Measuring change in trials of physical activity interventions: a comparison of self-report questionnaire and accelerometry within the PACE-UP trial

Limb, Elizabeth; Ahmad, Shaleen; Cook, Derek G; Kerry, Sally; Ekelund, Ulf; Whincup, Peter H.; Chapot, Victor; Iliffe, Steve; Ussher, Michael; Fox-Rushby, Julia; Furness, Cheryl; Ibison, Judith; DeWilde, Stephen; Harris, Tess

doi:10.1186/s12966-018-0762-5

Cited by 50 publications

(44 citation statements)

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“…Data presented as mean, standard error (SE), or 95% CI were converted to SD using the RevMan calculator. We analyzed objective and self-reported measures separately because self-reported outcomes have a higher risk of over-estimation [ 58 , 59 ]. Although some studies used different actigraph devices, PA measures (eg, steps and intensity of activity) were reported similarly.…”

Section: Methodsmentioning

confidence: 99%

Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Ringeval¹,

Wagner²,

Denford³

et al. 2020

J Med Internet Res

155

113

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Background Unhealthy behaviors, such as physical inactivity, sedentary lifestyle, and unhealthful eating, remain highly prevalent, posing formidable challenges in efforts to improve cardiovascular health. While traditional interventions to promote healthy lifestyles are both costly and effective, wearable trackers, especially Fitbit devices, can provide a low-cost alternative that may effectively help large numbers of individuals become more physically fit and thereby maintain a good health status. Objective The objectives of this meta-analysis are (1) to assess the effectiveness of interventions that incorporate a Fitbit device for healthy lifestyle outcomes (eg, steps, moderate-to-vigorous physical activity, and weight) and (2) to identify which additional intervention components or study characteristics are the most effective at improving healthy lifestyle outcomes. Methods A systematic review was conducted, searching the following databases from 2007 to 2019: MEDLINE, EMBASE, CINAHL, and CENTRAL (Cochrane). Studies were included if (1) they were randomized controlled trials, (2) the intervention involved the use of a Fitbit device, and (3) the reported outcomes were related to healthy lifestyles. The main outcome measures were related to physical activity, sedentary behavior, and weight. All the studies were assessed for risk of bias using Cochrane criteria. A random-effects meta-analysis was conducted to estimate the treatment effect of interventions that included a Fitbit device compared with a control group. We also conducted subgroup analysis and fuzzy-set qualitative comparative analysis (fsQCA) to further disentangle the effects of intervention components. Results Our final sample comprised 41 articles reporting the results of 37 studies. For Fitbit-based interventions, we found a statistically significant increase in daily step count (mean difference [MD] 950.54, 95% CI 475.89-1425.18; P<.001) and moderate-to-vigorous physical activity (MD 6.16, 95% CI 2.80-9.51; P<.001), a significant decrease in weight (MD −1.48, 95% CI −2.81 to −0.14; P=.03), and a nonsignificant decrease in objectively assessed and self-reported sedentary behavior (MD −10.62, 95% CI −35.50 to 14.27; P=.40 and standardized MD −0.11, 95% CI −0.48 to 0.26; P=.56, respectively). In general, the included studies were at low risk for bias, except for performance bias. Subgroup analysis and fsQCA demonstrated that, in addition to the effects of the Fitbit devices, setting activity goals was the most important intervention component. Conclusions The use of Fitbit devices in interventions has the potential to promote healthy lifestyles in terms of physical activity and weight. Fitbit devices may be useful to health professionals for patient monitoring and support. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42019145450; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145450

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Section: Methodsmentioning

confidence: 99%

Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Ringeval¹,

Wagner²,

Denford³

et al. 2020

J Med Internet Res

155

113

View full text Add to dashboard Cite

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“…[59] A possible limitation is that exercise/ physical activity is included in the definition of physical frailty, and as such exercise intervention may improve the definition, but not necessarily the person. This has been a criticism in the literature (especially when using self-reported physical activity [79]) and so well designed clinical trials are still necessary to remove this possible source of bias that may be present in some included studies.…”

