Physical Activity Questionnaire for Children: Validity and Cut-Points to Identify Sufficient Levels of Moderate- to Vigorous-Intensity Physical Activity Among Children and Adolescents Diagnosed With HIV.

PURPOSE: To investigate the validity of the Physical Activity Questionnaire for Older Children (PAQ-C) to assess the moderate- to vigorous-intensity physical activity (MVPA) level of children and adolescents diagnosed with HIV and propose cut-points, with accelerometer measures as the reference method. METHOD: Children and adolescents, aged 8-14 years (mean age = 12.21 y, SD = 2.09), diagnosed with HIV by vertical transmission, participated in the study. MVPA was investigated through the PAQ-C and triaxial accelerometer (ActiGraph GT3X+). Receiver operating characteristic curve and sensitivity and specificity values were used to identify a cut-point for PAQ-C to distinguish participants meeting MVPA guidelines. RESULTS: Fifty-six children and adolescents participated in the study. Among those, 16 met MVPA guidelines. The PAQ-C score was significantly related to accelerometry-derived MVPA (ρ = .506, P < .001). The PAQ-C score cut-point of 2.151 (sensitivity = 0.625, specificity = 0.875) was able to discriminate between those who met MVPA guidelines and those that did not (area under the curve = 0.751, 95% confidence interval, 0.616-0.886). CONCLUSION: The PAQ-C was useful to investigate MVPA among children and adolescents diagnosed with HIV and to identify those who meet MVPA guidelines.

Exploring the world of active play: A comprehensive review of global surveillance and monitoring of active play based on the global matrix data.

A valid assessment tool that measures active play is not yet available due to the sporadic and spontaneous nature of play, as well as the potential differences in how active play is understood and measured across different age groups, cultures, and contexts. The purpose of this review was to identify the scope and gaps in the measurement of active play based on data gathered from 68 countries that participated in the Global Matrix (GM) initiative, led by the Active Healthy Kids Global Alliance (AHKGA). GM is the global-level, biennial evaluation system of physical activity related behaviors among children and youth, including the Active Play indicator, and the sources of influence using letter grades (ranging between "A" and "F"). Based on the identified scope and gaps, this study offers recommendations for future research dedicated to the measurement/surveillance of active play. Out of the 68 countries involved in the previous GM (2014-22), 55% of the grades remained unassigned due to insufficient data on the Active Play indicator. The high number of unassigned grades, combined with the absence of valid measurement tool, highlight a need for a standardized measurement tool for improved global data generation of active play among children and youth. Our findings emphasize the need to address challenges in measuring active play. This review offers future considerations, research recommendations specific to the GM initiative, and two sets of age- and location-specific (indoor and outdoor settings) questionnaire items along with guidelines for its use. Together, these elements provide a roadmap for guiding future research and evaluation efforts on active play.

The impact of the COVID-19 pandemic on physical activity and sedentary behavior during pregnancy: a prospective study.

BACKGROUND: Prior studies evaluating the impact of the COVID-19 pandemic on pregnancy physical activity (PA) have largely been limited to internet-based surveys not validated for use in pregnancy. METHODS: This study used data from the Pregnancy PA Questionnaire Validation study conducted from 2019-2021. A prospective cohort of 50 pregnant women completed the Pregnancy PA Questionnaire (PPAQ), validated for use in pregnancy, in early, mid, and late pregnancy and wore an ActiGraph GT3X-BT for seven days. COVID-19 impact was defined using a fixed date of onset (March 13, 2020) and a self-reported date. Multivariable linear mixed effects regression models adjusted for age, early pregnancy BMI, gestational age, and parity. RESULTS: Higher sedentary behavior (14.2 MET-hrs/wk, 95% CI: 2.3, 26.0) and household/caregiving PA (34.4 MET-hrs/wk, 95% CI: 8.5, 60.3 and 25.9 MET-hrs/wk, 95% CI: 0.9, 50.9) and lower locomotion (-8.0 h/wk, 95% CI: -15.7, -0.3) and occupational PA (-34.5 MET-hrs/wk, 95% CI: -61.9, -7.0 and -30.6 MET-hrs/wk, 95% CI: -51.4, -9.8) was observed in middle and late pregnancy, respectively, after COVID-19 vs. before. There was no impact on steps/day or meeting American College of Obstetricians and Gynecologists guidelines. CONCLUSIONS: Proactive approaches for the promotion of pregnancy PA during pandemic-related restrictions are critically needed.

