Analysis of national physical activity and sedentary behaviour policies in China.

PURPOSE: The aims of this study were to advance knowledge on physical activity (PA) and sedentary behaviour (SB) policies in China and to highlight related gaps and opportunities in the Chinese policy landscape. METHODS: Literature and web-based searches were performed to identify national PA and SB policies in China. We assessed which of the 17 elements of the Health-Enhancing Physical Activity Policy Audit Tool (HEPA PAT, version 2) are included in each of the policy documents and whether and how they address the 'cornerstones' of PA and SB policy: PA and SB guidelines, targets, surveillance and monitoring, and public education programmes. RESULTS: We found 60 national PA and SB policies, of which 54 focused on PA only and 6 focused on both PA and SB. There was a rapid increase in the number of policies issued between 2002 and 2021. In totality, the policies include all 17 key elements for a successful national policy approach to PA promotion according to the HEPA PAT. The policies reflect engagement from a range of sectors and encompass PA targets, recommendations for PA and SB, mandates and recommendations for school-related PA, plans for public education on PA, and plans for surveillance and monitoring of PA and SB. CONCLUSION: Our findings demonstrate that there has been increasing focus on PA and SB policies in China, which reflects efforts by policymakers to address the health burden of insufficient PA and excessive SB. More emphasis may be placed on SB in Chinese policy, particularly in terms of setting specific targets for population SB. Policymakers and other relevant public health stakeholders in China could also consider developing or adopting the 24-hour movement guidelines, in accordance with recent trends in several other countries. Collaboration and involvement of different sectors in the development and implementation of Chinese PA and SB policies should continue to be facilitated as part of a whole-of-system approach to health promotion.

Promotion of health-enhancing physical activity in the sport sector: a study among representatives of 536 sports organisations from 36 European countries.

BACKGROUND: It is a common belief that most sports clubs and organisations are primarily focused on elite sports while placing less emphasis on the promotion of health-enhancing physical activity (HEPA). However, there is a lack of evidence on this topic in the scientific literature. Therefore, the aim of this study was to determine the level and correlates of the commitment of sports organisations in Europe to HEPA promotion. METHODS: Representatives of 536 sports organisations from 36 European countries responded to our survey. A multiple regression analysis was conducted with the commitment of sports organisation to HEPA promotion (0 ["not at all"] - 10 ["most highly"]) as the outcome variable and organisation type ("national sport association" reference group [ref], "European sports federation", "national umbrella sports organisation", "national Olympic committee", "national sport-for-all organisation"), headquarters in a European Union member state ("no" [ref], "yes"), region of Europe ("Western" [ref], "Central and Eastern", "Northern", "Southern"), commitment to elite sports ("low" [ref], "medium", "high"), and awareness of Sports Club for Health (SCforH) guidelines ("no" [ref], "yes") as explanatory variables. RESULTS: Approximately 75.2% (95% confidence interval [CI]: 71.5, 78.8) of sports organisations were highly committed to elite sports. Only 28.2% (95% CI: 24.4, 32.0) of sports organisations reported a high commitment to HEPA promotion. A higher commitment to HEPA promotion was associated with the national Olympic committees (ß = 1.48 [95% CI: 0.41, 2.55], p = 0.007), national sport-for-all organisations (ß = 1.68 [95% CI: 0.74, 2.62], p < 0.001), location in Central and Eastern Europe (ß = 0.56 [95% CI: 0.01, 1.12], p = 0.047), and awareness of SCforH guidelines (ß = 0.86 [95% CI: 0.35, 1.37], p < 0.001). CONCLUSION: From our findings, it seems that most sports organisations are primarily focused on elite sports. Coordinated actions at the European Union and national levels are needed to improve the promotion of HEPA through sports organisations. In this endeavour, it may be useful to consider national Olympic committees, national sport-for-all organisations, and relevant sports organisations in Central and Eastern Europe as role models and to raise the awareness of SCforH guidelines.

Status and Trends of Physical Activity Surveillance, Policy, and Research in 164 Countries: Findings From the Global Observatory for Physical Activity-GoPA! 2015 and 2020 Surveys.

