Monitoring Physical Activity: Uses and Measurement Issues With Automated Counters

Background: Promotion of physical activity is a public health priority, and environmental factors influence physical activity behavior. Valid and reliable automated measurement tools of physical activity for assessment and evaluation within public settings are needed. Methods: Searches of the research literature and governmental reports from physical activity, transportation, and recreation fields were conducted to identify methods of automated counting and validation studies. The article provides a summary of (a) current methods and uses of automated counters, (b) information about validity and reliability where available, (c) strengths and limitations of each methods, and (d) measurement issues. Results: Existing automated counting technology has strengths and limitations. Infrared sensors have been the most commonly used type of monitor and can mark date and time of passage, but are vulnerable to errors due to environmental conditions; cannot detect more than one person passing at a time; cannot identify mode of activity or distinguish among individuals; and lack consistent and adequate reliability for use in open spaces. Seismic devices and inductive loops may be useful for specific applications. More information is needed concerning the validity and reliability of infrared sensors, seismic devices, and inductive loops for confined areas. Computer imaging systems hold potential to address some of the limitations of author automated counters and for applications in both confined and open areas, but validation research is in the initial stages. Conclusions: Although automated monitoring is a promising method for measurement of physical activity, more research is necessary to determine the acceptable parameters of performance for each type of automated monitor and for which applications each is best suited

Psychometric Properties of the Self-Efficacy for Exercise Questionnaire in a Diverse Sample of Men and Women

Background: Self-efficacy is a consistent correlate of physical activity, but most self-efficacy measures have not been validated in diverse populations. This study examined the construct, criterion-related, and convergent validity and internal consistency of the Self-Efficacy for Exercise Questionnaire. Methods: African American and Caucasian adults (N = 1919) from two adjacent counties in South Carolina were identified through a list-assisted random digit-dialed telephone survey. Psychometric properties of the measure were assessed by gender, race, age, education, and body weight subgroups. Results: Across all subgroups, a single-factor solution explained 93 to 98% of the common variance in an exploratory factor analysis, and all 14 items had factor loadings exceeding 0.40. Higher exercise self-efficacy was significantly associated with greater physical activity, younger age, male gender, higher education, and lower body weight, as predicted. Internal consistency was high for all subgroups (α = 0.90 to 0.94). Conclusion: The Self-Efficacy for Exercise Questionnaire appears to be a valid and reliable measure for use with diverse populations

Perceived Individual, Social, and Environmental Factors for Physical Activity and Walking

Background: Few studies have explored associations of individual, social, and environmental factors with physical and walking behavior. Methods: A random-digit-dial questionnaire, which included selected individual, social, and environmental variables, was administered to 2025 adults, age 18 y and older, in two adjacent counties in a southeastern state. Logistic regressions were conducted adjusting for age, race, sex, education, and employment. Results: In multivariate models, somewhat different variables were associated with physical activity versus regular walking. Self-efficacy (OR = 19.19), having an exercise partner (OR = 1.47), recreation facilities (OR = 1.54), and safety of trails from crime (OR = 0.72) were associated with physical activity level; while self-efficacy (OR = 4.22), known walking routes (OR = 1.54), recreation facilities (OR = 1.57-1.59), and safety of trails from crime (OR = 0.69) were associated with regular walking behavior. Conclusions: Physical activity and walking behaviors were associated with similar variables in this study

The Effect of Question Order on Reporting Physical Activity and Walking Behavior

Background: Question order might affect self-reported regular physical activity (PA) measured with items from the Behavioral Risk Factor Surveillance System (BRFSS) PA module. Methods: A telephone survey was conducted using 2 forms (N = 1004, N = 212) with varying PA question order. The standard form presented moderate-PA, vigorous-PA, and walking questions, in that order, whereas the alternate form presented walking questions, followed by moderate-PA, and then vigorous-PA questions. Weighted, adjusted rates of vigorous PA, walking, meeting the Centers for Disease Control and Prevention (CDC) recommendation for moderate or vigorous PA, and moderate PA from each form were compared. Results: Vigorous PA and walking were similar regardless of question order. Meeting the CDC recommendation for moderate or vigorous PA was reported less often with the alternate form among 18- to 34-year-olds. Less moderate PA was reported with the alternate form overall and among 18- to 34-year-olds, women, whites, and those with a high school education or less. Conclusion: Estimating PA and walking across sociodemographic strata with differing patterns of PA requires asking moderate-PA and vigorous-PA questions before walking questions. Asking walking questions first might lead to bias, especially for moderate PA. Walking, added to a survey with BRFSS moderate and vigorous PA items, should be placed after moderate and vigorous PA. Walking questions first may cause bias, especially for moderate PA

