Comparing self-reported versus objectively measured physical activity behavior: a preliminary investigation of older Filipino American women

Executive functioning predicts discrepancies between objective and self-reported physical activity in older adults: a pilot study

Physical activity (PA) has been linked to cognitive functioning and mental health in older adulthood. Multiple subjective (i.e., self-report) and objective measures (e.g., pedometer) have been used to assess PA, however their agreement varies across studies. This pilot study examined cognitive predictors of the agreement between subjective and objectively measured PA. A total of 30 community-dwelling older adults completed a neuropsychological battery, as well as a measure of subjective PA and wore a wristwatch-based pedometer for 30 days to assess objective PA. Greater discrepancy between subjective and objective PA was correlated with poorer executive functioning (r = -.44, p = .02), and this remained true in regression models after controlling for age and education (b = .-54, p = .01). Older adults with lower executive functioning may be more likely to inaccurately report time spent engaging in PA. Future studies should explore whether this relationship holds in larger samples.

Faking self-reports of health behavior: a comparison between a within- and a between-subjects design

Background

This study examines people's ability to fake their reported health behavior and explores the magnitude of such response distortion concerning faking of preventive health behavior and health risk behavior. As health behavior is a sensitive topic, people usually prefer privacy about it or they wish to create a better image of themselves (Fekken et al., 2012; Levy et al., 2018). Nevertheless, health behavior is often assessed by self-report questionnaires that are prone to faking. Therefore, it is important to examine the possible impact of such faking.

Methods

To replicate the findings and test their robustness, two study designs were realized. In the within-subjects-design, 142 participants repeatedly answered a health behavior questionnaire with an instruction to answer honestly, fake good, and fake bad. In the between-subjects design, 128 participants were randomly assigned to one of three groups that filled out the health behavior questionnaire with only one of the three instructions.

Results

Both studies showed that successful faking of self-reported preventive and health risk behavior was possible. The magnitude of such faking effects was very large in the within-subjects design and somewhat smaller in the between-subjects design.

Conclusion

Even though each design has its inherent merits and problems, caution is indicated regarding faking effects.

Development of an Intervention to Promote Physical Activity and Reduce Dietary Sodium Intake for Preventing Hypertension and Chronic Disease in Filipino Americans

Hypertension is a common chronic health condition affecting Filipino Americans. This pilot study examined the feasibility of addressing high rates of hypertension among Filipino Americans through the implementation of a culturally tailored education intervention. Filipino Americans living in the Greater Philadelphia Area were recruited through community-based organizations for participation and were engaged using a community-based participatory research (CBPR) framework. The study included pre- and post-intervention blood pressure measurements, self-reported body mass index, and questionnaires about physical activity and salt intake. The intervention to promote physical activity and reduce salt intake was conducted through two educational sessions and was accompanied by follow-up at 3 months and by the collection of urine samples for 24-h urinary sodium intake biomarker analysis. Following intervention, a non-statistically significant decrease in urine sodium was observed in both the intervention and the control groups. For systolic blood pressure, a reduction of 12.6 mmHg and an increase in 5.3 mmHg was observed in the intervention and control groups, respectively. Diastolic pressure decreased 3.8 mmHg for the intervention group and increased 5.6 mmHg among controls. The culturally tailored education intervention reported here represents a promising tool for blood pressure reduction in high-risk ethnic populations. The methods used were effective for the recruitment and retention of ethnic minorities in a community-based setting.

Classification of human physical activity based on raw accelerometry data via spherical coordinate transformation

Human health is strongly associated with person's lifestyle and levels of physical activity. Therefore, characterization of daily human activity is an important task. Accelerometers have been used to obtain precise measurements of body acceleration. Wearable accelerometers collect data as a three-dimensional time series with frequencies up to 100 Hz. Using such accelerometry signal, we are able to classify different types of physical activity. In our work, we present a novel procedure for physical activity classification based on the raw accelerometry signal. Our proposal is based on the spherical representation of the data. We classify four activity types: resting, upper body activities (sitting), upper body activities (standing), and lower body activities. The classifier is constructed using decision trees with extracted features consisting of spherical coordinates summary statistics, moving averages of the radius and the angles, radius variance, and spherical variance. The classification accuracy of our method has been tested on data collected on a sample of 47 elderly individuals who performed a series of activities in laboratory settings. The achieved classification accuracy is over 90% when the subject-specific data are used and 84% when the group data are used. Main contributor to the classification accuracy is the angular part of the collected signal, especially spherical variance. To the best of our knowledge, spherical variance has never been previously used in the analysis of the raw accelerometry data. Its major advantage over other angular measures is its invariance to the accelerometer location shifts.