BACKGROUND: Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. METHODS: We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. RESULTS: The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world's population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world's population live in countries where PA promotion capacity should be significantly improved. CONCLUSION: Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion.

Implementation of non-pharmacological interventions for the treatment of hypertension in primary care: a narrative review of effectiveness, cost-effectiveness, barriers, and facilitators.

BACKGROUND: The current guidelines for the prevention, detection, evaluation, and management of hypertension recommend six types of non-pharmacological interventions: alcohol reduction, salt intake reduction, increased potassium intake, physical activity, weight loss, and heart-healthy diets. However, the non-pharmacological interventions are still not widely used in primary care. In this paper, we, therefore, reviewed and summarised the evidence on the effectiveness, cost-effectiveness, barriers, and facilitators of non-pharmacological interventions for the treatment of hypertension in primary care. METHODS: A thorough literature search was conducted in Embase, Google Scholar, and PubMed databases, to identify the most recent reviews or, in their absence, primary studies on alcohol reduction, salt intake reduction, potassium supplementation, physical activity, weight reduction, heart-healthy diets, and other non-pharmacological interventions for the treatment of hypertension in primary care. RESULTS: Alcohol reduction is a non-pharmacological intervention for the treatment of hypertension in primary care with proven effectiveness, feasibility, and acceptability. Interventions for sodium intake reduction, physical activity, and weight reduction are effective but there is insufficient evidence regarding their feasibility and acceptability in primary care settings. Evidence on the effectiveness of potassium intake and heart-healthy diets is limited and inconsistent. There is a lack of evidence on the cost-effectiveness of non-pharmacological interventions in the treatment of hypertension. The most common barriers to deliver such interventions related to healthcare providers include a lack of time, knowledge, self-confidence, resources, clear guidelines, and financial incentives. The most common barriers related to patients include a lack of motivation and educational resources. Less evidence is available on facilitators of implementing non-pharmacological interventions in primary care. Besides, facilitators differed by different types of interventions. CONCLUSIONS: Available evidence suggests that more pragmatic, clinically feasible, and logistically simple interventions are required for sodium intake reduction, physical activity, and weight reduction in primary care settings. Future studies should provide further evidence on the effectiveness of weight control, potassium intake, and heart-healthy diets. More research is also needed on cost-effectiveness and facilitators of all types of effective non-pharmacological interventions for the treatment of hypertension in primary care.

Validity and Reliability of the Daily Activity Behaviours Questionnaire (DABQ) for Assessment of Time Spent in Sleep, Sedentary Behaviour, and Physical Activity.

Sleep, sedentary behaviour (SB), and physical activity are among key behavioural determinants of health. There is a need to evaluate questionnaires that capture movement behaviours across the full 24-h day. The aim of this study was to examine the measurement properties of the Daily Activity Behaviours Questionnaire (DABQ), a novel questionnaire (with a past seven-day recall period) for estimating the time spent in sleep, SB, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) among adults. A sample of 126 adults was recruited. DABQ was administered to the participants on two occasions seven days apart to examine its test-retest reliability. The convergent validity of DABQ estimates was explored against activPAL4 accelerometer/inclinometer estimates. Intraclass correlation coefficients for absolute agreement and consistency between the times spent in sleep, SB, LPA, and MVPA estimated by DABQ in the test and re-test ranged from 0.59 to 0.69. Spearman's correlations between the times spent in sleep, SB, LPA, and MVPA estimated by DABQ and activPAL4 ranged from 0.38 to 0.66. In terms of reliability and validity, DABQ is comparable with existing questionnaires; however, it has an important advantage of enabling a comprehensive assessment of all four 24-h movement behaviours. The measurement properties of DABQ make it suitable for large-scale epidemiological studies on 24-h movement behaviours.

Test-retest reliability of isometric mid-thigh pull maximum strength assessment: a systematic review.

