Validation of the Stanford Leisure‐Time Activity Categorical Item (L‐Cat) using armband activity monitor data

Abstract

SummaryObjectiveAccurate assessment of physical activity (PA) in public health and healthcare settings remains a challenge given limitations of existing brief assessment tools. The Stanford Leisure‐Time Activity Categorical Item (L‐Cat), a single item with six categories, has previously demonstrated excellent reliability and adequate validity relative to pedometer steps. However, pedometers cannot assess key dimensions of PA intensity or duration.MethodsWe evaluated the L‐Cat's criterion validity and sensitivity to change relative to objectively measured Sensewear armband activity monitors among 76 adults with overweight/obesity (mean age 50.8 ± 11.9 years, BMI = 33.1 ± 3.4 kg m−2) at baseline and end of a 6‐month behavioural weight management pilot trial.ResultsAt baseline, L‐Cat category was associated with armband‐measured daily steps (Spearman's ρ = 0.41, p < 0.001), total weekly minutes of moderate/vigorous‐intensity PA (MVPA) (ρ = 0.40, p < 0.001) and weekly minutes of MVPA accumulated in bouts ≥10 min (ρ = 0.47, p < 0.0001). Participants increasing ≥1 L‐Cat category from baseline to 6 months had greater increases in steps (1,110.1 ± 1,852.1 vs. −18.0 ± 2,005.6 steps/d, p = 0.032), total minutes of MVPA (145.7 ± 180.6 vs. −2.1 ± 215.8 min/week, p = 0.007) and greater weight losses (−7.4 ± 7.7% vs. −3.1 ± 4.8%, p = 0.013) than those who stayed the same/decreased L‐Cat categories.ConclusionThe L‐Cat demonstrated adequate criterion validity and excellent sensitivity to change relative to objectively measured PA among behavioural weight management pilot trial participants. The L‐Cat may be particularly useful for identifying individuals at lower activity levels and when using all six categories.

Health Literacy for Cardiac Rehabilitation: An Examination of Associated Illness Perceptions, Self-Efficacy, Motivation and Physical Activity

“…Additional information collected included body mass index (BMI, computed from self-reported height and weight), smoking status and frequency, alcohol consumption and physical activity. Physical activity was measured using the validated Stanford L-Cat [ 35 ] measure as it has been shown to be valid in mixed health literacy populations [ 36 ]. The L-Cat asks participants to indicate on a scale of 1–6 their usual physical activity over the past month.…”

Gestational weight gain and optimal wellness (GLOW): rationale and methods for a randomized controlled trial of a lifestyle intervention among pregnant women with overweight or obesity

“…The objective physical activity assessments will include 4 to 7 complete days, including at least one weekend day [46]; all physical activity outcomes will be weighted (i.e., weekdays vs. weekend days) daily averages. Self-reported activity will be measured at all pregnancy and postpartum clinic visits (except delivery) using the validated Pregnancy Physical Activity Questionnaire (PPAQ) [47, 48] to assess physical activity frequency, duration, and estimated volume; and the validated Stanford Leisure-time Categorical Item (L-Cat) [49, 50] to assess relative categories of physical activity intensity and duration in relation to national recommendations.…”

Physical activity and stress management during COVID-19: a longitudinal survey study

“…Past-month PA was measured with the Stanford Leisure-Time Activity Categorical Item (L-Cat), a validated measure with excellent sensitivity to change in PA over time (Kiernan et al, 2013;Ross et al, 2018). Participants selected one of six descriptions that best matched their past-month leisure-time PA.…”