The effect of a video-supported assessment to increase the accuracy of self-reported physical activity.

Self-reported physical activity differs from activity levels measured by device. We tested the effect of a video that visualizes the intensity levels of physical activity to increase the agreement between self-reported and accelerometer-based moderate-to-vigorous physical activity (MVPA) within a single-blinded, randomized study. Participants (N = 378, 40-75 years) wore an accelerometer for seven days. Prior to the collection of self-reported data by the IPAQ-SF, participants were randomly assigned (1:1) to a control group (CG) or a video group (VG). The outcome was the absolute difference between self-reported and accelerometer-based time spent in MVPA (Δ MVPAIPAQ-Accelerometry ). To examine the agreement, we used Spearman correlation coefficients and Bland-Altman analysis. To test the video effect, we used Wilcoxon signed-rank test, Bayes factor, and simultaneous-quantile regression. In total, 302 participants fulfilled the accelerometer wear time criteria (≥10 hours/day; ≥6 days) and completed self-reports within three days after the wearing period. The median of Δ MVPAIPAQ-Accelerometry was -9.0 min/day (IQR: -32.0 to 66.6) for CG and -11.5 min/day (IQR: -29.9 to 14.3) for VG. Wilcoxon signed-rank test revealed no differences in Δ MVPAIPAQ-Accelerometry between study groups whereas Bayes factor indicated insensitivity of the data. Simultaneous-quantile regression revealed no relationship between video presentation and Δ MVPAIPAQ-Accelerometry in the 25th percentile. In the 50th (b = -12.4 [95% CI = -23.2 to -1.5] and 75th percentile (b = -45.7 [95% CI = -70.5 to -20.9]), Δ MVPAIPAQ-Accelerometry was negatively associated with video presentation. To conclude, video-supported assessment may increase the accuracy of self-reported MVPA among individuals who slightly underestimated and those who overestimated their MVPA.

Criterion validity of The International Physical Activity Questionnaire-Short Form (IPAQ-SF) for use in clinical practice in patients with osteoarthritis.

BACKGROUND: To tailor physical activity treatment programs for patients with osteoarthritis, clinicians need valid and feasible measurement tools to evaluate habitual physical activity. The widely used International Physical Activity Questionnaire-Short Form (IPAQ-SF) is not previously validated in patients with osteoarthritis. PURPOSE: To assess the concurrent criterion validity of the IPAQ-SF in patients with osteoarthritis, using an accelerometer as a criterion-method. METHOD: Patients with osteoarthritis (n = 115) were recruited at The Division of Rheumatology and Research at Diakonhjemmet Hospital (Oslo, Norway). Physical activity was measured by patients wearing an accelerometer (ActiGraph wGT3X-BT) for seven consecutive days, followed by reporting their physical activity for the past 7 days using the IPAQ-SF. Comparison of proportions that fulfilled physical activity recommendations as measured by the two methods were tested by Pearson Chi-Square analysis. Differences in physical activity levels between the IPAQ-SF and the accelerometer were analyzed with Wilcoxon Signed-Rank Test and Spearman rank correlation test. Bland-Altman plots were used to visualize the concurrent criterion validity for total- and intensity-specific physical activity levels. RESULTS: In total, 93 patients provided complete physical activity data, mean (SD) age was 65 (8.7) years, 87% were women. According to the IPAQ-SF, 57% of the patients fulfilled the minimum physical activity recommendations compared to 31% according to the accelerometer (p = 0.043). When comparing the IPAQ-SF to the accelerometer we found significant under-reporting of total physical activity MET-minutes (p = < 0.001), sitting (p = < 0.001) and walking (p < 0.001), and significant over-reporting of moderate-to-vigorous physical activity (p < 0.001). For the different physical activity levels, correlations between the IPAQ-SF and the accelerometer ranged from rho 0.106 to 0.462. The Bland-Altman plots indicated an increased divergence between the two methods with increasing time spent on moderate-to-vigorous intensity physical activity. CONCLUSION: Physical activity is a core treatment of osteoarthritis. Our finding that patients tend to over-report activity of higher intensity and under-report low-intensity activity and sitting-time is of clinical importance. We conclude that the concurrent criterion validity of the IPAQ-SF was weak in patients with osteoarthritis.

