Differences between accelerometer cut point methods among midlife women with cardiovascular risk markers

Abstract

Objective: Midlife women experience elevated risk for cardiovascular disease and often receive advice to increase physical activity to mitigate this risk. Use of accelerometers to measure ambulatory physical activity requires selection of appropriate thresholds for estimating moderate-to-vigorous physical activity (MVPA), and choice of cut points may lead to meaningfully different conclusions about midlife women's physical activity (PA) engagement. This is particularly important given the recent elimination of 10-minute bout requirements for MVPA. This two-phase study examined differences between four cut point methods among midlife women with cardiovascular disease (CVD) risk. We used findings from Study 1 (exploratory) to generate hypotheses for Study 2 (confirmatory). Methods: Across studies, participants (N = 65) were midlife women with an additional CVD risk factor (eg, hypertension). Participants wore waistband accelerometers for seven days. Daily totals were calculated for minutes in light and MVPA using four common quantification methods (Freedson, Matthews, Swartz, and Troiano). Results: Multilevel models showed meaningful differences between methods (P < 0.0001). For total (non-bouted) minutes of MVPA, Freedson and Troiano methods showed that participants barely met MVPA recommendations (30 min per day), whereas Matthews and Swartz methods showed that participants greatly exceeded this goal. As differences between methods were smaller using MVPA bouts of 10 minutes or more (though remained significant), the observed variation was due in part to small bursts of MVPA dispersed throughout the day. Conclusions: Findings demonstrate the need for careful consideration of PA quantification among midlife women with CVD risk, and for further investigation to determine the most appropriate quantification method. Video Summary: http://links.lww.com/MENO/A545.

Associations of changes in physical activity and sedentary time with weight recurrence after bariatric surgery: a 5-year prospective study

“…Total minutes in MVPA vs. bouted MVPA At 5 years after surgery, 72.2% of participants met current MVPA recommendations (≥150 MVPA minutes/week) based on total minutes in MVPA but only 16.5% of participants met previous MVPA recommendations based on bouted MVPA minutes. These data are aligned with findings within the general adult population [37][38][39], but represent novel information on the bariatric surgery population. Choosing the one method over the other clearly decides if our participants are described as a highrisk group for chronic diseases or not, and whether their PA level compares to, or exceeds, the PA level of the general adult population.…”

“…Also, only evaluating bouted minutes in MVPA might exclude many individuals within the bariatric surgery population because many do not engage in prolonged bouts of MVPA [27]. Importantly, studies within the general population find that using total minutes or bouted minutes in MVPA influence how participants are categorized [37][38][39]. Similar data is not available within the postbariatric surgery population.…”

A scoping review of behavior change techniques used to promote physical activity among women in midlife

“…Finally, BCTs and intervention features that were described as activating BCTs were extracted. An initial set of BCTs were selected for extraction based on the authors' familiarity with physical activity intervention research (specific to women in midlife and more broadly; Arigo, 2015 ; Butryn et al, 2016 ; Arigo et al, 2020a , b ). These BCTs included the following [with Michie et al ( 2013 ) associated numeric codes]: goal setting (proximal behavior [1.1] and/or distal outcome [1.3]), self-monitoring (proximal behavior [2.3] and/or distal outcome [2.4]), providing feedback (2.2), problem-solving and/or planning (1.4 and 1.2, respectively), social support (3.1–3.3), social comparison (6.2), and behavioral modeling (6.1).…”

Rationale and Design of the Women’s Health And Daily Experiences Project: Protocol for an Ecological Momentary Assessment Study to Identify Real-Time Predictors of Midlife Women’s Physical Activity

“…Individuals are excluded from participation if they do not meet the above criteria or if they state an intention to move away from the geographic area during the study period. Eligibility was not limited by current level of PA engagement, as existing evidence and pilot work suggested that engagement would range from low to moderate for the target population [ 115 , 116 ].…”