The aim of this systematic review was to explore the test-retest reliability of isometric mid-thigh pull maximum strength assessment. We searched through five databases to find studies that examined the test-retest reliability of peak force in the isometric mid-thigh pull exercise. From each included study, we extracted intra-class correlation coefficients (ICC) and/or coefficient of variation (CV). The methodological quality of the included studies was evaluated using the COSMIN checklist. A total of 16 good-to-excellent quality studies were included in the review. When considering results from all included studies, ICCs ranged from 0.73 to 0.99 (median ICC = 0.96), where 78% of ICCs were ≥ 0.90, and 98% of ICCs were ≥ 0.75. The range of reported CVs was from 0.7% to 11.1% (median CV = 4.9%), where 58% of CVs were ≤ 5%. Reliability was also good-to-excellent for both relative and absolute peak force and for both bilateral and unilateral isometric mid-thigh pull tests. The majority of studies did not find significant differences between testing sessions. It can be concluded that the isometric mid-thigh pull maximum strength assessment has good-to-excellent test-retest reliability. The isometric mid-thigh pull maximum strength assessment can be used as a reliable test in sports practice and for research purposes.

National physical activity and sedentary behaviour policies in 76 countries: availability, comprehensiveness, implementation, and effectiveness.

BACKGROUND: Evidence on current, national physical activity (PA) and sedentary behaviour (SB) policies is limited. We, therefore, analysed availability, comprehensiveness, implementation, and effectiveness of PA and SB policies internationally. METHODS: In this cross-sectional study, Global Observatory for Physical Activity (GoPA!) Country Contacts from 173 countries were asked to provide data on their national PA and SB policies by completing GoPA! Policy Inventory. Data were collected for 76 countries (response rate = 44%). RESULTS: Formal written policies for PA and SB were found in 92% (95% confidence interval [CI]: 86, 98) and 62% (95% CI: 50, 75) of countries, respectively. Sixty-two percent (95% CI: 51, 73) of countries have national PA guidelines, while 40% (95% CI: 29, 52) have SB guidelines. Fifty-two (95% CI: 40, 64) and 11% (95% CI: 3, 19) of countries have quantifiable national targets for PA and SB, respectively. The most represented ministries/departments involved in the promotion of more PA and/or less SB were in the sport (reported by 99% countries; 95% CI: 96, 100), health (97%; 95% CI: 94, 100), education (94%; 95% CI: 88, 100), and recreation and leisure (85%; 95% CI: 71, 99) sectors. The median score (0-10) for the comprehensiveness of PA and SB policies was 4 (95% CI: 4, 5) and 2 (95% CI: 2, 3), respectively. For PA and SB policy implementation it was 6 (95% CI: 5, 6). For the effectiveness of PA and SB policies it was 4 (95% CI: 3, 5) and 3 (95% CI: 2, 4), respectively. PA and SB policies were generally best developed in high-income countries and countries of European and Western-Pacific regions. CONCLUSIONS: Most of the included countries have PA policies, but their comprehensiveness, implementation, and effectiveness are generally low-to-moderate. SB policies are less available, comprehensive, implemented, and effective than PA policies. PA and SB policies are better developed in high-income countries, compared with low- and lower-middle-income countries, and in countries of European and Western-Pacific regions, compared with other world regions. More investment is needed in development and implementation of comprehensive and effective PA and SB policies, particularly in low- and lower-middle-income countries.

Test-Retest Reliability of the One-Repetition Maximum (1RM) Strength Assessment: a Systematic Review.

BACKGROUND: The test-retest reliability of the one-repetition maximum (1RM) test varies across different studies. Given the inconsistent findings, it is unclear what the true reliability of the 1RM test is, and to what extent it is affected by measurement-related factors, such as exercise selection for the test, the number of familiarization trials and resistance training experience. OBJECTIVES: The aim of this paper was to review studies that investigated the reliability of the 1RM test of muscular strength and summarize their findings. METHODS: The PRISMA guidelines were followed for this systematic review. Searches for studies were conducted through eight databases. Studies that investigated test-retest reliability of the 1RM test and presented intra-class correlation coefficient (ICC) and/or coefficient of variation (CV) were included. The COSMIN checklist was used for the assessment of the methodological quality of the included studies. RESULTS: After reviewing 1024 search records, 32 studies (pooled n = 1595) on test-retest reliability of 1RM assessment were found. All the studies were of moderate or excellent methodological quality. Test-retest ICCs ranged from 0.64 to 0.99 (median ICC = 0.97), where 92% of ICCs were ≥ 0.90, and 97% of ICCs were ≥ 0.80. The CVs ranged from 0.5 to 12.1% (median CV = 4.2%). ICCs were generally high (≥ 0.90), and most CVs were low (< 10%) for 1RM tests: (1) among those without and for those with some resistance training experience, (2) conducted with or without familiarization sessions, (3) with single-joint or multi-joint exercises, (4) for upper- and lower-body strength assessment, (5) among females and males, and (6) among young to middle-aged adults and among older adults. Most studies did not find systematic changes in test results between the trials. CONCLUSIONS: Based on the results of this review, it can be concluded that the 1RM test generally has good to excellent test-retest reliability, regardless of resistance training experience, number of familiarization sessions, exercise selection, part of the body assessed (upper vs. lower body), and sex or age of participants. Researchers and practitioners, therefore, can use the 1RM test as a reliable test of muscular strength.