Test-retest reliability and concurrent validity of the Adapted Short QUestionnaire to ASsess Health-enhancing physical activity (Adapted-SQUASH) in adults with disabilities.

The current study determined the test-retest reliability and concurrent validity of the Adapted Short QUestionnaire to ASsess Health-enhancing physical activity (Adapted-SQUASH) in adults with disabilities. Before filling in the Adapted-SQUASH twice with a recall period of 2 weeks, participants wore the Actiheart activity monitor up to 1 week. For the test-retest reliability (N = 68), Intraclass correlation coefficients (ICCs) were 0.67 (p < 0.001) for the total activity score (min x intensity/week) and 0.76 (p < 0.001) for the total minutes of activity (min/week). For the concurrent validity (N = 58), the Spearman correlation coefficient was 0.40 (p = 0.002) between the total activity score of the first administration of the Adapted-SQUASH and activity energy expenditure from the Actiheart (kcals kg-1 min-1). The ICC was 0.22 (p = 0.027) between the total minutes of activity assessed with the first administration of the Adapted-SQUASH and Actiheart. The Adapted-SQUASH is an acceptable measure to assess self-reported physical activity in large populations of adults with disabilities but is not applicable at the individual level due to wide limits of agreement. Self-reported physical activity assessed with the Adapted-SQUASH does not accurately represent physical activity assessed with the Actiheart in adults with disabilities, as indicated with a systematic bias between both instruments in the Bland-Altman analysis.

Agreement between the SHAPES Questionnaire and a Multiple-Sensor Monitor in Assessing Physical Activity of Adolescents Using Categorial Approach: A Cross-Sectional Study.

This study aimed to evaluate the agreement between a 7-day recall questionnaire and multiple-sensor monitor in identifying sufficiently active adolescents. A total of 282 students involved in the CRO-PALS study were randomly selected for a device-based measurement of physical activity (PA) using the SenseWear Armband device (SWA) no more than three weeks before or after having fulfilled the SHAPES questionnaire. Valid data was obtained from 150 participants (61 boys; 89 girls) and included in the analysis. In boys, SHAPES exhibited high specificity (92.3%), overall percent agreement (85.0%), and significant agreement (κ = 0.32, p = 0.014) with the SWA in recognising sufficiently active individuals. Conversely, no agreement was detected for quartiles of PA, although boys that were classified in the first and in the fourth quartile by SHAPES differed in device-based measured duration of MVPA (134 [95%CI: 109-160] vs. 87 [95%CI: 65-108], p = 0.032); and VPA (39 [95%CI: 23-56] vs. 14 [95%CI: 6-22], p = 0.011). In girls, no significant agreement between the two methods was found in any of the analyses. It appears that the SHAPES questionnaire is effective to identify individuals that comply with PA recommendations and to distinguish between the most active and the least active individuals for adolescent boys, but not for girls.

Show cards of the Global Physical Activity Questionnaire (GPAQ) - do they impact validity? A crossover study.

BACKGROUND: The Global Physical Activity Questionnaire (GPAQ) is applied internationally as a tool to assess the level of physical activity. The GPAQ was designed as an interview, including the use of show cards, which visualise activities of moderate and intensive physical activity and support the distinction between these intensities. The self-administered version of the GPAQ is used in the application-oriented research for reasons of economy and practicality. However, the use of show cards often remains unknown. The aim of the present study was to examine differences in validity between two self-administered versions of the GPAQ with and without show cards. METHODS: In this crossover study, two groups (n = 54; 57.4% female; 28.3 ± 12.2 years) received the GPAQ with or without show cards after 7 days and the respective other version after additional 7 days. For validation, all participants wore an accelerometer (ActiGraph GT3X+) on all 14 days. Differences between GPAQ versions and accelerometer data were compared by Wilcoxon signed rank test. Additionally, Spearman analyses and Bland-Altman plots were calculated. RESULTS: No statistically significant difference between the GPAQ versions could be found in regard to the accuracy of physical activity assessment (p > 0.05). Both GPAQ versions show similar correlation coefficients for vigorous physical activity (rho = 0.31-0.42) and sedentary behaviour (rho = 0.29-0.32). No statistically significant correlation was found for physical activity of moderate intensity. The Bland-Altman plots support these results, as both GPAQ versions have the same trends in terms of overestimation and underestimation of physical activity. CONCLUSION: The use of show cards had no significant impact on questionnaire validity. Therefore, both GPAQ versions can be applied interchangeably. Nevertheless the exact description of application of the GPAQ is desirable in terms of reproducibility and transparent scientific research.