Section: Limitationsmentioning

confidence: 99%

Primary care interventions to address physical frailty among community-dwelling adults aged 60 years or older: A meta-analysis

et al. 2020

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IntroductionThe best interventions to address frailty among older adults have not yet been fully defined, and the diversity of interventions and outcome measures makes this process challenging. Consequently, there is a lack of guidance for clinicians and researchers regarding which interventions are most likely to help older persons remain robust and independent. This paper uses meta-analysis to assess effectiveness of primary care interventions for physical frailty among community-dwelling adults aged 60+ and provides an up-to-date synthesis of literature in this area. MethodsPubMed, CINAHL, Cochrane Register of Controlled Trials, and PEDro databases were searched, and RCTs, controlled pilot studies, or trials with similar study designs addressing frailty in the primary care setting among persons aged 60+ were chosen. Study data was abstracted following PRISMA guidelines, then meta-analysis was performed using the random effects model. OPEN ACCESS Citation: Macdonald SH-F, Travers J, Shé ÉN, Bailey J, Romero-Ortuno R, Keyes M, et al. (2020) Primary care interventions to address physical frailty among community-dwelling adults aged 60 years or older: A meta-analysis. PLoS ONE 15(2): e0228821. https://doi.org/10.1371/journal.

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“…An overview of all previously included studies (including the latter two articles) is provided in Electronic Supplementary Material Table S1. In contrast to 2010, we considered the Cambridge Index as a stand-alone instrument which means that we reassessed 14 [100] from the update was excluded after reading the full text because the reported results for responsiveness could not be evaluated with respect to our set of hypotheses. Likewise, another study [82] from the previous review evaluated the sensitivity to change of the CHAMPS but did not use a PA comparison measure or test hypotheses about expected effect sizes.…”

Section: Literature Searchmentioning

confidence: 99%

Current Evidence of Measurement Properties of Physical Activity Questionnaires for Older Adults: An Updated Systematic Review

et al. 2020

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Background Questionnaires provide valuable information about physical activity (PA) behaviors in older adults. Until now, no firm recommendations for the most qualified questionnaires for older adults have been provided. Objectives This review is an update of a previous systematic review, published in 2010, and aims to summarize, appraise and compare the measurement properties of all available self-administered questionnaires assessing PA in older adults. Methods We included the articles evaluated in the previous review and conducted a new search in PubMed, Embase, and SPORTDiscus from September 2008 to December 2019, using the following inclusion criteria (1) the purpose of the study was to evaluate at least one measurement property (reliability, measurement error, hypothesis testing for construct validity, responsiveness) of a self-administered questionnaire; (2) the questionnaire intended to measure PA; (3) the questionnaire covered at least one domain of PA; (4) the study was performed in the general, healthy population of older adults; (5) the mean age of the study population was > 55 years; and (6) the article was published in English. Based on the Quality Assessment of Physical Activity Questionnaires (QAPAQ) checklist, we evaluated the quality and results of the studies. The content validity of all included questionnaires was also evaluated using the reviewers' rating. The quality of the body of evidence was evaluated for the overall construct of each questionnaire (e.g., total PA), moderate-to-vigorous physical activity (MVPA) and walking using a modified Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. Results In total, 56 articles on 40 different questionnaires (14 from the previous review and 26 from the update) were included. Reliability was assessed for 22, measurement error for four and hypotheses testing for construct validity for 38 different questionnaires. Evidence for responsiveness was available for one questionnaire. For many questionnaires, only one measurement property was assessed in only a single study. Sufficient content validity was considered for 22 questionnaires. All questionnaires displayed large measurement errors. Only versions of two questionnaires showed both sufficient reliability and hypotheses testing for construct validity, namely the Physical Activity Scale for the Elderly (PASE; English version, Turkish version) for the assessment of total PA, and the Physical Activity and Sedentary Behavior Questionnaire (PASB-Q; English version) for the assessment of MVPA. The quality of evidence for these results ranged from very low to high. Conclusions Until more high-quality evidence is available, we recommend the PASE for measuring total PA and the PASB-Q for measuring MVPA in older adults. However, they are not equally qualified among different languages. Future studies on the most promising questionnaires should cover all relevant measurement properties. We recommend using and improving existing PA questionnaires-instead of developing new ones-...

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Measuring change in trials of physical activity interventions: a comparison of self-report questionnaire and accelerometry within the PACE-UP trial

Cited by 50 publications

References 23 publications

Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Primary care interventions to address physical frailty among community-dwelling adults aged 60 years or older: A meta-analysis

Current Evidence of Measurement Properties of Physical Activity Questionnaires for Older Adults: An Updated Systematic Review

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