Content validity and methodological considerations in ecological momentary assessment studies on physical activity and sedentary behaviour: a systematic review

Background

Ecological momentary assessment (EMA) is a method of collecting real-time data based on repeated measures and observations that take place in participant’s daily environment. EMA has many advantages over more traditional, retrospective questionnaires. However, EMA faces some challenges to reach its full potential. The aims of this systematic review are to (1) investigate whether and how content validity of the items (i.e. the specific questions that are part of a larger EMA questionnaire) used in EMA studies on physical activity and sedentary behaviour was assessed, and (2) provide an overview of important methodological considerations of EMA in measuring physical activity and sedentary behaviour.

Methods

Thirty papers (twenty unique studies) were systematically reviewed and variables were coded and analysed within the following 4 domains: (1) Content validity, (2) Sampling approach, (3) Data input modalities and (4) Degree of EMA completion.

Results

Only about half of the studies reported the specific items (n = 12) and the source of the items (n = 11). None of the studies specifically assessed the content validity of the items used. Only a minority (n = 5) of the studies reported any training, and one tested the comprehensibility of the EMA items. A wide variability was found in the design and methodology of the EMA. A minority of the studies (n = 7) reported a rationale for the used prompt frequency, time selection, and monitoring period. Retrospective assessment periods varied from ‘now’ to ‘in the last 3.5 hours’. In some studies there was a possibility to delay (n = 6) or deactivate (n = 10) the prompt, and some provided reminders after the first prompt (n = 9).

Conclusions

Almost no EMA studies reported the content validation of the items used. We recommend using the COSMIN checklist (COnsensus-based Standards for the selection of health Measurement INstruments) to report on the content validity of EMA items. Furthermore, as often no rationale was provided for several methodological decisions, the following three recommendations are made. First, provide a rationale for choosing the sampling modalities. Second, to ensure assessment ‘in the moment’, think carefully about the retrospective assessment period, reminders, and deactivation of the prompt. Third, as high completion rates are important for representativeness of the data and generalizability of the findings, report completion rates.

Trial registration

This review is registered in PROSPERO, the International prospective register of systematic reviews (registration number: CRD42017077996).

A Study of Physical Activity Determinants among High-Risk Hypertensive Filipino and Korean Americans

Physical activity (PA) serves a critical role in maintaining health and preventing chronic diseases, though its influence on high-risk Asian American populations is unclear. The purpose of this study was to determine PA levels among Filipino and Korean Americans at high risk of hypertension and to identify sociodemographic and health-related factors associated with PA levels in these populations. A cross-sectional survey was administered to 137 participants in the Greater Philadelphia Area. Data was collected on PA levels, sociodemographic factors, and health factors. Multinomial logistic regression was conducted to determine predictors associated with low, moderate, and high PA and predictive probabilities were calculated for interaction terms, incorporating ethnicity and blood pressure variables. Overall, 42.33% of participants belonged to the moderately active PA group and 21.90% belonged to the highly active group. In the final multinomial regression model, it was found that having gone to college increased the odds of being in the moderately active PA group (coef. = 1.96, p = 0.034), while having high blood pressure reduced the odds of being in the moderately active PA group (coef. = -2.21, p = 0.022). Lastly, being Korean versus Filipino reduced the odds of being in the highly active category (coef. = -2.89, p = 0.035). Based on predictive probabilities, Koreans and Filipinos with high blood pressure were more likely to belong in the low active PA category (52.31% and 46.33%). These findings highlight the need for culturally relevant PA interventions for promoting and increasing PA levels to prevent and manage hypertension among these populations.

A Health Needs Assessment of the Filipino American Community in the Greater Las Vegas Area

Purpose: The number of Filipino Americans in Las Vegas, Nevada, is growing considerably, but no research to date has assessed the specific health needs of this burgeoning population. Thus, this study aims to assess health behaviors, perceived community health problems, and self-reported diseases/conditions among Filipino Americans in the Greater Las Vegas area and evaluate any difference by gender.

