Validity of the Pregnancy Physical Activity Questionnaire Short Form (PPAQ-SF).

To develop and evaluate the validity of the Pregnancy Physical Activity Questionnaire-Short Form (PPAQ-SF). A prospective cohort of participants (N=50) completed the updated PPAQ (long-form) and wore an ActiGraph for 7 days on the nondominant wrist in early, mid, and late pregnancy. The top ten questions with the highest relative contribution to the between-person variance in PPAQ-assessed total MET-hours/day were selected. Internal validity was evaluated using the ActiGraph and the updated PPAQ (long-form) within the current dataset. Validity was also assessed in an external validation dataset of 222 pregnant participants using the updated and original PPAQ (long-forms). Spearman correlations between the PPAQ-SF and ActiGraph estimates of MVPA MET-hours/day were r = 0.34 (95% CI 0.18-0.48) for overall pregnancy and ranged from 0.21 (95% CI -0.07-0.47) in early pregnancy to 0.49 (95% CI 0.23-0.69) in mid-pregnancy. In the external validation dataset, correlations between the PPAQ-SF and the PPAQ (long forms) estimates of MVPA MET-hours/day were statistically significant across pregnancy (r=0.94-0.99). Reproducibility ranged from 0.35 in early pregnancy to 0.77 in mid pregnancy. In summary, the PPAQ-SF can provide a time-efficient measure of MVPA during pregnancy with acceptable validity; reproducibility was reasonable in mid-pregnancy.

Update and Novel Validation of a Pregnancy Physical Activity Questionnaire.

The aim of this study was to update and validate the Pregnancy Physical Activity Questionnaire (PPAQ), using novel and innovative accelerometer and wearable camera measures in a free-living setting, to improve the measurement performance of this method for self-reporting physical activity. A prospective cohort of 50 eligible pregnant women were enrolled in early pregnancy (mean = 14.9 weeks' gestation). In early, middle, and late pregnancy, participants completed the updated PPAQ and, for 7 days, wore an accelerometer (GT3X-BT; ActiGraph, Pensacola, Florida) on the nondominant wrist and a wearable camera (Autographer; OMG Life (defunct)). At the end of the 7-day period, participants repeated the PPAQ. Spearman correlations between the PPAQ and accelerometer data ranged from 0.37 to 0.44 for total activity, 0.17 to 0.53 for moderate- to vigorous-intensity activity, 0.19 to 0.42 for light-intensity activity, and 0.23 to 0.45 for sedentary behavior. Spearman correlations between the PPAQ and wearable camera data ranged from 0.52 to 0.70 for sports/exercise and from 0.26 to 0.30 for transportation activity. Reproducibility scores ranged from 0.70 to 0.92 for moderate- to vigorous-intensity activity and from 0.79 to 0.91 for sports/exercise, and were comparable across other domains of physical activity. The PPAQ is a reliable instrument and a valid measure of a broad range of physical activities during pregnancy.

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.

Cross-Sectional Associations of 24-Hour Sedentary Time, Physical Activity, and Sleep Duration Compositions with Sleep Quality and Habits in Preschoolers.

Although some studies indicate physical activity and sleep quality are positively associated in children, most reports examined physical activity independent of other 24-h behaviors and focused on older children. The aim of this cross-sectional study was to examine the predicted changes in sleep efficiency and habits when reallocating time between movement behaviors using compositional isotemporal substitution in preschool-aged children. Accelerometers were worn by 288 participants (51.6 ± 9.5 months) for up to 16 days. Sleep outcomes included sleep efficiency, nap frequency, sleep disturbances, and bedtime resistance. Compositional isotemporal substitution analyses demonstrated that the combined effect of 24-h movement behaviors was associated with sleep efficiency (p < 0.001) and nap frequency (p < 0.003). When sleep increased by 30 min at the expense of stationary time or light physical activity, estimates of sleep efficiency and bedtime resistance decreased while nap frequency increased. When stationary time increased by 30 min from moderate to vigorous physical activity, estimated sleep efficiency increased and sleep disturbances decreased. Although this study presents preliminary evidence that 24-h movement behavior compositions in early childhood are associated with sleep quality and nap frequency, estimated effects from theoretical time reallocations across sleep outcomes were mixed.

Estimating Sedentary Time from a Hip- and Wrist-Worn Accelerometer.

