To select appropriate physical activity assessment methods and correctly interpret the measures obtained, researchers should carefully consider the purpose for assessment, physical activity constructs of interest, characteristics of the population and measurement tool, and the theoretical link between the exposure and outcome of interest.

Context:The selection of the most psychometrically appropriate self-report tool(s) to measure specific physical activity constructs has been a challenge for researchers, public health practitioners, and clinicians, alike. The lack of a reasonable gold standard measure and inconsistent use of established and evolving terminology have contributed to these challenges. The variation of self-report measures and quality of the derived summary estimates could be attributed to the absence of a standardized conceptual framework for physical activity.Objective:To present a conceptual framework for physical activity as a complex and multidimensional behavior that differentiates behavioral and physiological constructs of human movement.Process:The development of a conceptual framework can provide the basic foundation from which to standardize definitions, guide design and development of self-report measures, and provide consistency during instrument selection.Conclusions:Based on our proposed conceptual framework for physical activity, we suggest that physical activity is more clearly defined as the behavior that involves human movement, resulting in physiological attributes including increased energy expenditure and improved physical fitness. Utilization of the proposed conceptual framework can result in better instrument choices and consistency in methods used to assess physical activity and sedentary behaviors across research and public health practice.

The Women on the Move through Activity and Nutrition (WOMAN) study was designed to test whether a nonpharmacological intervention including qualitative and quantitative dietary changes to induce weight loss and increased physical activity levels would reduce blood triglyceride levels and number of low-density lipoprotein particles (LDL-P). Such decreases in lipoproteins and other risk factors could reduce or slow progression of subclinical cardiovascular disease (CVD). Study participants were randomized to either the intervention (Lifestyle Change) or assessment (Health Education) group. Most of the intervention ended at the 30-month visit. The last 48-month examination was completed in 9/2008. There was very substantial weight loss and increased exercise during the first 30 months of the trial resulting in significant decreases in CV risk factors. Most of the intervention effect was lost through 48 months. Weight loss was 3.4 kg in Lifestyle Intervention and 0.2 kg in the Health Education at 48 months (P = 0.000). There were no significant changes at 48 months in lipid levels, blood pressure (BP), glucose, insulin, or in the subclinical measures of coronary calcium, carotid intima media thickness, or plaque. There was a significant decrease in long-distance corridor walk time in the Lifestyle vs. Health Education groups. Significant lifestyle changes can be achieved that result in decreases in CV risk factors. Whether such changes reduce CV outcomes is still untested in clinical trials of weight loss or exercise. Long-term maintenance of successful lifestyle changes, weight loss and reduced risk factors is the hurdle for lifestyle interventions attempting to prevent CV and other chronic diseases.

Background Although the American Heart Association/American College of Sports Medicine’s Preparticipation Questionnaire (AAPQ) is a recommended pre-exercise cardiovascular screening tool, it has never been systematically evaluated. The purpose of this research is to provide preliminary evidence of its effectiveness among adults aged 40 years or older. Methods and Results Under the assumption that respondents would respond to AAPQ items as they responded to NHANES questionnaire responses, we calculated the gender- and age-specific proportions of adult participants in NHANES, 2001–2004 who would be receive a recommendation for physician consultation based on AAPQ referral criteria. Additionally, we compared recommended AAPQ referrals to a similar assessment using the Physical Activity Readiness Questionnaire (PAR-Q) in the study sample. AAPQ referral proportions were higher with older age. Across all age groups 40 years and older, 95.5% (94.3–96.8%) of women and 93.5% (92.2–94.7%) of men in the US would be advised to consult a physician before exercise. Prescription medication use and age were the most commonly selected items. When referral based on AAPQ was compared to that of the PAR-Q, the two screening tools produced similar results for 72.4% of respondents. Conclusions These results suggest that more than 90% of US adults aged 40 years or older would receive a recommendation for physician consultation by the AAPQ. Excessive referral may present an unnecessary barrier to exercise adoption and stress the healthcare infrastructure. (228/250)

These results suggest that recreational distance runners are simultaneously highly sedentary and highly active, supporting independence of sedentary behaviors and moderate- to vigorous-intensity PA. This population may provide the characteristics needed to study the joint effects of active and sedentary behaviors on health outcomes.