Research article
Test-Retest Reliability of Adult Surveillance Measures for Physical Activity and Inactivity

https://doi.org/10.1016/j.amepre.2005.02.005Get rights and content

Background

Several physical activity measures used in U.S. surveillance systems lack estimates of reliability in this country. This information is needed among diverse populations of women and men, to aid in interpretation and use of the measures. The objective of this study was to document the test-retest reliability of several measures of physical activity and inactivity used in surveillance in a diverse adult population.

Methods

Test and retest surveys were conducted over the telephone with 106 African-American and white women and men living in Forsyth County, North Carolina or Jackson, Mississippi in 2003. Physical activity and inactivity were self-reported using surveillance measures, such as from the Behavioral Risk Factor Surveillance System. Reliability was determined using kappa and intraclass correlation coefficients (ICCs) overall and separately by gender and race.

Results

Thirteen percent of the participants met recommendations for physical activity, 44% were insufficiently active, and 43% were inactive. Reliability of the measures to categorize participants into these categories was 0.44 (95% confidence interval [CI]=0.27–0.58). The reliability of several categoric definitions of leisure activity ranged from 0.46 to 0.68. Occupational activity had substantial reliability (0.82, 95% CI=0.72–0.89), while any transportation activity (0.27, 95% CI=0.09–0.44) and walking (0.40, 95% CI=0.23–0.55) were lower. Indicators of inactivity categorized at >7 hours/week included time per week on the computer (0.83, 95% CI=0.57–0.78) and time per week watching television (0.40, 95% CI=0.22–0.54). Some gender and racial differences were noted in the reliability estimates.

Conclusions

In conclusion, this study provides estimates of test-retest reliability for several physical activity and inactivity measures used for surveillance purposes. Validity data, coupled with the reliability estimates reported here and elsewhere, can aid in interpretation and use of these measures in surveillance, as well as in epidemiologic studies.

Introduction

In the United States, adult physical activity and inactivity behaviors are presently tracked through several surveillance systems, including the Behavioral Risk Factor Surveillance System (BRFSS), the National Health Interview Survey (NHIS), and the National Health and Nutrition Examination Survey (NHANES). These surveillance measures are used, in part, to monitor statewide and national trends in comparison to the Healthy People 2010 goals.1 Measures used in surveillance should be reliable; however, some measures utilized in the surveillance system for physical activity lack measures of reliability or lack detail on reliability of the components that make up the measures (e.g., frequency and time performing physical activity). This information is needed among diverse populations of women and men, to aid in interpretation and use of the measures. Therefore, the purpose of this study was to document the test-retest reliability of several measures of physical activity used in surveillance in a diverse adult population.

Section snippets

Sample

A telephone survey was conducted using a computer-assisted telephone interview system between January and July 2003, using a random sample of non-institutionalized adults aged ≥18 years residing in two regions—Forsyth County NC, and the metropolitan statistical area of Jackson MS. Disproportionate sampling was used for Forsyth County in order to ensure representation for less-urban areas outside the Winston-Salem metropolitan area within the county. Respondents were randomly chosen in two

Results

Among the sample of 106 adults, approximately half were women (n =57), half were African American (n =52), and half were from Forsyth County (n =54). The median age of participants was 47 years (standard deviation, 16.8). Among respondents, 6.6% (n =6) had less than a high school education, 27.4% (n =29) were high school graduates, 26.4% (n =28) had some technical school or college, and 39.6% (n =42) were college graduates. Other characteristics of the reliability sample are reported elsewhere.

Discussion

This study examined the test-retest reliability of several surveillance measures of physical activity and inactivity among African-American and white women and men. Many of these surveillance questions have been recommended for use in only the categoric form rather than the continuous form, such as the proportion of adults meeting recommendations for physical activity (categoric) rather than the number of minutes adults spend in physical activity (continuous). For these analyses, we explored

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    This work was supported by a grant from the American Heart Association. We are grateful to Fang Wen for assisting with these analyses, and to the anonymous reviewers for their helpful comments. We also acknowledge Clearwater Research Inc. for the survey data collection, and we would especially like to thank John Hetherington and Patty Burke.

    No financial conflict of interest was reported by the authors of this paper.

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