AI Approaches Towards Prechtl's Assessment of General Movements: A Systematic Literature Review.

General movements (GMs) are spontaneous movements of infants up to five months post-term involving the whole body varying in sequence, speed, and amplitude. The assessment of GMs has shown its importance for identifying infants at risk for neuromotor deficits, especially for the detection of cerebral palsy. As the assessment is based on videos of the infant that are rated by trained professionals, the method is time-consuming and expensive. Therefore, approaches based on Artificial Intelligence have gained significantly increased attention in the last years. In this article, we systematically analyze and discuss the main design features of all existing technological approaches seeking to transfer the Prechtl's assessment of general movements from an individual visual perception to computer-based analysis. After identifying their shared shortcomings, we explain the methodological reasons for their limited practical performance and classification rates. As a conclusion of our literature study, we conceptually propose a methodological solution to the defined problem based on the groundbreaking innovation in the area of Deep Learning.

A Review of Current Literature on Vital Sign Assessment of Physical Activity in Primary Care.

PURPOSE: To conduct an integrated review of the performance and implementation of two physical activity (PA) assessment tools, the exercise vital sign (EVS) and the physical activity vital sign (PAVS), in U.S. primary care practice. DESIGN: An integrative review following Whittemore and Knafl's methodology. METHODS: Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched. Search terms were "exercise vital sign" OR "physical activity vital sign" AND "primary care". Additional inclusion criteria were studies conducted in the United States, published in English, in primary care, between 2010 and 2016. RESULTS: Nine studies met inclusion criteria. Five studies reported validity data of the EVS tool, while four studies reported data from the PAVS tool. Compared with the accelerometer, the EVS tool overestimated moderate-vigorous PA, while the PAVS tool demonstrated moderate agreement in identifying those not meeting national PA guidelines. The EVS tool was successfully implemented in large, integrated practices utilizing electronic health record systems. PA documentation increased compared to non-EVS practices. The predictive ability of the PAVS tool for clinical outcomes was shown. Studies of PA assessment tool use in children were not found. CONCLUSIONS: Preliminary evidence on the validity of both the EVS and PAVS tools support cautious use of each as a screening tool in primary care. There were no data on reliability, with limited data on tool use in diverse populations or settings. Data in children, older adults, and diverse population subgroups were lacking. CLINICAL RELEVANCE: Two brief exercise vital signs tools have each shown some initial validity for use by primary care clinicians as measures to identify patients not meeting PA guidelines.

Number of days required for reliably estimating physical activity and sedentary behaviour from accelerometer data in older adults.

The purpose of the study was to examine the minimum number of monitoring days for reliably estimating physical activity (PA) and sedentary behaviour (SB) from accelerometer data in older adults. Forty-two older adults from a local senior centre participated in this study. Participants wore an ActiGraph wGT3X-BT on the right hip for 7 consecutive days. Accelerometer data were downloaded to a computer and converted to activity count data in 60s epochs. Time spent in SB and different PA intensity categories were estimated with commonly used activity count cut-points. Participants with at least 7 valid days of monitoring (≥10 h.day-1) were included in the analysis. Intraclass correlation coefficients (ICC) were calculated for determining single-day monitoring reliability. The Spearman-Brown prophecy formula was used to estimate the minimum number of monitoring days required for achieving an ICC of 0.80. Single-day ICC values for time spent in SB and PA intensity categories ranged from 0.45 to 0.61. Minimum number of monitoring days required for achieving an ICC of 0.80 ranged from 2.5 to 4.9 days. In this study, a minimum of 5 consecutive days of monitoring was required for reliably estimating SB and PA from accelerometer data in older adults.

