Reliability and validity of three questionnaires measuring context-specific sedentary behaviour and associated correlates in adolescents, adults and older adults

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Abstract

Background

Reliable and valid measures of total sedentary time, context-specific sedentary behaviour (SB) and its potential correlates are useful for the development of future interventions. The purpose was to examine test-retest reliability and criterion validity of three newly developed questionnaires on total sedentary time, context-specific SB and its potential correlates in adolescents, adults and older adults.

Methods

Reliability and validity was tested in six different samples of Flemish (Belgium) residents. For the reliability study, 20 adolescents, 22 adults and 20 older adults filled out the age-specific SB questionnaire twice. Test-retest reliability was analysed using Kappa coefficients, Intraclass Correlation Coefficients and/or percentage agreement, separately for the three age groups. For the validity study, data were retrieved from 62 adolescents, 33 adults and 33 older adults, with activPAL™ as criterion measure. Spearman correlations and Bland-Altman plots (or non-parametric approach) were used to analyse criterion validity, separately for the three age groups and for weekday, weekend day and average day.

Results

The test-retest reliability for self-reported total sedentary time indicated following values: ICC = 0.37-0.67 in adolescents; ICC = 0.73-0.77 in adults; ICC = 0.68-0.80 in older adults. Item-specific reliability results (e.g. context-specific SB and its potential correlates) showed good-to-excellent reliability in 67.94 %, 68.90 % and 66.38 % of the items in adolescents, adults and older adults respectively. All items belonging to sedentary-related equipment and simultaneous SB showed good reliability. The sections of the questionnaire with lowest reliability were: context-specific SB (adolescents), potential correlates of computer use (adults) and potential correlates of motorized transport (older adults). Spearman correlations between self-reported total sedentary time and the activPAL™ were different for each age group: ρ = 0.02-0.42 (adolescents), ρ = 0.06-0.52 (adults), ρ = 0.38-0.50 (older adults). Participants over-reported total sedentary time (except for weekend day in older adults) compared to the activPAL™, for weekday, weekend day and average day respectively by +57.05 %, +46.29 %, +53.34 % in adolescents; +40.40 %, +19.15 %, +32.89 % in adults; +10.10 %, −6.24 %, +4.11 % in older adults.

Conclusions

The questionnaires showed acceptable test-retest reliability and criterion validity. However, over-reporting of total SB was noticeable in adolescents and adults. Nevertheless, these questionnaires will be useful in getting context-specific information on SB.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-015-0277-2) contains supplementary material, which is available to authorized users.

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Most cited references 40

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Measuring agreement in method comparison studies.

Elliot Bland, Michael Altman (1999)

Agreement between two methods of clinical measurement can be quantified using the differences between observations made using the two methods on the same subjects. The 95% limits of agreement, estimated by mean difference +/- 1.96 standard deviation of the differences, provide an interval within which 95% of differences between measurements by the two methods are expected to lie. We describe how graphical methods can be used to investigate the assumptions of the method and we also give confidence intervals. We extend the basic approach to data where there is a relationship between difference and magnitude, both with a simple logarithmic transformation approach and a new, more general, regression approach. We discuss the importance of the repeatability of each method separately and compare an estimate of this to the limits of agreement. We extend the limits of agreement approach to data with repeated measurements, proposing new estimates for equal numbers of replicates by each method on each subject, for unequal numbers of replicates, and for replicated data collected in pairs, where the underlying value of the quantity being measured is changing. Finally, we describe a nonparametric approach to comparing methods.

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Sedentary Behavior and Health Outcomes: An Overview of Systematic Reviews

Leandro de Rezende, Maurício Rodrigues Lopes, Juan Rey-López … (2014)

Objective 1) To synthesize the current observational evidence for the association between sedentary behavior and health outcomes using information from systematic reviews. 2) To assess the methodological quality of the systematic reviews found. Methodology/Principal Findings Medline; Excerpta Medica (Embase); PsycINFO; and Web of Science were searched for reviews published up to September 2013. Additional publications were provided by Sedentary Behaviour Research Network members. The methodological quality of the systematic reviews was evaluated using recommended standard criteria from AMSTAR. For each review, improper use of causal language in the description of their main results/conclusion was evaluated. Altogether, 1,044 review titles were identified, 144 were read in their entirety, and 27 were included. Based on the systematic reviews with the best methodological quality, we found in children and adolescents, strong evidence of a relationship between time spent in sedentary behavior and obesity. Moreover, moderate evidence was observed for blood pressure and total cholesterol, self-esteem, social behavior problems, physical fitness and academic achievement. In adults, we found strong evidence of a relationship between sedentary behavior and all-cause mortality, fatal and non-fatal cardiovascular disease, type 2 diabetes and metabolic syndrome. In addition, there is moderate evidence for incidence rates of ovarian, colon and endometrial cancers. Conclusions This overview based on the best available systematics reviews, shows that sedentary behavior may be an important determinant of health, independently of physical activity. However, the relationship is complex because it depends on the type of sedentary behavior and the age group studied. The relationship between sedentary behavior and many health outcomes remains uncertain; thus, further studies are warranted.