Prevalence, patterns, and correlates of physical activity in Nepal: findings from a nationally representative study using the Global Physical Activity Questionnaire (GPAQ).

BACKGROUND: The promotion of a physically active lifestyle might help address the increasing burden of non-communicable diseases in Nepal. However, there is a lack of nationally representative estimates of physical activity (PA) prevalence in Nepal. The aim of this nationwide cross-sectional study was to determine domain-specific PA levels and the association of socio-demographic and lifestyle characteristics with total PA among Nepalese adults aged 15-69 years. METHODS: The data were collected using self-administered questionnaires in a nationally representative sample of 4143 adults (66.5% females), comprised of both rural and urban populations in Nepal. PA levels were assessed using the Global Physical Activity Questionnaire (GPAQ). RESULTS: Based on self-reported estimates, around 97% (95% confidence interval [CI]: 96-98%) of men and 98% (95% CI: 98-99%) of women were found to meet the recommended levels of PA. Both men and women reported high occupational PA, whilst most participants of both sexes did not report engaging in any leisure-time PA. A multiple regression analysis showed that less self-reported total PA was associated with older age, higher level of education, urban place of residence, never been married, being underweight, and smoking in both sexes and with overweight and obesity in males (p < 0.05 for all). CONCLUSION: According to self-reported estimates, majority of Nepalese men and women are meeting the recommended levels of PA. The total self-reported PA in Nepalese adults is high, because many of them have labour intensive jobs. Although older age, higher level of education, urban place of residence, never been married, being underweight, and smoking in both sexes, as well as overweight and obesity in males were inversely associated with self-reported PA, the overall level of PA in all these groups was very high. Given the high overall self-reported PA found in the current study, promoting more PA in Nepal may not be as important as in some other countries; not even in the population groups for which we found a negative association with PA. Nevertheless, future studies should examine whether a more balanced distribution of occupational and leisure-time PA would promote better health among Nepalese adults.

A global systematic scoping review of studies analysing indicators, development, and content of national-level physical activity and sedentary behaviour policies.

BACKGROUND: National policy approaches to physical activity (PA) promotion and sedentary behaviour (SB) reduction are needed to address rising rates of non-communicable diseases. Understanding the policy process and impact through robust research and evaluation is crucial for facilitating successful reforms in national health policy. This scoping review, therefore, aimed to map the evidence on indicators, development, and content of national PA and/or SB policies globally. METHODS: A systematic search of academic and grey literature was conducted through six bibliographic databases, Google, and websites of three large organisations for PA promotion. RESULTS: Out of 24,872 screened documents, 203 publications from 163 studies were selected. The selected studies investigated PA/SB policies in 168 countries worldwide, and we provided summary results for each of the countries. Overall, 69, 29, and 2% of the analyses of national PA/SB policies were conducted for high-, middle-, and low-income countries, respectively. Twenty-two percent of the studies mentioned SB policies as part of their analysis, with only one study focusing solely on assessing SB policies. Operational definitions of policy were found in only 13% of publications. Only 15% of the studies used a conceptual or theoretical framework. A large variety of methods were used for data collection and analysis of PA/SB policy. CONCLUSIONS: We found that PA policy research is much more developed than it was considered several years ago. Research around SB policies is still in its infancy, but it seems to have experienced some positive progress in the last few years. Three key issues were identified that should be addressed in further research: [i] there is a lack of PA/SB policy research in low- and middle-income countries, which is an important limitation of the current body of evidence; [ii] the definition of policy varied significantly across studies, and most studies did not rely on any theoretical framework, which may impede cross-study comparisons; and [iii] studies have used a variety of methods to analyse policy, which may also cause problems with comparability. Future PA/SB policy research should aim towards a clearer conceptualisation of policy, greater reliance on existing theoretical frameworks, and the use and further development of standardised methods for PA/SB policy analysis.