Validity of proximity sensor-based wear-time detection using the ActiGraph GT9X.

Our study investigated the performance of proximity sensor-based wear-time detection using the GT9X under laboratory and free-living settings. Fifty-two volunteers (23.2 ± 3.8 y; 23.2 ± 3.7 kg/m2) participated in either a laboratory or free-living protocol. Lab participants wore and removed a wrist-worn GT9X on 3-5 occasions during a 3-hour directly observed activity protocol. The 2-day free-living protocol used an independent temperature sensor and self-report as the reference to determine if wrist and hip-worn GT9X accurately determined wear (i.e., sensitivity) and non-wear (i.e., specificity). Free-living estimates of wear/non-wear were also compared to Troiano 2007 and Choi 2012 wear/non-wear algorithms. In lab, sensitivity and specificity of the wrist-worn GT9X in detecting total minutes of wear-on and off was 93% and 49%, respectively. The GT9X detected wear-off more often than wear-on, but with a greater margin of error (4.8 ± 11.6 vs. 1.4 ± 1.4 min). In the free-living protocol, wrist and hip-worn GT9X's yielded sensitivity and specificity of 72 and 90% and 84 and 92%, respectively. GT9X estimations had inferior sensitivity but superior specificity to Troiano 2007 and Choi 2012 algorithms. Due to inaccuracies, it may not be advisable to singularly use the proximity-sensor-based wear-time detection method to detect wear-time.

Objectively-measured physical activity in children is influenced by social indicators rather than biological lifecourse factors: Evidence from a Brazilian cohort.

The aim of this study was to examine the longitudinal influences of early life social and biological indicators on objectively measured physical activity. All newborns in 2004 in the city of Pelotas, Southern Brazil were enrolled in a birth cohort study. At the age of 6years, a follow-up visit included objective assessment of overall physical activity (summarized in milli-g, 1mg=0.001g) by tri-axial wrist worn accelerometry. The associations between early life exposures, such as type of delivery, parity, birth weight, preterm delivery, maternal physical activity, socioeconomic position, and overall physical activity were examined. Valid accelerometry data were obtained from 2604 children (78.2% of the eligible individuals). Girls were less active than boys (ß=-8.65mg; 95% CI -10.0; -7.30). Higher socioeconomic position was related to lower activity levels (ß=-9.69mg. 95% CI -12.45; -6.93) and a similar association was found with maternal schooling. No associations were found with birthweight, type of delivery or preterm delivery. This study provides evidence for the role of some social factors in explaining children's physical activity behaviors, and minimizes the influence of some early life biological factors at determining physical activity levels.

Users' experiences of wearable activity trackers: a cross-sectional study.

BACKGROUND: Wearable activity trackers offer considerable promise for helping users to adopt healthier lifestyles. This study aimed to explore users' experience of activity trackers, including usage patterns, sharing of data to social media, perceived behaviour change (physical activity, diet and sleep), and technical issues/barriers to use. METHODS: A cross-sectional online survey was developed and administered to Australian adults who were current or former activity tracker users. Results were analysed descriptively, with differences between current and former users and wearable brands explored using independent samples t-tests, Mann-Whitney, and chi square tests. RESULTS: Participants included 200 current and 37 former activity tracker users (total N = 237) with a mean age of 33.1 years (SD 12.4, range 18-74 years). Fitbit (67.5%) and Garmin devices (16.5%) were most commonly reported. Participants typically used their trackers for sustained periods (5-7 months) and most intended to continue usage. Participants reported they had improved their physical activity (51-81%) more commonly than they had their diet (14-40%) or sleep (11-24%), and slightly more participants reported to value the real time feedback (89%) compared to the long-term monitoring (78%). Most users (70%) reported they had experienced functionality issues with their devices, most commonly related to battery life and technical difficulties. CONCLUSIONS: Results suggest users find activity trackers appealing and useful tools for increasing perceived physical activity levels over a sustained period.

Harnessing the Potential of Wearable Activity Trackers for Heart Failure Self-Care.