A Randomized Trial of a Diet and Exercise Intervention for Overweight and Obese Women from Economically Disadvantaged Neighborhoods: Sisters Taking Action for Real Success (STARS)

Background - Lower socioeconomic status at both the individual and neighborhood level is associated with increased health risks. Weight loss can reduce this risk, but few high quality weight loss studies target this population. Objectives - STARS tests a culturally-appropriate, group-based behavioral and social support intervention on body weight and waist circumference in women from financially disadvantaged neighborhoods. Design - A stratified (by BMI) randomized trial. Randomization to group was generated by a random numbers table with allocation concealment by opaque envelopes. Methods - Participants 25-50 years who had a BMI ≥ 25 kg/m2 and a waist circumference ≥ 88 cm were recruited from 18 census tracts in Columbia, SC with high rates of poverty between November 2008 and November 2010. All participants received a dietary and exercise counseling session. Intervention participants then receive 16 theoretically-based and tailored weekly group sessions followed by 8 weeks of telephone maintenance counseling. Control participants receive 16 weekly health education mailings. Measurements correspond to baseline, post-group intervention, and post-telephone counseling, and for intervention participants, after a 12-week no-contact period. Measurement staff was blinded to group assignment. Results - Participants (N=155; n=80 intervention, n=75 minimal intervention control) were primarily African American (86.5%) and averaged 38.9 years with a mean BMI of 40.1 kg/m2 and waist circumference of 115.4 cm. Food insecurity was reported by 43% of participants. Summary - STARS targeted an underserved population with an innovative, tailored, and theoretically-grounded, group-based intervention followed by telephone maintenance. If effective, the approach has the potential to be feasible and cost-effective for community delivery

Using Focus Groups in the Consumer Research Phase of a Social Marketing Program to Promote Moderate-Intensity Physical Activity and Walking Trail Use in Sumter County, South Carolina

INTRODUCTION: The use of social marketing approaches in public health practice is increasing. Using marketing concepts such as the "four Ps" (product, price, place, and promotion), social marketing borrows from the principles of commercial marketing but promotes beneficial health behaviors. Consumer research is used to segment the population and develop a strategy based on those marketing concepts. In a community-based participatory research study, 17 focus groups were used in consumer research to develop a social marketing program to promote walking and other moderate-intensity physical activities. METHODS: Two phases of focus groups were conducted. Phase 1 groups, which included both men and women, were asked to respond to questions that would guide the development of a social marketing program based on social marketing concepts. Phase 1 also determined the intervention's target audience, which was irregularly active women aged 35 to 54. Phase 2 groups, composed of members of the target audience, were asked to further define the product and discuss specific promotion strategies. RESULTS: Phase 1 participants determined that the program product, or target behavior, should be walking. In addition, they identified price, place, and promotion strategies. Phase 2 participants determined that moderate-intensity physical activity is best promoted using the term exercise and offered suggestions for marketing walking, or exercise, to the target audience. CONCLUSION: There have been few published studies of social marketing campaigns to promote physical activity. In this study, focus groups were key to understanding the target audience in a way that would not have been accomplished with quantitative data alone. The group discussions generated important insights into values and motivations that affect consumers' decisions to adopt a product or behavior. The focus group results guided the development of a social marketing program to promote physical activity in the target audience in Sumter County, South Carolina

How does community context influence coalitions in the formation stage? a multiple case study based on the Community Coalition Action Theory

<p>Abstract</p> <p>Background</p> <p>Community coalitions are rooted in complex and dynamic community systems. Despite recognition that environmental factors affect coalition behavior, few studies have examined how community context impacts coalition formation. Using the Community Coalition Action theory as an organizing framework, the current study employs multiple case study methodology to examine how five domains of community context affect coalitions in the formation stage of coalition development. Domains are history of collaboration, geography, community demographics and economic conditions, community politics and history, and community norms and values.</p> <p>Methods</p> <p>Data were from 8 sites that participated in an evaluation of a healthy cities and communities initiative in California. Twenty-three focus groups were conducted with coalition members, and 76 semi-structured interviews were conducted with local coordinators and coalition leaders. Cross-site analyses were conducted to identify the ways contextual domains influenced selection of the lead agency, coalition membership, staffing and leadership, and coalition processes and structures.</p> <p>Results</p> <p>History of collaboration influenced all four coalition factors examined, from lead agency selection to coalition structure. Geography influenced coalition formation largely through membership and staffing, whereas the demographic and economic makeup of the community had an impact on coalition membership, staffing, and infrastructure for coalition processes. The influence of community politics, history, norms and values was most noticeable on coalition membership.</p> <p>Conclusions</p> <p>Findings contribute to an ecologic and theory-based understanding of the range of ways community context influences coalitions in their formative stage.</p