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Validation of wearable monitors for assessing sedentary behavior.

Sarah Kozey-Keadle, Amanda Libertine, Kate Lyden … (2011)

A primary barrier to elucidating the association between sedentary behavior (SB) and health outcomes is the lack of valid monitors to assess SB in a free-living environment. The purpose of this study was to examine the validity of commercially available monitors to assess SB. Twenty overweight (mean ± SD: body mass index = 33.7 ± 5.7 kg·m(-2)) inactive, office workers age 46.5 ± 10.7 yr were directly observed for two 6-h periods while wearing an activPAL (AP) and an ActiGraph GT3X (AG). During the second observation, participants were instructed to reduce sitting time. We assessed the validity of the commonly used cut point of 100 counts per minute (AG100) and several additional AG cut points for defining SB. We used direct observation (DO) using focal sampling with duration coding to record either sedentary (sitting/lying) or nonsedentary behavior. The accuracy and precision of the monitors and the sensitivity of the monitors to detect reductions in sitting time were assessed using mixed-model repeated-measures analyses. On average, the AP and the AG100 underestimated sitting time by 2.8% and 4.9%, respectively. The correlation between the AP and DO was R2 = 0.94, and the AG100 and DO sedentary minutes was R2 = 0.39. Only the AP was able to detect reductions in sitting time. The AG 150-counts-per-minute threshold demonstrated the lowest bias (1.8%) of the AG cut points. The AP was more precise and more sensitive to reductions in sitting time than the AG, and thus, studies designed to assess SB should consider using the AP. When the AG monitor is used, 150 counts per minute may be the most appropriate cut point to define SB.

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Author and article information

Contributors

Cedric Busschaert: 00 32 9 264 63 11 , Cedric.Busschaert@UGent.be

Ilse De Bourdeaudhuij: Ilse.Debourdeaudhuij@UGent.be

Veerle Van Holle: Veerle.vanholle@ugent.be

Sebastien FM Chastin: Sebastien.Chastin@gcu.ac.uk

Greet Cardon: greet.cardon@ugent.be

Katrien De Cocker: katrien.decocker@ugent.be

Journal

Journal ID (nlm-ta): Int J Behav Nutr Phys Act

Journal ID (iso-abbrev): Int J Behav Nutr Phys Act

Title: The International Journal of Behavioral Nutrition and Physical Activity

Publisher: BioMed Central (London )

ISSN (Electronic): 1479-5868

Publication date (Electronic): 17 September 2015

Publication date PMC-release: 17 September 2015

Publication date Collection: 2015

Volume: 12

Electronic Location Identifier: 117

Affiliations

[ ]Department Movement and Sport Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium

[ ]School of Health and Life Science, Institute of Applied Health Research, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA Scotland UK

[ ]Fund for Scientific Research Flanders (FWO), Egmontstraat 5, 1000 Brussels, Belgium

Article

Publisher ID: 277

DOI: 10.1186/s12966-015-0277-2

PMC ID: 4574538

PubMed ID: 26381488

SO-VID: 334aceef-735e-4bb7-b184-5ec1ee244912

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 5 March 2015

Date accepted : 8 September 2015

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ScienceOpen disciplines: Nutrition & Dietetics

Keywords: adolescents,adults,older adults,questionnaire,validity,reliability,sedentary behaviour

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ScienceOpen disciplines: Nutrition & Dietetics

Keywords: adolescents, adults, older adults, questionnaire, validity, reliability, sedentary behaviour

Reliability and validity of three questionnaires measuring context-specific sedentary behaviour and associated correlates in adolescents, adults and older adults

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Most cited references 40

Measuring agreement in method comparison studies.

Sedentary Behavior and Health Outcomes: An Overview of Systematic Reviews

Validation of wearable monitors for assessing sedentary behavior.

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