IntroductionNo tool currently used by primary health care providers to assess physical activity has been evaluated for its ability to determine whether or not patients achieve recommended levels of activity. The purpose of this study was to assess concurrent validity of physical activity self-reported to the brief (<30 sec) Physical Activity “Vital Sign” questionnaire (PAVS) compared with responses to the lengthier (3–5 min), validated Modifiable Activity Questionnaire (MAQ).MethodsAgreement between activity reported to the PAVS and MAQ by primary care patients at 2 clinics in 2014 was assessed by using percentages and κ coefficients. Agreement consisted of meeting or not meeting the 2008 Aerobic Physical Activity Guidelines for Americans (PA Guidelines) of the US Department of Health and Human Services. We compared self-reported usual minutes per week of moderate-to-vigorous physical activity among patients at a primary care clinic in 2014 who reported to PAVS and to MAQ by using Pearson correlation and Bland–Altman plots of agreement.ResultsAmong 269 consenting patients who reported physical activity, PAVS results agreed with those of MAQ 89.6% of the time and demonstrated good agreement in identifying patients who did not meet PA Guidelines recommendations (κ = 0.55, ρ = 0.57; P < .001). Usual minutes per week of moderate-to-vigorous physical activity reported to PAVS had a high positive correlation with the same reported to MAQ (r = 0.71; P < .001).ConclusionPAVS may be a valid tool for identifying primary care patients who need counseling about physical activity. PAVS should be assessed further for agreement with repeated objective measures of physical activity in the patient population.

The strong association of the PAVS found with patient BMI and moderately-strong association with disease burden supports initial predictive validity of the PAVS recorded in EHRs. PA recorded in EHRs may be vastly useful for assessing patient disease and cost burdens attributed independently to PA behavior.

Background: To date, no physical activity (PA) questionnaires intended for primary care have been compared against a criterion measure of PA and current (2008) aerobic PA recommendations of the American College of Sports Medicine/American Heart Association (ACSM/AHA). Aim: This study evaluated preliminary evidence for criterion validity of two brief (<1 min) PA questionnaires with accelerometry, and their ability to identify if individuals meet ACSM/AHA PA recommendations. Methods: 45 health clinic staff wore an accelerometer for seven consecutive days and afterwards completed two brief PA questionnaires, the Physical Activity Vital Sign (PAVS), and the Speedy Nutrition and Physical Activity Assessment (SNAP). Agreement and descriptive statistics were calculated between the PAVS or SNAP and accelerometry in order to measure each questionnaire's ability to quantify the number of days participants achieved ⩾30 min of moderate-vigorous PA (MVPA) performed in bouts of ⩾10 continuous minutes. Participants with <5 days of ⩾30 bout-min of MVPA were considered insufficiently active according to PA recommendations. Findings: There was a significant positive correlation between number of days with ⩾30 bout-min MVPA and the PAVS (r = 0.52, P < 0.001), and SNAP (r = 0.31, P < 0.05). The PAVS had moderate agreement with accelerometry for identifying if individuals met or did not meet PA recommendations (κ = 0.46, P < 0.001), whereas SNAP had poor agreement (κ = 0.12, P < 0.05). Conclusions: This study provides preliminary evidence of criterion validity of the PAVS and SNAP with accelerometry and agreement identifying if respondents meet current (2008) ACSM/AHA aerobic PA recommendations. The PAVS and SNAP should be evaluated further for repeatability, and in populations varying in PA levels, age, gender, and ethnicity.

Introduction. Most dietary questionnaires are not created for use in a clinical setting for an adult health exam. We created the Healthy Eating Vital Sign (HEVS) to assess eating behaviors associated with excess weight. This study investigated the validity and reliability of the HEVS. Methods. Using a cross-sectional study design, participants responded to the HEVS and the Block Food Frequency Questionnaire (BFFQ). We analyzed the data descriptively, and, with Pearson's correlation and Cronbach coefficient alpha. Results. We found moderate correlation (rho > 0.3) between multiple items of the HEVS and BFFQ. The Cronbach's alpha was 0.49. Conclusion. Our results support the criterion validity and internal reliability of the HEVS as compared to the BFFQ. The HEVS can help launch a dialogue between patients and providers to monitor and potentially manage dietary behaviors associated with many chronic health conditions, including obesity.

Background: Physical inactivity is a risk factor for many chronic conditions. This retrospective cohort study examined associations between physical activity (PA) with health care utilization (HU). Methods: A PA vital sign was recorded in clinics from January 2018 to December 2020. Patients were categorized as inactive, insufficiently active, or sufficiently active by US PA aerobic guidelines. Associations between PA vital sign and visits (inpatient admissions, emergency department, urgent care, and primary care) were estimated using population average regression by visit type. Results: 23,721 patients had at least one PA vital sign recorded, with a mean age of 47.3 years and mean body mass index (BMI) of 28; 52% were female and 63% were White. Sufficiently active patients were younger, male, White, and had lower BMI than insufficiently active patients. Achieving 150 minutes per week of moderate to vigorous PA per 1000 patient years was associated with 34 fewer emergency department visits (P < .001), 19 fewer inpatient admissions (P < .001), and 38 fewer primary care visits (P < .001) compared with inactive patients. Stronger associations between lower PA and higher HU were present among those who were older or had a higher comorbidity. BMI, sex, ethnicity, and race did not modify the association between PA and HU. Conclusions: Meeting aerobic guidelines was associated with reduced HU for inpatient, primary care, and emergency department visits.