Validity of two brief primary care physical activity questionnaires with accelerometry in clinic staff

Abstract

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.

Physical Activity as a Vital Sign: A Systematic Review

“…No additional articles were identified from bibliographies. Authors agreed to include 9 articles using 5 vital sign tools during the data extraction phase (13–21). No articles focused on arthritis; only 1 included participants specifically with arthritis (18).…”

“…The Exercise Vital Sign (EVS) (16–18,20,21), the Physical Activity Vital Sign (PAVS) (13–15,19), the PA component of the Speedy Nutrition and Physical Activity Assessment (SNAP) (13), the General Practice Physical Activity Questionnaire (GPPAQ) (17), and the Stanford Brief Activity Survey (SBAS) (20) were the brief PA vital sign instruments identified during this review. All 5 tools (Table 1) assessed moderate to vigorous PA in adults.…”

“…SNAP was developed as a PA assessment tool for primary care with involvement from culturally diverse health care providers, their staff, and patients (13). It was created on the basis of feedback from focus groups of providers, staff, and patients with broad cultural backgrounds from community health centers (13).…”

“…SNAP was developed as a PA assessment tool for primary care with involvement from culturally diverse health care providers, their staff, and patients (13). It was created on the basis of feedback from focus groups of providers, staff, and patients with broad cultural backgrounds from community health centers (13). Written at a fifth-grade literacy level, SNAP consists of one question: “Are you active for 30 minutes on 5 days of the week?” Respondents are given examples of activities (eg, walking, housework), and they select one answer choice: 1) “No, and I have no plans to be more active”; 2) “No, but I have been thinking about being more active”; 3) “Sometimes I am active for 30 minutes, but not all the time”; and 4) “Yes, I am active for 30 minutes on 5 days of the week.” SNAP requires less than 1 minute to complete.…”

“…Medical assistants and nurses collected EVS responses during the outpatient visit before the provider interacted with the patient (16). PAVS was assessed in patients from 2 university-based family medicine clinics in the Utah Health Research Network (14,15,19) in clinic staff from 7 primary care clinics in the Salt Lake Valley area (13) and in electronic health records of primary care patients from Intermountain Healthcare, Salt Lake City, Utah (14). SNAP also was assessed among the sample of clinic staff.…”