Methods: A cross-sectional survey was conducted among 200 Filipino American adults residing in the Greater Las Vegas area using a prevalidated instrument.

Results: The self-reported prevalence of hypertension, high cholesterol, and diabetes was 48%, 46%, and 25%, respectively. Adverse health behaviors, in terms of insufficient exercise and diets lacking in fruits and vegetables, were noted among our participants. Approximately 67% of participants reported exercising less than the recommended 150 min of physical activity per week and <3% of the study population ate the recommended five servings of fruits and vegetables a day. On the contrary, consumption of sweet snacks and salty condiments was high. More than two-thirds of respondents indicated that the Filipino American community should address the identified health conditions.

Conclusions: The high self-reported prevalence of hypertension, high cholesterol, and diabetes demonstrates a pressing public health problem among Filipino Americans in Las Vegas. Given that our study population comprised predominantly college-educated, middle-income, and insured individuals, the findings may be underestimated and thus the actual disease prevalence may be even higher. Results of this survey will be used to develop future interventions for the Filipino American community in Las Vegas using the principles of community-based participatory research.

Strategies to Increase Filipino American Participation in Cardiovascular Health Promotion: A Systematic Review

Introduction

Cultural tailoring of interventions can be effective in reducing health disparities by attracting underserved populations to health promotion programs and improving their outcomes. The purpose of this systematic review was to assess what is known about increasing access to and participation in cardiovascular disease (CVD) prevention and control programs among Filipino Americans.

Methods

PubMed MEDLINE, CINAHL, and Sociologic Abstracts were searched for peer-reviewed studies and dissertations conducted in the United States from 2004 through 2016.

Results

A total of 347 articles were identified through the search, and 9 articles reporting on 7 interventions focused on CVD prevention in a Filipino American sample were included. All but one intervention used evidence-based curricula, and implementation varied across sites. All but 2 interventions used word-of-mouth advertising from friends, family, and community leaders to increase participation. The Filipino cultural values of food, social relationships, and family were prevalent aspects across interventions tailored for Filipino Americans. Aspects of spirituality and the arts were integrated into only 3 studies.

Conclusion

Given the burden of CVD in Filipino American populations, tailored interventions rooted in Filipino cultural values are vital to address this known health disparity.

Validation and calibration of HeadCount, a self-report measure for quantifying heading exposure in soccer players

The long-term effects of repetitive head impacts due to heading are an area of increasing concern, and exposure must be accurately measured; however, the validity of self-report of cumulative soccer heading is not known. In order to validate HeadCount, a 2-week recall questionnaire, the number of player-reported headers was compared to the number of headers observed by trained raters for a men's and a women's collegiate soccer teams during an entire season of competitive play using Spearman's correlations and intraclass correlation coefficients (ICCs), and calibrated using a generalized estimating equation. The average Spearman's rho was 0.85 for men and 0.79 for women. The average ICC was 0.75 in men and 0.38 in women. The calibration analysis demonstrated that men tend to report heading accurately while women tend to overestimate. HeadCount is a valid instrument for tracking heading behaviour, but may have to be calibrated in women.

Movement prediction using accelerometers in a human population

We introduce statistical methods for predicting the types of human activity at sub-second resolution using triaxial accelerometry data. The major innovation is that we use labeled activity data from some subjects to predict the activity labels of other subjects. To achieve this, we normalize the data across subjects by matching the standing up and lying down portions of triaxial accelerometry data. This is necessary to account for differences between the variability in the position of the device relative to gravity, which are induced by body shape and size as well as by the ambiguous definition of device placement. We also normalize the data at the device level to ensure that the magnitude of the signal at rest is similar across devices. After normalization we use overlapping movelets (segments of triaxial accelerometry time series) extracted from some of the subjects to predict the movement type of the other subjects. The problem was motivated by and is applied to a laboratory study of 20 older participants who performed different activities while wearing accelerometers at the hip. Prediction results based on other people's labeled dictionaries of activity performed almost as well as those obtained using their own labeled dictionaries. These findings indicate that prediction of activity types for data collected during natural activities of daily living may actually be possible.

