Concurrent Validity of a Self-Reported Physical Activity “Vital Sign” Questionnaire With Adult Primary Care Patients

Abstract

IntroductionNo tool currently used by primary health care providers to assess physical activity has been evaluated for its ability to determine whether or not patients achieve recommended levels of activity. The purpose of this study was to assess concurrent validity of physical activity self-reported to the brief (<30 sec) Physical Activity “Vital Sign” questionnaire (PAVS) compared with responses to the lengthier (3–5 min), validated Modifiable Activity Questionnaire (MAQ).MethodsAgreement between activity reported to the PAVS and MAQ by primary care patients at 2 clinics in 2014 was assessed by using percentages and κ coefficients. Agreement consisted of meeting or not meeting the 2008 Aerobic Physical Activity Guidelines for Americans (PA Guidelines) of the US Department of Health and Human Services. We compared self-reported usual minutes per week of moderate-to-vigorous physical activity among patients at a primary care clinic in 2014 who reported to PAVS and to MAQ by using Pearson correlation and Bland–Altman plots of agreement.ResultsAmong 269 consenting patients who reported physical activity, PAVS results agreed with those of MAQ 89.6% of the time and demonstrated good agreement in identifying patients who did not meet PA Guidelines recommendations (κ = 0.55, ρ = 0.57; P < .001). Usual minutes per week of moderate-to-vigorous physical activity reported to PAVS had a high positive correlation with the same reported to MAQ (r = 0.71; P < .001).ConclusionPAVS may be a valid tool for identifying primary care patients who need counseling about physical activity. PAVS should be assessed further for agreement with repeated objective measures of physical activity in the patient population.

Physical Activity as a Vital Sign: A Systematic Review

“…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.…”

“…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.…”

“…Among 269 patients (15), the PAVS agreed almost 90% of the time with the Modifiable Activity Questionnaire (MAQ), a long questionnaire shown to be strongly associated with accelerometry measures of PA [26]), and agreement was good for identifying those who met the 2008 PA guidelines (κ = 0.55, P < .001). The usual minutes per week of moderate to vigorous PA was highly correlated between PAVS and MAQ ( r = 0.71, P < .001).…”

Regular Exercise, Quality of Life, and Mobility in Parkinson’s Disease: A Longitudinal Analysis of National Parkinson Foundation Quality Improvement Initiative Data

“…Sensors are likely to have better reliability and responsiveness than self-reported data, but questions remain about the most sensitive devices and analysis algorithms to define activity across the stages of the disease [26]. In the absence of body-worn sensors, the substantial baseline differences between exercisers and non-exercisers suggest that participants provide acceptable estimations of their activity and ability [27, 28]. However, the baseline differences remaining between exercisers and non-exercisers after risk-adjustment indicates that exercisers and non-exercisers have other fundamental differences that are not explained by age, disease duration, disease severity, sex, and number of comorbidities.…”

Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

“…These trials were informed by earlier successes in changing clinician behavior regarding use of the “5 A's” for effective counseling for smoking cessation (eg, ask, advise, agree, assist, and arrange for follow‐up) . To date, the EIM approach has been adopted in several primary health care clinics as well as broadly across 3 large health care systems in the United States . To date, very few studies have used elements of EIM in the oncology care setting, but there is ample scope and a need to examine integration into cancer care.…”