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      Measuring physical activity-related environmental factors: reliability and predictive validity of the European environmental questionnaire ALPHA

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          Abstract

          Background

          A questionnaire to assess physical activity related environmental factors in the European population (a 49-item and an 11-item version) was created as part of the framework of the EU-funded project "Instruments for Assessing Levels of PHysical Activity and fitness (ALPHA)". This paper reports on the development and assessment of the questionnaire's test-retest stability, predictive validity, and applicability to European adults.

          Methods

          The first pilot test was conducted in Belgium, France and the UK. In total 190 adults completed both forms of the ALPHA questionnaire twice with a one-week interval. Physical activity was concurrently measured (i) by administration of the long version of the International Physical Activity Questionnaire (IPAQ) by interview and (ii) by accelerometry (Actigraph™ device). After adaptations, the second field test took place in Belgium, the UK and Austria; 166 adults completed the adapted questionnaire at two time points, with minimum one-week interval. In both field studies intraclass correlation coefficients (ICC) and proportion of agreement were computed to assess the stability of the two test scores. Predictive validity was examined in the first field test by correlating the results of the questionnaires with physical activity data from accelerometry and long IPAQ-last 7 days.

          Results

          The reliability scores of the ALPHA questionnaire were moderate-to good in the first field testing (ICC range 0.66 - 0.86) and good in the second field testing (ICC range 0.71 - 0.87). The proportion of agreement for the ALPHA short increased significantly from the first (range 50 - 83%) to the second field testing (range 85 - 95%). Environmental scales from both versions of the ALPHA questionnaire were significantly associated with self-reported minutes of transport-related walking, and objectively measured low intensity physical activity levels, particularly in women. Both versions were easily administered with an average completion time of six minutes for the 49-item version and less than two minutes for the short version.

          Conclusion

          The ALPHA questionnaire is an instrument to measure environmental perceptions in relation to physical activity. It appears to have good reliability and predictive validity. The questionnaire is now available to other researchers to investigate its usefulness and applicability across Europe.

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          Most cited references21

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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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            Environmental factors associated with adults' participation in physical activity: a review.

            N Humpel (2002)
            Promoting physical activity is a public health priority, and changes in the environmental contexts of adults' activity choices are believed to be crucial. However, of the factors associated with physical activity, environmental influences are among the least understood. Using journal scans and computerized literature database searches, we identified 19 quantitative studies that assessed the relationships with physical activity behavior of perceived and objectively determined physical environment attributes. Findings were categorized into those examining five categories: accessibility of facilities, opportunities for activity, weather, safety, and aesthetic attributes. Accessibility, opportunities, and aesthetic attributes had significant associations with physical activity. Weather and safety showed less-strong relationships. Where studies pooled different categories to create composite variables, the associations were less likely to be statistically significant. Physical environment factors have consistent associations with physical activity behavior. Further development of ecologic and environmental models, together with behavior-specific and context-specific measurement strategies, should help in further understanding of these associations. Prospective studies are required to identify possible causal relationships.
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              Understanding environmental influences on walking; Review and research agenda.

              Understanding how environmental attributes can influence particular physical activity behaviors is a public health research priority. Walking is the most common physical activity behavior of adults; environmental innovations may be able to influence rates of participation. Review of studies on relationships of objectively assessed and perceived environmental attributes with walking. Associations with environmental attributes were examined separately for exercise and recreational walking, walking to get to and from places, and total walking. Eighteen studies were identified. Aesthetic attributes, convenience of facilities for walking (sidewalks, trails); accessibility of destinations (stores, park, beach); and perceptions about traffic and busy roads were found to be associated with walking for particular purposes. Attributes associated with walking for exercise were different from those associated with walking to get to and from places. While few studies have examined specific environment-walking relationships, early evidence is promising. Key elements of the research agenda are developing reliable and valid measures of environmental attributes and walking behaviors, determining whether environment-behavior relationships are causal, and developing theoretical models that account for environmental influences and their interactions with other determinants.
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                Author and article information

                Journal
                Int J Behav Nutr Phys Act
                The International Journal of Behavioral Nutrition and Physical Activity
                BioMed Central
                1479-5868
                2010
                26 May 2010
                : 7
                : 48
                Affiliations
                [1 ]Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
                [2 ]Centre for Sport and Exercise Research, Staffordshire University, Leek Road, Stoke-on-Trent, Staffordshire ST4 2DF, UK
                [3 ]Nutritional Epidemiology Unit, UMR INSERM U557/INRA U1125/CNAM/University Paris 13, CRNH IdF, 93017 Bobigny, France
                [4 ]Department of Nutrition, Pitie-Salpetriere Hospital (AP-HP), University Pierre et Marie Curie-Paris6, CRNH IdF, 75013 Paris, France
                [5 ]Institute of Sports Science, University of Graz, Mozartgasse 14, 8010 Graz, Austria
                [6 ]Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK
                [7 ]National Obesity Observatory, 4150 Chancellor Court, Oxford OX4 2GX, UK
                [8 ]Urho Kaleva Kekkonen Institute for Health Promotion Research, FIN-33500 Tampere, Finland
                [9 ]Karolinska Institute, Department of Biosciences, Preventive Nutrition, Novum, 141 57 Huddinge, Sweden
                Article
                1479-5868-7-48
                10.1186/1479-5868-7-48
                2892430
                20504339
                e18d0069-bb22-4cc9-9abc-bb08c9568786
                Copyright ©2010 Spittaels et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 November 2009
                : 26 May 2010
                Categories
                Research

                Nutrition & Dietetics
                Nutrition & Dietetics

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