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      A comparison of self-reported and device measured sedentary behaviour in adults: a systematic review and meta-analysis

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          Abstract

          Background

          Sedentary behaviour (SB) is a risk factor for chronic disease and premature mortality. While many individual studies have examined the reliability and validity of various self-report measures for assessing SB, it is not clear, in general, how self-reported SB (e.g., questionnaires, logs, ecological momentary assessments (EMAs)) compares to device measures (e.g., accelerometers, inclinometers).

          Objective

          The primary objective of this systematic review was to compare self-report versus device measures of SB in adults.

          Methods

          Six bibliographic databases were searched to identify all studies which included a comparable self-report and device measure of SB in adults. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses.

          Results

          The review included 185 unique studies. A total of 123 studies comprising 173 comparisons and data from 55,199 participants were used to examine general criterion validity. The average mean difference was -105.19 minutes/day (95% CI: -127.21, -83.17); self-report underestimated sedentary time by ~1.74 hours/day compared to device measures. Self-reported time spent sedentary at work was ~40 minutes higher than when assessed by devices. Single item measures performed more poorly than multi-item questionnaires, EMAs and logs/diaries. On average, when compared to inclinometers, multi-item questionnaires, EMAs and logs/diaries were not significantly different, but had substantial amount of variability (up to 6 hours/day within individual studies) with approximately half over-reporting and half under-reporting. A total of 54 studies provided an assessment of reliability of a self-report measure, on average the reliability was good (ICC = 0.66).

          Conclusions

          Evidence from this review suggests that single-item self-report measures generally underestimate sedentary time when compared to device measures. For accuracy, multi-item questionnaires, EMAs and logs/diaries with a shorter recall period should be encouraged above single item questions and longer recall periods if sedentary time is a primary outcome of study. Users should also be aware of the high degree of variability between and within tools. Studies should exert caution when comparing associations between different self-report and device measures with health outcomes.

          Systematic review registration

          PROSPERO CRD42019118755

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          Most cited references174

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          Validation of wearable monitors for assessing sedentary behavior.

          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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            Measurement of adults' sedentary time in population-based studies.

            Sedentary time (too much sitting) increasingly is being recognized as a distinct health risk behavior. This paper reviews the reliability and validity of self-reported and device-based sedentary time measures and provides recommendations for their use in population-based studies. The focus is on instruments that have been used in free-living, population-based research in adults. Data from the 2003-2006 National Health and Nutrition Examination Survey are utilized to compare the descriptive epidemiology of sedentary time that arises from the use of different sedentary time measures. A key recommendation from this review is that, wherever possible, population-based monitoring of sedentary time should incorporate both self-reported measures (to capture important domain- and behavior-specific sedentary time information) and device-based measures (to measure both total sedentary time and patterns of sedentary time accumulation). Copyright © 2011 American Journal of Preventive Medicine. All rights reserved.
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              Methods of Measurement in epidemiology: sedentary Behaviour.

              Research examining sedentary behaviour as a potentially independent risk factor for chronic disease morbidity and mortality has expanded rapidly in recent years. We present a narrative overview of the sedentary behaviour measurement literature. Subjective and objective methods of measuring sedentary behaviour suitable for use in population-based research with children and adults are examined. The validity and reliability of each method is considered, gaps in the literature specific to each method identified and potential future directions discussed. To date, subjective approaches to sedentary behaviour measurement, e.g. questionnaires, have focused predominantly on TV viewing or other screen-based behaviours. Typically, such measures demonstrate moderate reliability but slight to moderate validity. Accelerometry is increasingly being used for sedentary behaviour assessments; this approach overcomes some of the limitations of subjective methods, but detection of specific postures and postural changes by this method is somewhat limited. Instruments developed specifically for the assessment of body posture have demonstrated good reliability and validity in the limited research conducted to date. Miniaturization of monitoring devices, interoperability between measurement and communication technologies and advanced analytical approaches are potential avenues for future developments in this field. High-quality measurement is essential in all elements of sedentary behaviour epidemiology, from determining associations with health outcomes to the development and evaluation of behaviour change interventions. Sedentary behaviour measurement remains relatively under-developed, although new instruments, both objective and subjective, show considerable promise and warrant further testing.
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                Author and article information

                Contributors
                stephanie.princeware@canada.ca
                Journal
                Int J Behav Nutr Phys Act
                Int J Behav Nutr Phys Act
                The International Journal of Behavioral Nutrition and Physical Activity
                BioMed Central (London )
                1479-5868
                4 March 2020
                4 March 2020
                2020
                : 17
                : 31
                Affiliations
                [1 ]GRID grid.28046.38, ISNI 0000 0001 2182 2255, Division of Cardiac Prevention and Rehabilitation, , University of Ottawa Heart Institute, ; Ottawa, Canada
                [2 ]GRID grid.415368.d, ISNI 0000 0001 0805 4386, Centre for Surveillance and Applied Research, , Public Health Agency of Canada, ; 785 Carling Avenue, Ottawa, K1A 0K9 Canada
                [3 ]Birmingham Community Healthcare NHS Foundation Trust, Community Cardiac Services, Birmingham, United Kingdom
                [4 ]GRID grid.43710.31, ISNI 0000 0001 0683 9016, Centre for Active Living, University Centre Shrewsbury, , University of Chester, ; Guildhall, Frankwell Quay, Shrewsbury, United Kingdom
                [5 ]GRID grid.28046.38, ISNI 0000 0001 2182 2255, School of Human Kinetics, Faculty of Health Sciences, , University of Ottawa, ; Ottawa, Canada
                [6 ]GRID grid.28046.38, ISNI 0000 0001 2182 2255, School of Epidemiology and Public Health, Faculty of Medicine, , University of Ottawa, ; Ottawa, Canada
                [7 ]GRID grid.139596.1, ISNI 0000 0001 2167 8433, Department of Applied Human Sciences, , University of Prince Edward Island, ; Charlottetown, Canada
                [8 ]GRID grid.7273.1, ISNI 0000 0004 0376 4727, School of Life and Health Sciences, , Aston University, ; Birmingham, United Kingdom
                [9 ]GRID grid.28046.38, ISNI 0000 0001 2182 2255, Health Sciences Library, , University of Ottawa, ; Ottawa, Canada
                Author information
                http://orcid.org/0000-0001-6729-5649
                Article
                938
                10.1186/s12966-020-00938-3
                7055033
                32131845
                7d1d22ee-ffec-4275-8f67-070c625db150
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. 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 in a credit line to the data.

                History
                : 17 October 2019
                : 19 February 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research;
                Award ID: Health System Impact Fellowship
                Award ID: New Investigator
                Award Recipient :
                Categories
                Review
                Custom metadata
                © The Author(s) 2020

                Nutrition & Dietetics
                self-report,device,sedentary behaviour,systematic review
                Nutrition & Dietetics
                self-report, device, sedentary behaviour, systematic review

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