PURPOSE OF REVIEW: The purpose of this study was to explore the potential of wearable activity trackers to promote self-care management for physical activity in heart failure (HF). RECENT FINDINGS: Exercise participation decreases hospital admissions and improves quality of life in HF, and activity tracking devices provide more precise means to assess free-living physical activity and thus enable tailored exercise instruction. Use of activity trackers by cardiac patients for self-monitoring and motivational purposes is associated with increased levels of physical activity and is predictive of disease severity. However, more research is required to establish the feasibility and validity of these devices in HF patients. It is also critical that the devices can be easily used to collect, process and utilise relevant data. Activity trackers have the potential to promote HF self-care because they provide monitoring of physical activity behaviours and the potential to generate habit formation and goal reinforcement, all of which foster physical activity.

Evidence for data missing at random in youth physical activity monitoring research.

This study examined whether or not activity monitor data collected as part of a typical 7-day physical activity (PA) measurement protocol can be expected to be missing at random. A total of 315 participants (9-18 years) each wore a SenseWear Armband monitor for 7 consecutive days. Participants were classified as "compliant" (86 boys and 124 girls) if they had recorded accelerometer data during 70% or more of the predefined awake time (7 AM-10 PM) on four different days; and "non-compliant" (44 boys and 51 girls) when not meeting these criteria. Linear mixed models were used to examine differences in energy expenditure (EE) levels by compliance across 10 different time periods. The results indicated that non-compliant girls were older (13.4 ± 2.9 vs. 12.2 ± 2.5) and taller (156.8 ± 10.3 vs. 152.8 ± 11.3) than their same gender compliant peers (P < .05). Comparisons of EE rates at segmented portions of the day revealed no differences between compliant and non-compliant groups (P ≥ .05). Differences in EE ranged from -0.32 kcal · kg-1 · h-1 (before school time) to 0.62 kcal · kg-1 · h-1 (physical education class) in boys and -0.39 kcal · kg-1 · h-1 (transportation from school) to 0.37 kcal · kg-1 · hour-1 (recess) in girls. The results showed that compliant and non-compliant individuals differed in a few demographic characteristics but exhibited similar activity patterns. This suggests that data were considered to be missing at random, but additional work is needed to confirm this observation in a representative sample of children using other types of activity monitors and protocols.

Measuring Overall Physical Activity for Cardiac Rehabilitation Participants: A Review of the Literature.

BACKGROUND: Assessment of physical activity (PA) for cardiac rehabilitation (CR) participants is critical to monitor changes. However, the validity and reliability of PA measures to assess PA throughout the day, not only during exercise training, is poorly investigated. AIM: To establish a reliable and valid measure to assess overall PA in CR participants. METHODS: A narrative literature review was performed based on a systematic search of Embase, CINAHL, MEDLINE and PubMed databases. Eight studies comparing two or more PA measures with at least one direct measure met the inclusion criteria. RESULTS: Methodological designs were heterogeneous. Correlations and levels of agreement between self-reported measures and direct measures were weak to moderate, while the correlations between direct measures were high. Of the direct measures, the SenseWear armband (BodyMedia Inc., Pittsburgh, PA, USA) had the highest validity, and the PA diary and MobilePAL questionnaires performed better than other self-reported PA measures. CONCLUSION: Direct measures were more valid and reliable than self-reported measures. No recommendation for a definitive PA measure was made due to lack of strong evidentiary support for one PA measure over another. There is a need for accurate measures of overall PA in evaluating current and changing PA levels following CR.

Toddler physical activity study: laboratory and community studies to evaluate accelerometer validity and correlates.

