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Citation

Limb ES, Ahmad S, Cook DG, Kerry SM, Ekelund U, Whincup PH, Victor CR, Iliffe S, Ussher M, Fox-Rushby J, Furness C, Ibison J, Dewilde S & Harris T (2019) Measuring change in trials of physical activity interventions: A comparison of self-report questionnaire and accelerometry within the PACE-UP trial 11 Medical and Health Sciences 1117 Public Health and Health Services. International Journal of Behavioral Nutrition and Physical Activity, 16 (1), Art. No.: 10. https://doi.org/10.1186/s12966-018-0762-5

Abstract
Background: Few trials have compared estimates of change in physical activity (PA) levels using self-reported and objective PA measures when evaluating trial outcomes. The PACE-UP trial offered the opportunity to assess this, using the self-administered International Physical Activity Questionnaire (IPAQ) and waist-worn accelerometry. Methods: The PACE-UP trial (N = 1023) compared usual care (n = 338) with two pedometer-based walking interventions, by post (n = 339) or with nurse support (n = 346). Participants wore an accelerometer at baseline and 12 months and completed IPAQ for the same 7-day periods. Main outcomes were weekly minutes, all in ≥10 min bouts as per UK PA guidelines of: i) accelerometer moderate-to-vigorous PA (Acc-MVPA) ii) IPAQ moderate+vigorous PA (IPAQ-MVPA) and iii) IPAQ walking (IPAQ-Walk). For each outcome, 12 month values were regressed on baseline to estimate change. Results: Analyses were restricted to 655 (64%) participants who provided data on all outcomes at baseline and 12 months. Both intervention groups significantly increased their accelerometry MVPA minutes/week compared with control: postal group 42 (95% CI 22, 61), nurse group 43 (95% CI 24, 63). IPAQ-Walk minutes/week also increased: postal 57 (95% CI 2, 112), nurse 43 (95% CI -11, 97) but IPAQ-MVPA minutes/week showed non-significant decreases: postal -11 (95% CI -65, 42), nurse -34 (95% CI -87, 19). Conclusions: Our results demonstrate the necessity of using a questionnaire focussing on the activities being altered, as with IPAQ-Walk questions. Even then, the change in PA was estimated with far less precision than with accelerometry. Accelerometry is preferred to self-report measurement, minimising bias and improving precision when assessing effects of a walking intervention. ? 2019 The Author(s).

Keywords
accelerometry; adult; aged; Article; clinical effectiveness; comparative study; controlled study; female; human; international physical activity questionnaire; male; nurse; nursing care; parallel design; patient care; randomized controlled trial; self report; treatment outcome; walking; actimetry; exercise; health promotion; middle aged; outcome assessment; procedures; questionnaire; walking, Accelerometry; Actigraphy; Aged; Exercise; Female; Health Promotion; Humans; Male; Middle Aged; Outcome Assessment (Health Care); Self Report; Surveys and Questionnaires; Walking

Journal
International Journal of Behavioral Nutrition and Physical Activity: Volume 16, Issue 1

• Published version