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      Screening Physical Activity in Family Practice: Validity of the Spanish Version of a Brief Physical Activity Questionnaire

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          Abstract

          Objectives

          The use of brief screening tools to identify inactive patients is essential to improve the efficiency of primary care-based physical activity (PA) programs. However, the current employment of short PA questionnaires within the Spanish primary care pathway is unclear. This study evaluated the validity of the Spanish version of a Brief Physical Activity Assessment Tool (SBPAAT).

          Methods

          A validation study was carried out within the EVIDENT project. A convenience sample of patients (n = 1,184; age 58.9±13.7 years; 60.5% female) completed the SBPAAT and the 7-day Physical Activity Recall (7DPAR) and, in addition, wore an accelerometer (ActiGraph GT3X) for seven consecutive days. Validity was evaluated by measuring agreement, Kappa correlation coefficients, sensitivity and specificity in achieving current PA recommendations with the 7DPAR. Pearson correlation coefficients with the number of daily minutes engaged in moderate and vigorous intensity PA according to the accelerometer were also assessed. Comparison with accelerometer counts, daily minutes engaged in sedentary, light, moderate, and vigorous intensity PA, total daily kilocalories, and total PA and leisure time expenditure (METs-hour-week) between the sufficiently and insufficiently active groups identified by SBPAAT were reported.

          Results

          The SBPAAT identified 41.3% sufficiently active (n = 489) and 58.7% insufficiently active (n = 695) patients; it showed moderate validity (k = 0.454, 95% CI: 0.402–0.505) and a specificity and sensitivity of 74.3% and 74.6%, respectively. Validity was fair for identifying daily minutes engaged in moderate (r = 0.215, 95% CI:0.156 to 0.272) and vigorous PA (r = 0.282, 95% CI:0.165 to 0.391). Insufficiently active patients according to the SBPAAT significantly reported fewer counts/minute (-22%), fewer minutes/day of moderate (-11.38) and vigorous PA (-2.69), spent fewer total kilocalories/day (-753), and reported a lower energy cost (METs-hour-week) of physical activities globally (-26.82) and during leisure time (-19.62).

          Conclusions

          The SBPAAT is a valid tool to identify Spanish-speaking patients who are insufficiently active to achieve health benefits.

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          Most cited references17

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          Calibration of the Computer Science and Applications, Inc. accelerometer.

          We established accelerometer count ranges for the Computer Science and Applications, Inc. (CSA) activity monitor corresponding to commonly employed MET categories. Data were obtained from 50 adults (25 males, 25 females) during treadmill exercise at three different speeds (4.8, 6.4, and 9.7 km x h(-1)). Activity counts and steady-state oxygen consumption were highly correlated (r = 0.88), and count ranges corresponding to light, moderate, hard, and very hard intensity levels were or = 9499 cnts x min(-1), respectively. A model to predict energy expenditure from activity counts and body mass was developed using data from a random sample of 35 subjects (r2 = 0.82, SEE = 1.40 kcal x min(-1)). Cross validation with data from the remaining 15 subjects revealed no significant differences between actual and predicted energy expenditure at any treadmill speed (SEE = 0.50-1.40 kcal x min(-1)). These data provide a template on which patterns of activity can be classified into intensity levels using the CSA accelerometer.
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            Assessment of physical activity by self-report: status, limitations, and future directions.

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              Calibration of accelerometer output for adults.

              This paper reviews the collective experience of monitor calibration studies in adults and seeks to answer the following questions: What has been done? What have we learned? What could be done to further enhance the comparability of results from future calibration research? Calibration studies in adults have typically used oxygen consumption as a criterion measure, similar types of source activities, and linear regression to obtain prediction equations that calibrate the activity counts to measured activity intensity levels. However, the methodological diversity of these studies has produced a great deal of variation in the resulting prediction equations and cut points, even when using the same monitor. Thus, data obtained from a relatively robust activity monitoring technology that captures many dynamic physical activities reasonably well have been splintered by the calibration process into a wide range of summary measures that are much less comparable than they could otherwise be. This heterogeneity in calibration results reduces our ability to interpret data obtained from accelerometers between different research groups, across the life span, between populations, and probably between the different monitor types. This report reviews and critiques methods typically used for developing calibration equations and determining activity count cut points for identifying specific intensities of PA among adults, and it highlights the need for flexible research methods that can enhance the comparability of results from future calibration studies.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                17 September 2015
                2015
                : 10
                : 9
                : e0136870
                Affiliations
                [1 ]Sport and Physical Activity Research Group (GREAF), Department of Physical Activity Sciences, Centre for Health and Social Care Research (CEES), University of Vic-Central University of Catalonia (UVic-UCC), Barcelona, Spain
                [2 ]Department of Medicine, Universitat Autònoma de Barcelona, Passeig de Sant Joan Health Center, Catalan Health Service, Barcelona, Spain
                [3 ]Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
                [4 ]School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Valles, Spain
                [5 ]Ca N’Oriac Health Centre. Catalan, Health Service, Spain
                [6 ]Torre Ramona Health Center, Aragón Health Service, Zaragoza, Spain
                [7 ]Primary Care Research Unit, The Alamedilla Health Center, Castilla and Leon Health Service–SACYL, Salamanca, Spain
                [8 ]Occupational Therapy, Logopedia and Nursing Faculty, University of Castilla-La Mancha, Spain
                [9 ]Primary Care Research Unit of Bizkaia, Basque Health Care Service-Osakidetza, Bilbao, Spain
                [10 ]Primary care research unit of Valladolid, Castilla y León Health Service, Valladolid, Spain
                [11 ]Primary Care Research Unit, The Alamedilla Health Center, Castilla and Leon Health Service–SACYL, IBSAL, and Department of Medicine, University of Salamanca, Salamanca, Spain
                Texas Tech University Health Science Centers, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: JIRR LGO. Performed the experiments: JIRR LGO CMC. Analyzed the data: APR CMC EP JR. Wrote the paper: APR,CMC EP JR. Read the draft critically: MR, JFMB, JIRR, BRM, MSA, IRG, LGO. Made scientific and writing contributions to improve manuscript's quality: MR, JFMB, JIRR, BRM, MSA, IRG, LGO. Approved the final text: MR, JFMB, JIRR, BRM, MSA, IRG, LGO.

                ¶ Membership of the EVIDENT Group is provided in the Acknowledgments.

                Article
                PONE-D-15-04103
                10.1371/journal.pone.0136870
                4574733
                26379036
                55fa3dab-6ca4-47c8-adef-9f5a77de207c
                Copyright @ 2015

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                : 2 February 2015
                : 9 August 2015
                Page count
                Figures: 2, Tables: 5, Pages: 16
                Funding
                This project was financed by the Carlos III Health Institute of the Ministry of Health in Spain (FIS: PS09/00233, PS09/01057, PS09/01972, PS09/01376, PS09/0164, PS09/01458, RETICS D06/0018) and the Autonomous Government of Castile and Leon (SAN/1778/2009). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

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