BACKGROUND: Toddlerhood is an important age for physical activity (PA) promotion to prevent obesity and support a physically active lifestyle throughout childhood. Accurate assessment of PA is needed to determine trends/correlates of PA, time spent in sedentary, light, or moderate-vigorous PA (MVPA), and the effectiveness of PA promotion programs. Due to the limited availability of objective measures that have been validated and evaluated for feasibility in community studies, it is unclear which subgroups of toddlers are at the highest risk for inactivity. Using Actical ankle accelerometry, the objectives of this study are to develop valid thresholds, examine feasibility, and examine demographic/ anthropometric PA correlates of MVPA among toddlers from low-income families. METHODS: Two studies were conducted with toddlers (12-36 months). Laboratory Study (n = 24)- Two Actical accelerometers were placed on the ankle. PA was observed using the Child Activity Rating Scale (CARS, prescribed activities). Analyses included device equivalence reliability (correlation: activity counts of two Acticals), criterion-related validity (correlation: activity counts and CARS ratings), and sensitivity/specificity for thresholds. Community Study (n = 277, low-income mother-toddler dyads recruited)- An Actical was worn on the ankle for > 7 days (goal >5, 24-h days). Height/weight was measured. Mothers reported demographics. Analyses included frequencies (feasibility) and stepwise multiple linear regression (sMLR). RESULTS: Laboratory Study- Acticals demonstrated reliability (r = 0.980) and validity (r = 0.75). Thresholds demonstrated sensitivity (86 %) and specificity (88 %). Community Study- 86 % wore accelerometer, 69 % had valid data (mean = 5.2 days). Primary reasons for missing/invalid data: refusal (14 %) and wear-time ≤2 days (11 %). The MVPA threshold (>2200 cpm) yielded 54 min/day. In sMLR, MVPA was associated with age (older > younger, ß = 32.8, p < 0.001), gender (boys > girls, ß = -11.21, p = 0.032), maternal MVPA (ß = 0.44, p = 0.002) and recruitment location (suburban > urban, ß = 19.6, p < 0.001), or race (non-Black > Black, ß = 18.5, p = 0.001). No association with toddler weight status. CONCLUSIONS: Ankle accelerometry is a valid, reliable, and feasible method of assessing PA in community studies of toddlers from low-income families. Sub-populations of toddlers may be at increased risk for inactivity, including toddlers that are younger, female, Black, those with less active mothers, and those living in an urban location.

An explorative qualitative study on acceptability of physical activity assessment instruments among primary care professionals in southern Sydney.

BACKGROUND: There are a substantial number of instruments for primary-care clinicians to assess physical-activity (PA). However, there are few studies that have explored the views of clinicians regarding comparative acceptability and ease of use. A better understanding of how clinicians perceive instruments could help overcome barriers, and inform future interventions. This study explored the acceptability of five PA-assessment instruments amongst a sample of Australian primary-care clinicians, including family-physicians (FP) and practice-nurses (PN). METHODS: A purposive sample of FPs (N = 9) and PNs (N = 10) from eight family-practices in southern Sydney consented to participate. Stage-1 involved semi-structured interviews with participants to select preferred instruments. An analysis of the two preferred instruments was conducted as Stage-2, to identify differences in instrument purpose and content. Stage-3 involved participants using the two instruments, selected from Stage-1, for 12-weeks. At the end of this period, semi-structured interviews were repeated to explore clinician experience. RESULTS: Clinicians indicated preferences for the GP-Physical-Activity-Questionnaire and 3-Questionnaire Physical-Activity-Questionnaire. These instruments demonstrated distinct variations in content, theoretical orientation, and outcome measures. Reasons for preference included; variations in individual clinician PA levels, knowledge in PA-assessment and instrument features. CONCLUSION: Findings demonstrated two instruments as preferred. Reasons for preference related to internal characteristics of clinicians such as variations in the level of individual PA and external circumstances, such as instrument features.

Measurement of physical activity in obese persons: how and why? A review.

[Purpose] Overweight and obesity are major risk factors for poor health, especially in children. Reduced physical activity, prompted by a sedentary lifestyle, is a major contributor. Hence, it is important to assess physical activity using standardized methods in public health to identify the risks associated with obesity. There have been no recent reports comparing such modalities for use by clinicians and researchers. In this article, some of these methods for use in the assessment of physical activity are reviewed, and their advantages and disadvantages are described. [Subjects and Methods] Electronic databases including PubMed, Medline, and Google Scholar were searched for literature, using key words Obesity, Physical activity, and Physical Behavior Monitoring. [Results] With advances in technology, various novel methods have been developed to assess physical behavior, but conventional methods are still relevant and easy to administer. [Conclusion] There are various measurement options available. Researchers may choose devices providing more accurate measurements, while clinicians may prefer portability and affordability for patients.