The vagaries of self-reports of physical activity: A problem revisited and addressed in a study of exercise promotion in the over 65s in general practice
St George's, University of London, Londinium, England, United Kingdom Family Practice
(Impact Factor: 1.86).
05/1999; 16(2):152-7. DOI: 10.1093/fampra/16.2.152
The assessment of levels of physical activity relies upon suitable measurement tools.
We aimed to investigate whether a practice nurse, using a motivational interview technique, could encourage older patients to increase their physical activity.
Health and well-being were monitored at baseline and 8 weeks following intervention. Physical activity levels were ascertained using both a self-report measure and ambulatory heart-rate monitoring.
Whilst patients reported higher levels of physical activity at follow-up, this finding was not confirmed by the heart-rate data.
The study concludes that patients tend to overestimate the amount of physical activity undertaken and that ambulatory heart-rate monitoring may be more useful for verifying actual behaviour.
Available from: Nicola Casartelli
- "Personality traits, social desirability and social approval were recognized to be possible sources of systematic bias
. Since TKA patients are encouraged by doctors and therapists to exercise, we suppose that patients in this study tended to overestimate their physical activity to attain social approval and desirability of the investigator at the first session
. In contrast, knowing that the PASE total score referred to the week objectively assessed by the accelerometer, patients committed to report their physical activities more precisely and truthfully at the second session. "
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ABSTRACT: The need for valid and reproducible questionnaires to routinely assess the physical activity level of patients after total knee arthroplasty (TKA) is of particular concern in clinical settings. Aims of this study were to evaluate the validity and reproducibility of the physical activity scale for the elderly (PASE) questionnaire in TKA patients, with a particular view on gender differences.
A total of 50 elderly patients (25 women and 25 men aged 70 ± 6 years) following primary unilateral TKA were recruited. The reproducibility was evaluated by administering the PASE questionnaire during two occasions separated by 7 days. The construct (criterion) validity was investigated by comparing the physical activity level reported by patients in the PASE questionnaire to that measured by accelerometry. Reproducibility was evaluated using intraclass correlation coefficients (ICC3,1) for reliability and standard error of measurement (SEM) and smallest detectable change (SDC) for agreement, while validity was investigated with Pearson correlation coefficients.
Reliability of the PASE total score was acceptable for men (ICC = 0.77) but not for women (ICC = 0.58). Its agreement was low for both men and women, as witnessed by high SEM (32% and 35%, respectively) and SDC (89% and 97%, respectively). Construct validity of the PASE total score was low in both men (r = 0.45) and women (r = 0.06).
The PASE questionnaire has several validity and reproducibility shortcomings, therefore its use is not recommended for the assessment of physical activity level in patients after TKA, particularly in women.
- "Self-report was the primary method used for outcome measurement in all studies, and this method is subject to recall and social desirability bias, and a Hawthorn effect was identified in one (Sims, Smith, Duffy & Hilton, 1999). Randomization by patient was utilized in five of the studies, and this design style is susceptible to cross contamination and may result in carry-over effects, as there is the potential for the PCP to unintentionally deliver counseling to control subjects (Armit et al., 2009;Burton et al., 1995;Pfeiffer et al., 2001;Pinto et al., 2005;Sims et al., 1999). Analysis by intention to treat is an appropriate form of analysis for this style of research because of the high potential for dropout; however, this was only reported to be used in six of the studies (Armit et al., 2009;Burton et al., 1995;Kerse et al., 1999;Petrella et al., 2003;Pfeiffer et al., 2001;Pinto et al., 2005). "
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ABSTRACT: This integrative review identifies and examines research literature focused on physical activity promotion provided in primary care settings to older adult patients in order to evaluate the effectiveness of provider-delivered interventions on elders short- and long-term activity levels.
A comprehensive review of original research published in English from all countries through May 2010 was performed. Relevant literature was identified through MEDLINE, CINAHL, and ProQuest on-line databases. Data from 11 unique studies were systematically extracted and summarized in table format.
Activity interventions delivered in primary care can produce at least short term increases in activity; however, there is limited evidence to evaluate whether long-term changes can be achieved and thus making the case for future longitudinal studies.
Tailored activity prescriptions should be provided after holistic patient assessment. Activity counseling requires recognition as a billable service and further study is needed to identify the most efficient intervention. Inclusion of health-economic evaluations in future research could reveal if efforts to improve physical activity levels are an efficient use of resources.
Available from: Holly Blake
- "Most primary prevention studies rely on participants' self-reports of physical activity levels, and these levels are often over-and under-reported. Studies find disagreement between self-reported levels of physical activity and levels measured using other methods such as accelerometers, pedometers, heart rate monitors, and direct observation, and usually find that physical activity levels are over-reported and sedentary activities are under-reported (DOH, 2010; Prince et al, 2008; Sims et al, 1999). This may be due to inaccurate recall, or due to social desirability bias, where respondents report levels of activity which will be seen as more favourable (Adams et al, 2005). "
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