Predicting human movement with multiple accelerometers using movelets

PURPOSE

The study aims were 1) to develop transparent algorithms that use short segments of training data for predicting activity types and 2) to compare the prediction performance of the proposed algorithms using single accelerometers and multiple accelerometers.

METHODS

Sixteen participants (age, 80.6 yr (4.8 yr); body mass index, 26.1 kg·m (2.5 kg·m)) performed 15 lifestyle activities in the laboratory, each wearing three accelerometers at the right hip and left and right wrists. Triaxial accelerometry data were collected at 80 Hz using ActiGraph GT3X+. Prediction algorithms were developed, which, instead of extracting features, build activity-specific dictionaries composed of short signal segments called movelets. Three alternative approaches were proposed to integrate the information from the multiple accelerometers.

RESULTS

With at most several seconds of training data per activity, the prediction accuracy at the second-level temporal resolution was very high for lying, standing, normal/fast walking, and standing up from a chair (the median prediction accuracy ranged from 88.2% to 99.9% on the basis of the single-accelerometer movelet approach). For these activities, wrist-worn accelerometers performed almost as well as hip-worn accelerometers (the median difference in accuracy between wrist and hip ranged from -2.7% to 5.8%). Modest improvements in prediction accuracy were achieved by integrating information from multiple accelerometers.

DISCUSSION AND CONCLUSIONS

It is possible to achieve high prediction accuracy at the second-level temporal resolution with very limited training data. To increase prediction accuracy from the simultaneous use of multiple accelerometers, a careful selection of integrative approaches is required.

Movelets: A dictionary of movement

Recent technological advances provide researchers with a way of gathering real-time information on an individual's movement through the use of wearable devices that record acceleration. In this paper, we propose a method for identifying activity types, like walking, standing, and resting, from acceleration data. Our approach decomposes movements into short components called "movelets", and builds a reference for each activity type. Unknown activities are predicted by matching new movelets to the reference. We apply our method to data collected from a single, three-axis accelerometer and focus on activities of interest in studying physical function in elderly populations. An important technical advantage of our methods is that they allow identification of short activities, such as taking two or three steps and then stopping, as well as low frequency rare(compared with the whole time series) activities, such as sitting on a chair. Based on our results we provide simple and actionable recommendations for the design and implementation of large epidemiological studies that could collect accelerometry data for the purpose of predicting the time series of activities and connecting it to health outcomes.

Filipino older adults' beliefs about exercise activity

PURPOSE

This study explored how the older traditional Filipino adults 65 years old and above living in Honolulu, Hawaii, describe their beliefs regarding exercise activity. The location of this research setting is unique because a blending of traditional Filipino culture exists within an acculturated social setting. The Filipino older adults who have relocated to this U.S. location may have also stayed close to their own cultural traditions.

METHODOLOGIES

A perception of exercise activity was generated through the lens of 47 participants using qualitative methodology.

FINDINGS

While focusing on the older adults' beliefs about exercise activity, it became evident that exercise may have been seen as a proxy measure of physical activity. The study revealed four main domains: balancing barriers against benefits; engaging capabilities; intervening factors; and defining exercise. The data suggest that the four themes are juxtaposed among each other, with overarching social obligations to the kin group governing the older adults' engagement in what constitutes structured exercise by Western definition.

IMPLICATIONS

Further investigation is needed to conceptualize what types of physical activities traditional Filipino elders perceive as exercise, and whether these activities fall into the Western definition of exercise.

A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review

BACKGROUND

Accurate assessment is required to assess current and changing physical activity levels, and to evaluate the effectiveness of interventions designed to increase activity levels. This study systematically reviewed the literature to determine the extent of agreement between subjectively (self-report e.g. questionnaire, diary) and objectively (directly measured; e.g. accelerometry, doubly labeled water) assessed physical activity in adults.

METHODS

Eight electronic databases were searched to identify observational and experimental studies of adult populations. Searching identified 4,463 potential articles. Initial screening found that 293 examined the relationship between self-reported and directly measured physical activity and met the eligibility criteria. Data abstraction was completed for 187 articles, which described comparable data and/or comparisons, while 76 articles lacked comparable data or comparisons, and a further 30 did not meet the review's eligibility requirements. A risk of bias assessment was conducted for all articles from which data was abstracted.