Associations between multiple indicators of socio-economic status and muscle-strengthening activity participation in a nationally representative population sample of Australian adults.

BACKGROUND: Muscle-strengthening activity (MSA) (e.g. weight training), confers unique health benefits. While socioeconomic status (SES) correlates with leisure time physical activity, little is known about its relation with MSA. METHODS: Cross-sectional study of a representative sample of 8993 Australian adults (>18years) who participated in the National Nutrition and Physical Activity Survey 2011-12. Information was collected on SES (income, education, socio-economic disadvantage and remoteness) and MSA participation. RESULTS: 17.9% (CI: 16.8-19.0) met the national guidelines for MSA (≥2 sessions/week). Men and younger adults (<35years) met MSA guidelines more than females (19.7%; CI: 18.3-21.1% vs 16.1%; CI: 14.6-17.6%; p<0.001) and older adults respectively (25.0%; CI: 22.4-27.7% vs 10.4%; CI: 8.9-11.8%; p<0.001). All SES indicators were associated with meeting the guidelines in unadjusted analyses. When adjusting for total physical activity and mutually adjusting for each socioeconomic indicator only remoteness (OR for city vs rural=1.65; CI: 1.17-2.32; p<0.001) was associated with MSA participation (education OR=1.09 for high vs low; CI: 0.80-1.47, p=0.748; income OR=1.31 for Q5 vs Q1, CI: 0.93-1.85, p=0.328; social disadvantage OR=1.04 for v.high vs v.low, CI: 0.76-1.43, p=0.855). These associations were further attenuated when adjusting for BMI, smoking status and self-rated health. CONCLUSION: Remoteness, and to a lesser degree, education, income and social disadvantage, were independently associated with MSA participation. Public health interventions should improve access to strength training facilities, and/or increase home-based muscle-strengthening activity in remote areas.

Pumping Iron in Australia: Prevalence, Trends and Sociodemographic Correlates of Muscle Strengthening Activity Participation from a National Sample of 195,926 Adults.

OBJECTIVE: The current Australian Physical Activity Guidelines recommend that adults engage in regular muscle-strengthening activity (e.g. strength or resistance training). However, public health surveillance studies describing the patterns and trends of population-level muscle-strengthening activity participation are sparse. The aim of this study is to examine the prevalence, trends and sociodemographic correlates of muscle-strengthening activity participation in a national-representative sample of Australians aged 15 years and over. METHODS: Between 2001 and 2010, quarterly cross-sectional national telephone surveys were conducted as part of the Australian Sports Commission's 'Exercise, Recreation and Sport Survey'. Pooled population-weighted proportions were calculated for reporting: [i] no muscle-strengthening activity; [ii] insufficient muscle-strengthening activity, and [iii] sufficient muscle-strengthening activity. Associations with sociodemographic variables were assessed using multiple logistic regression analyses. RESULTS: Out of 195,926 participants, aged 15-98 years, only 10.4% (95% CI: 10.1-10.7) and 9.3% (95% CI: 9.1-9.5) met the muscle-strengthening activity recommendations in the past two weeks and in the past year, respectively. Older adults (50+ years), and those living in socioeconomically disadvantaged, outer regional/remote areas and with lower education were less likely to report sufficient muscle-strengthening activity (p<0.001). Over the 10-year monitoring period, there was a significant increase in the prevalence of sufficient muscle-strengthening activity (6.4% to 12.0%, p-value for linear trend <0.001). CONCLUSIONS: A vast majority of Australian adults did not engage in sufficient muscle-strengthening activity. There is a need for public health strategies to support participation in muscle-strengthening activity in this population. Such strategies should target older and lower educated adults, and those living in socioeconomically disadvantaged, outer regional/remote and areas.

