Validity and reliability of three self-report instruments for assessing attainment of physical activity guidelines in third level students.

Murphy, J. (1) Woods, C. (1) Murphy, N. (2) MacDonncha, C. (3) Murphy, M. (4)(1) Dublin City University, (2) Waterford Institute of Technology, (3) University of Limerick, (4) University of Ulster

All Ireland Postgraduate Conference

29th April 2016Waterford Institute of Technology

Introduction

• Third level education students comprise a large portion of the population and may wield a sizable degree of future influence in society through their post-graduation roles.

170 million students in 2009

+ 21 million by 2020

• The transition from school to third level education is associated with greater independence in lifestyle choices, allowing students to become involved in more healthy or unhealthy activities.

(Hussain et al. 2013; Dinger et al. 2014; Fotheringham et al. 2000; Owen et al. 2000; Lesliephillip et al. 1999; Sallis et al. 1998)

• Environments which promote sedentary behaviour or physical inactivity are likely to contribute to shaping persistent and potentially long-term physical inactivity patterns.

Introduction

• The regular monitoring and surveillance of population prevalence of physical activity (PA) is of paramount importance.

• A challenge is in establishing a universal measurement tool, one that is psychometrically valid and specifically applies to this young adult population.

• Selecting the appropriate measurement tool depends on the population of interest, the purpose of the study and the required outcome variables.

ValidityReliability

• However, the use of different measures for assessing PA often results in findings which are inconsistent and not comparable.

(Hallal et al. 2012; Ridgers et al. 2012; Chinapaw et al. 2010).

Introduction

Single Item Measure (SIM) IPAQ-SFPACE

2 – item measure1 – item measure 9 – item measure

This monitor is an acceptable criterion measure for evaluating questionnaire validity and is widely used for this purpose.

Actigraph Accelerometer

(Welk 2005; Hardie Murphy et al. 2015; Milton et al. 2013; Craig et al. 2003; Dinger et al. 2014)

Methods

• As part of the SASSI Project a convenience sample was recruited from 5 third level institutions across the island of Ireland (N = 463, 53% male, mean age = 22.2 ± 4.5).

QuestionnaireDay 1

Accelerometer9 days

QuestionnaireDay 9

Methods – Statistical Analysis

• Compliance - Percentage of students achieving the Physical Activity Guidelines (PAGL)

using either an all days method or total minutes method.

• Validity - Spearman Rho Correlations - Levels of Agreement Cross Tabulation Analysis

• Test-retest Reliability - Intraclass Correlations

• Accelerometer - 7 days wear time needed - Troiano cut-points applied

Results

  Total Males Females  7 valid accelerometer days N =190 N =87 N = 103 t-scorePhysical Activity Levels (mean ± SD)         Moderate (mins/day) 48.80 ± 16.95 51.31 ± 15.60 46.68 ±17.81 1.89 Vigorous (mins/day) 6.78 ± 7.27 7.51 ± 7.85 6.16 ± 6.71 1.28 MVPA (mins/day) 55.58 ±20.44 58.82 ± 19.80 52.84 ± 20.67 2.03* Total PA (CPM/day)a 229.28 ± 81.20 241.92 ± 84.93 218.60 ± 76.71 1.99*         Self-Report         Single Measure (days.30.MVPA) 3.51 ± 1.80 3.80 ± 1.80 3.25 ± 1.76 2.13* PACE+ (days.30.MVPA) 3.68 ± 1.66 3.98 ± 1.64 3.43 ±1.65 2.32* IPAQ MVPA (mins/week) 461 ± 403 544 ± 445 392 ± 351 2.62*         Meeting PA guidelines30 mins.5/wk (%)         Single Item Measure 32.1 39.1 26.2 - PACE+ 31.1 37.9 25.2 - Accelerometer (all days method)b 71.6 75.9 68.0 -        -Meeting PA guidelines150 mins/week (%)         IPAQ (MVPA) (mins/week)c 77.4 81.6 73.8 - Accelerometer (total minutes method) 95.8 96.6 95.1 -

* = p<0.05

Results

• IPAQ-SF was the only measure that found a significant association with accelerometer derived minutes of MVPA per day for males (r = 0.34; p<0.01) and females (r = 0.31; p<0.01).

• Levels of agreement reported for the SIM and the PACE+ were low (45.8%), while stronger for the IPAQ-SF (77.9%).

