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

Reliability of a Brief Intercept Survey for Trail Use Behaviors

Purpose: This study assessed test-retest reliability of an interviewer-administered trail survey. Methods: An intercept survey was conducted with adults using 2 paved trails in Indiana and South Carolina (N = 295; mean age = 46.9 ± 18 y). The survey included items on frequency and duration of trail use for recreation and transportation, other patterns of trail use, and sociodemographic characteristics. Fiftyfive adults completed the survey twice (2–16 d apart; mean = 7.4 ± 2.6 d). Test-retest reliability was assessed with Spearman rank correlation coefficients, Kappa coefficients, and percent agreement. Results: Kappa coefficients and percent agreement for 9 categorical items ranged from 0.65 to 0.96 and from 64.0% to 98.2%, respectively. Among these items, the lowest Kappas were found for perceived safety (0.65) and reported duration of visits for recreational purposes (0.67). Spearman rank correlation coefficients for travel distance to and on the trail and frequency of trail use during the past 7 days and past 4 weeks ranged from 0.62 to 0.93. Conclusion: Though further assessments of this survey with different populations and types of trails may be warranted, its overall high reliability indicates it can be used by researchers and practitioners in its current form

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

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

Subjective Estimation of Physical Activity Using the IPAQ Varies by Fitness Level

Background: Subjective measures of moderate and vigorous physical activity (MVPA) rely on ‘relative’ intensity while objective measures capture ‘absolute’ intensity, thus fit individuals may perceive the same activity differently than unfit individuals. Methods: Adults (N=211) wore the SenseWear Armband (SWA) for ten consecutive days to objectively assess sedentary time and MVPA. On day eight participants completed the International Physical Activity Questionnaire (IPAQ) to subjectively assess sitting time and MVPA. Fitness was assessed via a maximal treadmill test, and participants were classified as ’unfit’ if the result was in the bottom tertile of the study population by sex or ‘fit’ if in the upper two tertiles. Results: Overall, estimates of MVPA between the IPAQ and SWA were not significantly different (IPAQ minus SWA, 67.4±919.1 MVPA minutes/week, P=.29). However, unfit participants overestimated MVPA using the IPAQ by 37.3% (P=.02), but fit participants did not (P=.99). This between-group difference was due to overestimation using the IPAQ of moderate activity by 93.8 minutes/week among the unfit individuals, but underestimation of moderate activity among the fit participants by 149.4 minutes/week. Conclusion: Subjective measures of MVPA using the IPAQ varied by fitness category, with unfit participants overestimating their MVPA and fit participants accurately estimating their MVPA

Patterns of Sedentary Behavior and Mortality in U.S. Middle-Aged and Older Adults: A National Cohort Study

Background: Excessive sedentary time is ubiquitous in Western societies. Previous studies have relied on self-reporting to evaluate the total volume of sedentary time as a prognostic risk factor for mortality and have not examined whether the manner in which sedentary time is accrued (in short or long bouts) carries prognostic relevance. Objective: To examine the association between objectively measured sedentary behavior (its total volume and accrual in prolonged, uninterrupted bouts) and all-cause mortality. Design: Prospective cohort study. Setting: Contiguous United States. Participants: 7985 black and white adults aged 45 years or older. Measurements: Sedentary time was measured using a hip-mounted accelerometer. Prolonged, uninterrupted sedentariness was expressed as mean sedentary bout length. Hazard ratios (HRs) were calculated comparing quartiles 2 through 4 to quartile 1 for each exposure (quartile cut points: 689.7, 746.5, and 799.4 min/d for total sedentary time; 7.7, 9.6, and 12.4 min/bout for sedentary bout duration) in models that included moderate to vigorous physical activity. Results: Over a median follow-up of 4.0 years, 340 participants died. In multivariable-adjusted models, greater total sedentary time (HR, 1.22 [95% CI, 0.74 to 2.02]; HR, 1.61 [CI, 0.99 to 2.63]; and HR, 2.63 [CI, 1.60 to 4.30]; P for trend < 0.001) and longer sedentary bout duration (HR, 1.03 [CI, 0.67 to 1.60]; HR, 1.22 [CI, 0.80 to 1.85]; and HR, 1.96 [CI, 1.31 to 2.93]; P for trend < 0.001) were both associated with a higher risk for all-cause mortality. Evaluation of their joint association showed that participants classified as high for both sedentary characteristics (high sedentary time [≥12.5 h/d] and high bout duration [≥10 min/bout]) had the greatest risk for death. Limitation: Participants may not be representative of the general U.S. population. Conclusion: Both the total volume of sedentary time and its accrual in prolonged, uninterrupted bouts are associated with all-cause mortality, suggesting that physical activity guidelines should target reducing and interrupting sedentary time to reduce risk for death

Association Between Objectively Measured Physical Activity and Cognitive Function in Older Adults—The Reasons for Geographic and Racial Differences in Stroke Study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/116310/1/jgs13829_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/116310/2/jgs13829.pd

Patterns of Sedentary Behavior in US Middle-Age and Older Adults: The REGARDS Study

Purpose The purpose of this study was to examine patterns of objectively-measured sedentary behavior in a national cohort of U.S. middle-aged and older adults and determine factors that influence prolonged sedentary behavior. Methods We studied 8,096 participants from the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study, a population-based study of black and white adults ≥45 years. Seven-day accelerometry was conducted. Prolonged sedentary behavior was defined as accumulating ≥50% of total sedentary time in bouts ≥30 min. Results The number of sedentary bouts ≥20, ≥30, ≥60, and ≥90 min were 8.8 ± 2.3, 5.5 ± 1.9, 1.9 ± 1.1, and 0.8 ± 0.7 bouts/day, respectively. Sedentary bouts ≥20, ≥30, ≥60, and ≥90 min accounted for 60.0 ± 13.9%, 48.0 ± 15.5%, 26.0 ± 15.4%, and 14.2 ± 12.9% of total sedentary time, respectively. Several factors were associated with prolonged sedentary behavior in multivariate-adjusted models (Odds Ratio [95% CI]): older age (65-74 years: 1.99 [1.55-2.57]; ≥75 years: 4.68 [3.61-6.07] vs. 45-54 years), male sex (1.41 [1.28-1.56] vs. female), residence in non-stroke belt/buckle region of U.S. (stroke belt: 0.87 [0.77-0.98]; stroke buckle: 0.86 [0.77-0.95] vs. non-belt/buckle), body mass index (BMI) (overweight: 1.33 [1.18-1.51]; obese: 2.15 [1.89-2.44] vs. normal weight), winter (1.18 [1.03-1.35] vs. summer), and low amounts of moderate-vigorous physical activity (MVPA) [0 min/week: 2.00 [1.66-2.40] vs. ≥150 min/week). Conclusions In this sample of U.S. middle-aged and older adults, a large proportion of total sedentary time was accumulated in prolonged, uninterrupted bouts of sedentary behavior as almost one-half was accumulated in sedentary bouts ≥30 min. Several sociodemographic (age, sex, BMI), behavioral (MVPA), environmental (region), and seasonal factors are associated with patterns of prolonged sedentary behavior

Physical activity outcomes in afterschool programs: A group randomized controlled trial

Afterschool programs (ASPs) across the US are working towards achieving the standard of all children accumulating 30minutes of moderate-to-vigorous physical activity (MVPA) during program time. This study describes the two-year impact of an intervention designed to assist ASPs meeting the 30min/d MVPA standard