Comprehensive sector-wide strategies to prevent and control obesity: what are the potential health and broader societal benefits? A case study from Australia.

AIM: Several countries have recently established multistakeholder strategies to prevent or control overweight and obesity; however, studies have not yet been done on their effectiveness and likely impact. This study's objectives were to (i) explore sector-wide benefits and impacts likely to accrue from implementing an obesity prevention strategy in the Australian state of New South Wales; (ii) discuss the wider implications of the findings for research and practice; and (iii) strengthen the case for sustained implementation of a comprehensive, intersectoral approach. METHOD: A case study approach, including evidence reviews and illustrative epidemiological models, was used to show potential benefits from meeting selected targets and objectives specified in the strategy. RESULTS: For adults, improved health outcomes potentially include reductions in all-cause mortality, cardiovascular disease, type 2 diabetes, various cancers, osteoarthritis, infant mortality and healthcare costs. Potential benefits beyond the health sector involve disability payments, absenteeism, worker productivity, workplace injuries and insurance claims. For children and adolescents, improved health outcomes potentially include metabolic risk factors, dental health, prehypertension/hypertension, cardiovascular disease risk factors, depression, rates of mortality in hospitalised children, bullying and otitis media. CONCLUSION: Sector-wide health, social and economic benefits from successful implementation of multisector obesity prevention strategies are likely to be substantial if specified targets are achieved. Epidemiological modelling described in this paper for selected examples provides illustrative rather than comprehensive evidence for potential benefits. Process evaluation of the extent of implementation of these multisectoral strategies, together with the accumulated data on intervention effectiveness, will determine their potential population health benefit. Quantifying the health and social benefits that are likely to accrue if comprehensive sector-wide obesity prevention and control strategies are established can strengthen advocacy for their sustained implementation.

Accelerometer-based measures in physical activity surveillance: current practices and issues.

OBJECTIVE: Self-reports of physical activity (PA) have been the mainstay of measurement in most non-communicable disease (NCD) surveillance systems. To these, other measures are added to summate to a comprehensive PA surveillance system. Recently, some national NCD surveillance systems have started using accelerometers as a measure of PA. The purpose of this paper was specifically to appraise the suitability and role of accelerometers for population-level PA surveillance. METHODS: A thorough literature search was conducted to examine aspects of the generalisability, reliability, validity, comprehensiveness and between-study comparability of accelerometer estimates, and to gauge the simplicity, cost-effectiveness, adaptability and sustainability of their use in NCD surveillance. CONCLUSIONS: Accelerometer data collected in PA surveillance systems may not provide estimates that are generalisable to the target population. Accelerometer-based estimates have adequate reliability for PA surveillance, but there are still several issues associated with their validity. Accelerometer-based prevalence estimates are largely dependent on the investigators' choice of intensity cut-off points. Maintaining standardised accelerometer data collections in long-term PA surveillance systems is difficult, which may cause discontinuity in time-trend data. The use of accelerometers does not necessarily produce useful between-study and international comparisons due to lack of standardisation of data collection and processing methods. To conclude, it appears that accelerometers still have limitations regarding generalisability, validity, comprehensiveness, simplicity, affordability, adaptability, between-study comparability and sustainability. Therefore, given the current evidence, it seems that the widespread adoption of accelerometers specifically for large-scale PA surveillance systems may be premature.

Workplace Sitting Breaks Questionnaire (SITBRQ): an assessment of concurrent validity and test-retest reliability.