• Interestingly, only females reported significant correlations with the SIM (0.36, p<0.01) and the PACE + measure (0.36, p<0.01).

• Reliability scores were moderate (SIM and IPAQ-SF) to strong (PACE+) in this study suggesting that the each of the measures has suitable reliability for use in this population.

Discussion

• Validity of the IPAQ-SF in 123 university students reported that the IPAQ-SF was significantly associated with the majority of accelerometer variables (r = 0.19-0.23; p<0.05)

• Research has shown the SIM achieve higher levels of correlations with accelerometry derived PA levels ranging from 0.46-0.57 in a study from 2013 (Milton et al. 2013).

• The results of previous studies showed percent agreement values ranging from 58% (for the SIM against accelerometry in adults) (Milton et al. 2013) to 66% (for IPAQ-SF against accelerometry in adults) (Ekelund et al. 2006).

• Reliability scores reported in this study were lower than research suggests for both the SIM (ICC = 0.86) (Milton et al. 2011) and the IPAQ-SF (ICC = 0.71 – 0.89) (Dinger et al. 2006).

Conclusion

• This study would recommend that when assessing levels of high active third level students achieving the PAGL, the IPAQ-SF is the most suitable.

• Other tools are available for PA measurement, especially for measuring the number of days third level students are achieving the PAGL.

• It is important to ensure that suitable measures are selected in future studies, depending on the population and the outcome measure of the studies.

References

• Hussain, R. et al., 2013. Physical and mental health perspectives of first year undergraduate rural university students. BMC public health, 13(1), p.848. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3847612&tool=pmcentrez&rendertype=abstract [Accessed September 29, 2015].

• Dinger, M.K., Brittain, D.R. & Hutchinson, S.R., 2014. Associations between physical activity and health-related factors in a national sample of college students. Journal of American college health : J of ACH, 62(1), pp.67–74. Available at: http://dx.doi.org/10.1080/07448481.2013.849710 [Accessed October 16, 2014].

• Fotheringham, M., Wonnacott, R. & Owen, N., 2000. Computer use and physical inactivity in young adults: public health perils and potentials of new information technologies. Annals of Behavioral Medicine, 22(4), pp.269–75.

• Owen, N. et al., 2000. Environmental determinants of physical activity and sedentary behavior. Exercise and sport sciences reviews, 28(4), pp.153–8.

• Lesliephillip, E. et al., 1999. Insufficiently active Australian college students: perceived personal, social, and environmental influences. Preventive medicine, 28(1), pp.20–7.

• Sallis, J.F., Bauman, A. & Pratt, M., 1998. Environmental and policy interventions to promote physical activity. American Journal of Preventive Medicine, 15(4), pp.379–97.

• Hallal, P.C. et al., 2012. Physical activity levels of the world ’ s population Surveillance progress , gaps and prospects. Lancet, 380(9838), pp.247–257.

• Ridgers, N. et al., 2012. Validity of a brief self-report instrument for assessing compliance with physical activity guidelines amongst adolescents Nicola D . Ridgers , Anna Timperio , David Crawford & Jo Salmon Centre for Physical Activity and Nutrition Research , Deakin Universi. Journal of science and medicine in sport, 15(2), pp.136–141.

• Chinapaw, M. et al., 2010. Physical Activity Questionnaires for Youth. Sports Medicine, 40(7), pp.539–63.• Welk, G.J., 2005. Principles of Design and Analyses for the Calibration of Accelerometry-Based Activity Monitors. Medicine & Science in

Sports & Exercise, 37(11), pp.501–11. • Hardie Murphy, M. et al., 2015. Validity of a two-item physical activity questionnaire for assessing attainment of physical activity guidelines in

youth. BMC public health, 15(1), p.1080. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4619274&tool=pmcentrez&rendertype=abstract [Accessed February 18, 2016].

• Milton, K., Clemes, S. & Bull, F., 2013. Can a single question provide an accurate measure of physical activity? British journal of sports medicine, 47(1), pp.44–8. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22522584 [Accessed October 20, 2015].

• Craig, C.L. et al., 2003. International physical activity questionnaire: 12-country reliability and validity. Medicine and science in sports and exercise, 35(8), pp.1381–95. Available at: http://www.ncbi.nlm.nih.gov/pubmed/12900694 [Accessed July 9, 2014].

Full SASSI Study available at: http://www.studentsport.ie