower sedentary behaviour levels. The final chapter, which aimed to compare daily cumulative patterns of minute-by-minute physical behaviour intensities across those with and without MetS, revealed significant differences in weekday and weekend day MVPA. In particular, those with MetS start accumulating MVPA later in the day and for a shorted day period. Conclusion In conclusion, the results of this thesis add to the evidence base regards an optimal monitoring period for physical behaviour measurement to accurately capture weekly physical behaviour patterns. In addition, the results highlight whether weekly and daily distribution of activity is associated with cardiometabolic health and inflammatory profiles. The key findings of this thesis demonstrate the importance of daily and weekly physical behaviour patterning of activity intensity in the context of cardiometabolic health risk. In addition, these findings highlight the importance of using physical behaviour patterns of free-living adults observed in a population-based study to inform and aid health promotion activity programmes and primary care prevention and treatment strategies and development of future tailored physical activity based interventions.

Validity of the physical activity questionnaires IPAQ-SF and GPAQ for Cancer Survivors: Insights from a Spanish cohort

Regular physical activity (PA) decreases mortality risk in survivors of breast and colorectal cancer. Such impacts of exercise have prompted initiatives designed both to promote and adequately monitor PA in cancer survivors. This study examines the validity of 2 widely used self-report methods for PA determination, the International Physical Activity Questionnaire short version (IPAQ-SF) and Global Physical Activity Questionnaire (GPAQ). Both instruments were compared with the triaxial accelerometry (Actigraph) method as an objective reference standard. Study participants were 204 cancer survivors (both sexes, aged 18-79 years). Compared with accelerometry, both questionnaires significantly overestimated PA levels (across all intensities) and underestimated physical inactivity levels. No differences were detected between the 2 questionnaires except for a shorter inactivity time estimated by GPAQ (p=0.001). The Bland and Altman method confirmed that both questionnaires overestimated all PA levels. Receiver operating characteristic (ROC) analysis classified IPAQ and GPAQ as fair and poor predictors, respectively, of the proportions of survivors fulfilling international PA recommendations (≥150 min·week-1 of moderate-vigorous PA). IPAQ-SF showed a higher sensitivity but lower specificity than GPAQ. Our data do not support the use of IPAQ-SF or GPAQ to determine PA or inactivity levels in cancer survivors.

Criterion-related validity of the short form of the international physical activity questionnaire in adults who are Deaf

Background: To implement appropriate programs for promoting physical activity (PA) in people who are Deaf, it is important to have valid instruments for assessing PA in this population. Objective: The main purpose of this study was to examine the criterion validity of the short form of the International Physical Activity Questionnaire (IPAQ-S) in Deaf adults. Method: This study included 44 adults (18e65 years) of both genders (63.6% were females) who met the inclusion criteria. Objective measures of PAwere collected using accelerometers, which were worn by each participant during one week. After using the accelerometer, the IPAQ-S was applied to assess participants’ physical activity during the last 7 days. Results: There was no significant correlation between the average time spent in moderate to vigorous physical activity (MVPA) as measured by the accelerometer (40.1 6 24.5 min/day) and by the IPAQ-S (41.3 6 57.5 min/day). The IPAQ-S significantly underestimated the time spent in sedentary behavior (7.6 6 2.7 h/day vs. 10.1 6 1.6 h/day). Sedentary behavior and MVPA as measured by the accelerometer and the IPAQ-S showed limited agreement. Conclusions: Our results show some limitations on the use of IPAQ-S for quantifying PA among adults who are Deaf. The IPAQ-S tends to overestimate the MVPA and to underestimate sedentary behavior in adults who are Deaf.