BACKGROUND: Breaks in prolonged sitting may have beneficial cardiometabolic and musculoskeletal health outcomes. Desk-based work settings are an important environment to promote and support breaks in sitting time. However, few studies have reported the psychometric properties of self-report measures to assess the frequency and duration of breaks from sitting. This study examined the concurrent validity and test-retest reliability of the Workplace Sitting Breaks Questionnaire (SITBRQ) designed to assess frequency and duration of breaks in sitting within desk-based work settings. METHODS: To assess the concurrent validity, a sample of 147 desk-based employees completed the SITBRQ and wore an Actigraph GT1M accelerometer for seven consecutive days. To establish test-retest reliability, SITBRQ was administered on two separate occasions 7-14 days apart to a separate sample of 96 desk-based employees. RESULTS: A low relative agreement with accelerometry (Spearman's r = 0.24 [95% CI 0.07-0.40]) was determined for self-reported frequency, but not for the duration of sitting breaks (Spearman's r = 0.05 [95% CI -0.12-0.22]). Adequate reliability was determined for both self-reported frequency (Spearman's r = 0.71 [95% CI 0.59-0.79], Cohen's kappa = 0.74 [95% CI 0.64-0.84]) and duration of sitting breaks (Spearman's r = 0.59 [95% CI 0.45-0.71], Cohen's kappa = 0.61 [95% CI 0.38-0.85]). CONCLUSION: SITBRQ may be used for assessment of the frequency of sitting breaks within desk-based work settings with validity and reliability similar to other self-reports in the field of sedentary behaviour research. However, until adequately improved and re-evaluated, it should not be used to collect data about the duration of breaks in sitting time.

Age- and sex-specific criterion validity of the health survey for England Physical Activity and Sedentary Behavior Assessment Questionnaire as compared with accelerometry.

The criterion validity of the 2008 Physical Activity and Sedentary Behavior Assessment Questionnaire (PASBAQ) was examined in a nationally representative sample of 2,175 persons aged ≥16 years in England using accelerometry. Using accelerometer minutes/day greater than or equal to 200 counts as a criterion, Spearman's correlation coefficient (ρ) for PASBAQ-assessed total activity was 0.30 (95% confidence interval (CI): 0.25, 0.35) in women and 0.20 (95% CI: 0.15, 0.26) in men. Correlations between accelerometer counts/minute of wear time and questionnaire-assessed relative energy expenditure (metabolic equivalent-minutes/day) were higher in women (ρ = 0.41, 95% CI: 0.36, 0.46) than in men (ρ = 0.32, 95% CI: 0.26, 0.38). Similar correlations were observed for minutes/day spent in vigorous activity (women: ρ = 0.39, 95% CI: 0.33, 0.46; men: ρ = 0.31, 95% CI: 0.26, 0.36) and moderate-to-vigorous activity (women: ρ = 0.42, 95% CI: 0.36, 0.48; men: ρ = 0.38, 95% CI: 0.32, 0.45). Correlations for time spent being sedentary (<100 counts/minute) were 0.30 (95% CI: 0.24, 0.35) and 0.25 (95% CI: 0.19, 0.30) in women and men, respectively. Sedentary behavior correlations showed no sex difference. The validity of sedentary behavior and total physical activity was higher in older age groups, but validity was higher in younger persons for vigorous-intensity activity. The PASBAQ is a useful and valid instrument for ranking individuals according to levels of physical activity and sedentary behavior.

Physical activity of Croatian population: cross-sectional study using International Physical Activity Questionnaire.

AIM: To determine the physical activity level of the Croatian population in different domains of everyday life. METHODS: A random stratified sample of 1032 Croatians aged 15 years and older was interviewed using the official Croatian long version of the International Physical Activity Questionnaire (IPAQ). Total physical activity and physical activity in each of the 4 life domains--work, transport, domestic and garden, and leisure-time--were estimated. Physical activity was expressed as metabolic equivalent-hours per week (MET-hour/week). RESULTS: Median total physical activity for the whole sample was 58.2 MET-hour/week. Median physical activity in MET-hour/week was 30.4 for work, 5.0 for transportation, 13.1 for domestic and garden, and 6.0 for leisure-time domain. The lowest physical activity was found in the 15-24 age group (42.7 MET-hour/week) and the highest in the 55-64 age group (72.0 MET-hour/week). Multiple regression analysis showed a significant relationship of socio-demographic and health-related characteristics (size of settlements, household income, educational level, age, body mass index, self-rated physical health, and self-rated mental health) with physical activity in all domains (P < 0.001). CONCLUSION: Studies on physical activity in transition countries should include the domains of work and domestic and garden, since if only leisure-time domain is examined, the total physical activity level could be underestimated. As the lowest physical activity was reported by adolescents and young adults, strategies for increasing physical activity in this age group should be developed.