PURPOSE: This study aimed to determine the validity of existing methods to estimate sedentary behavior (SB) under free-living conditions using ActiGraph GT3X+ accelerometers (AG). METHODS: Forty-eight young (18-25 yr) adults wore an AG on the right hip and nondominant wrist and were video recorded during four 1-h sessions in free-living settings (home, community, school, and exercise). Direct observation videos were coded for postural orientation, activity type (e.g., walking), and METs derived from the Compendium of Physical Activities, which served as the criterion measure of SB (sitting or lying posture, <1.5 METs). Thirteen methods using cut points from vertical counts per minute (CPM), counts per 15-s (CP15s), and vector magnitude (VM) counts (e.g., CPM1853VM), raw acceleration and arm angle (sedentary sphere), Euclidean norm minus one (ENMO) corrected for gravity (mg) thresholds, uni- or triaxial sojourn hybrid machine learning models (Soj1x and Soj3x), random forest (RF), and decision tree (TR) models were used to estimate SB minutes from AG data. Method bias, mean absolute percent error, and their 95% confidence intervals were estimated using repeated-measures linear mixed models. RESULTS: On average, participants spent 34.1 min per session in SB. CPM100, CPM150, Soj1x, and Soj3x were the only methods to accurately estimate SB from the hip. Sedentary sphere and ENMO44.8 overestimated SB by 3.9 and 6.1 min, respectively, whereas the remaining wrist methods underestimated SB (range, 9.5-2.5 min). In general, mean absolute percent error was lower using hip methods compared with wrist methods. CONCLUSION: Accurate group-level estimates of SB from a hip-worn AG can be achieved using either simpler count-based approaches (CPM100 and CPM150) or machine learning models (Soj1x and Soj3x). Wrist methods did not provide accurate or precise estimates of SB. The development of large open-source free-living calibration data sets may lead to improvements in SB estimates.

Efficacy of Community-Based Exercise Therapy Among African American Patients With Peripheral Artery Disease: A Randomized Clinical Trial.

Importance: African American individuals are 2 times more likely than non-Hispanic white individuals to have peripheral artery disease (PAD). Structured community-based exercise therapy improves walking distance among patients with PAD, but these patients require motivation to adhere to therapy. Objective: To assess whether motivational interviewing (MI) is more efficacious than Patient-Centered Assessment and Counseling for Exercise (PACE) or control to improve walking distance in African American patients with PAD. Design, Setting, and Participants: In this 3-group randomized clinical trial, 174 African American patients with PAD were studied from May 1, 2012, to November 30, 2016, at health care centers, churches, and health fairs in Wichita, Kansas; Kansas City, Kansas, and Kansas City, Missouri. Interventions: Patients were randomized in a 1:1:1 fashion to 1 of 3 groups (57 to MI, 57 to PACE, and 60 to control). The 2 counseling interventions were delivered biweekly for 3 months and monthly for 3 months followed by a 6-month maintenance phase with limited contact. Control participants received a mailing at 3 and 9 months. Main Outcomes and Measures: The primary outcome was 6-month change in 6-minute walking performance. Secondary outcomes included 12-month change in walking performance and 6- and 12-month changes in quality of life. Results: A total of 174 African American patients (mean [SD] age, 64.2 [11.2] years; 128 [74.0%] female) were studied. At 6 months, mean (SE) change in walking distance by group was as follows: MI, -3.42 (4.55) m; PACE, 2.74 (6.00) m; and control, -0.18 (4.40) m. At 12 months, mean (SE) change in walking distance by group was as follows: MI, -7.75 (5.50) m; PACE, 13.75 (6.13) m; and control, -1.08 (5.73) m. Comparing each of the intervention arms (MI and PACE) with the control arm, no statistically significant increases in walking distance at 6 months (MI: change, -2.10 m; 95% CI, -16.54 to 12.35 m; PACE: change, 2.31 m; 95% CI, -11.36 to 15.97 m) or 12 months (MI: change, -5.56 m; 95% CI, -21.18 to 10.06 m; PACE: change, 14.24 m; 95% CI, -1.85 to 30.34 m) were found. Compared with MI, PACE resulted in a statistically significant increase in walking distance at 12 months of 19.80 m (95% CI, 3.33-36.28 m). Conclusions and Relevance: In a cohort of African American patients with PAD, MI was not efficacious in improving walking distance at 6 or 12 months. The results of this study do not support the use of MI to improve walking performance in African American patients with PAD. Trial Registration: ClinicalTrials.gov Identifier: NCT01321086.