Measuring change in trials of physical activity interventions: a comparison of self-report questionnaire and accelerometry within the PACE-UP trial
ISPAH ePoster Library. Limb E. Oct 16, 2018; 225257; 332
Elizabeth Limb
Elizabeth Limb
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Abstract BackgroundFew 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 this opportunity, using the self-administered International Physical Activity Questionnaire (IPAQ) and waist-worn accelerometry.MethodsThe 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. Outcomes were minutes of: i) accelerometer moderate-to-vigorous PA (MVPA) in ≥10 minute bouts ii) IPAQ moderate+vigorous PA and iii) IPAQ walking. For each outcome, 12 month values were regressed on baseline to estimate change.ResultsAnalyses were restricted to 655 (64%) participants with data on all outcomes at baseline and 12 months. Both intervention groups significantly increased accelerometry MVPA minutes/week compared with control: postal group 42 (95% CI 22, 61), nurse group 43 (95% CI 24, 63). IPAQ walking 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).ConclusionsOur results demonstrate the necessity of using a questionnaire focussing on the activities being altered, as with IPAQ-Walk. Even then, 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. External funding details National Institute of Health Research, HTA Programme
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