RESULTS

Correlations between self-report and direct measures were generally low-to-moderate and ranged from -0.71 to 0.96. No clear pattern emerged for the mean differences between self-report and direct measures of physical activity. Trends differed by measure of physical activity employed, level of physical activity measured, and the gender of participants. Results of the risk of bias assessment indicated that 38% of the studies had lower quality scores.

CONCLUSION

The findings suggest that the measurement method may have a significant impact on the observed levels of physical activity. Self-report measures of physical activity were both higher and lower than directly measured levels of physical activity, which poses a problem for both reliance on self-report measures and for attempts to correct for self-report - direct measure differences. This review reveals the need for valid, accurate and reliable measures of physical activity in evaluating current and changing physical activity levels, physical activity interventions, and the relationships between physical activity and health outcomes.

Two short questionnaires on leisure-time physical activity compared with serum lipids, anthropometric measurements and aerobic power in a suburban population from Oslo, Norway

The aim was to indirectly validate two short postal questionnaires measuring leisure-time physical activity (LPA) by comparing the answers with serum lipids and anthropometric measurements.

METHODS

All inhabitants aged 31-67 years in two suburban, multicultural areas of Oslo, Norway were invited to "Romsås in Motion", a community intervention survey, in 2000. Of those, 2950 participants (48%) met and were re-invited in 2003. LPA was measured by two short instruments used since the 1970s (referred to as the Gothenburg instrument) and since 1994 in Cohort of Norway (CONOR). Each instrument was compared with relevant measurements at baseline including LPA according to an adapted version of the long International Physical Activity Questionnaire (IPAQ-L). In addition, changes during 2000--2003 in reported LPA were compared with changes in body weight, waist-to-hip ratio, lipids and other measurements.

RESULTS

LPA measured by the Gothenburg instrument correlated weakly, but consistently with relevant biological and anthropometrical measurements and with IPAQ-L. The correlation coefficients were -0.1-(-0.2) with triglycerides, total-to-high density lipoprotein (HDL)-cholesterol ratio and waist-to-hip ratio, around 0.1 with HDL-cholesterol and 0.3 with maximal aerobic power. For the CONOR instrument a similar pattern was found in both sexes for the hard LPA and in women for light LPA. LPA measured by each short instrument was in line with LPA measured with IPAQ-L.

CONCLUSIONS

In a multi-linguistic, suburban population in Oslo, Norway, LPA measurements by each of two short questionnaires were weakly, but consistently correlated with relevant biological and anthropometric measurements and strongly with IPAQ-L.

An adapted version of the long International Physical Activity Questionnaire (IPAQ-L): construct validity in a low-income, multiethnic population study from Oslo, Norway

BACKGROUND

The aim was to assess the construct validity characteristics of an adapted version of the long International Physical Activity Questionnaire (IPAQ-L) and report seasonal variations in physical activity (PA).

METHODS

In two multiethnic suburbs of Oslo, Norway, all men and women aged 31-67 years (N = 6140) were invited to a survey in 2000, and participants (N = 2950) were re-invited in 2003. Complete IPAQ-L forms were delivered by 2274 baseline participants. We used the first IPAQ-L version, which asks for PA in a usual week with separate answering alternatives for summer and winter. Baseline energy expenditure calculated from IPAQ-L was compared with anthropometrical and biological measurements including maximal aerobic power in a subgroup, and individual changes in PA were compared with changes in these measurements.

RESULTS

Vigorous PA within all domains, leisure-time PA (LPA), total PA, and in men occupational PA correlated with waist-to-hip ratio (rho around -0.1, p < 0.05). For vigorous PA and LPA similar correlations were found with triglycerides and high-density lipoprotein-cholesterol (rho 0.1, p < 0.05). LPA was correlated with maximal aerobic power in both sexes with rho 0.2 for total LPA and 0.4 for vigorous LPA (p < 0.01). In men, similar correlations were found for changes in total vigorous PA. The overall energy expenditure reported was 18% higher in summer than in winter. The amount of total and commuting PA in the two seasons were highly correlated with rho values of 0.9 and 0.7, respectively (p < 0.01).

CONCLUSION

Weak, but consistent correlations with baseline biological and anthropometrical measurements were found in both sexes, but for changes in PA such a pattern was seen in men only. The total energy expenditure in summer and winter were highly correlated although the absolute volume was higher in summer than in winter.