A Framework for Physical Activity as a Complex and Multidimensional Behavior

Transcription

1 A Framework for Physical Activity as a Complex and Multidimensional Behavior Kelley K. Pettee Gabriel University of Texas Health Science Center James R. Morrow, Jr. University of North Texas

2 OBJECTIVES o PA Self-Report Methods: Hit and Miss o Conceptual Framework: PA o Revisiting Definitions o Considerations: Selecting Self-report Methods 2

3 BACKGROUND o Research Link: PA and Health Outcomes o PA Incorporated: Design and Implementation o Need: Accurate Quantification of PA o Lack of Gold Standard Measure(s) o Relevant Construct Confusion 3

4 SELF-REPORT HIT AND MISS Misconstrue Misname Miscount Misrepresent Misstate Mischoose Misjudge Misplace Misprint Mischief Individual-Level Miscommunication Population-Level Misunderstand Misread Mistake Surveillance Misreport Mislead Missay Miscode Misdescribe Misquote Misguide Misidentify Misinform Miscue Misinterpret Mischievous 4

5 FRAMEWORK 5

6 CONCEPTUAL FRAMEWORK HUMAN MOVEMENT Physical Activity Energy Expenditure Behavior Human Movement Physiological Attributes Sedentary Physical Fitness 6

7 Human Movement Framework Leisure Metabolic Rate Basal Occupational/School Household/Caretaking/Domestic Physical Activity Energy Expenditure Resting Thermic Effect of Food Sitting Media Use Non-Occupational School Computer Use Transportation Discretionary Sedentary Behavior Human Movement Attributes Physical Fitness PA Related EE Cardiorespiratory Fitness Strength Muscular Fitness Body Composition Endurance Sleeping Flexibility Occupation/School Non Discretionary Balance and Coordination Driving Sitting Riding 7

8 BOUCHARD AND SHEPHARD Bouchard and Shephard,

9 LAMONTE and AINSWORTH LaMonte & Ainsworth, MSSE, June

10 PHYSICAL ACTIVITY MODEL COMPARISON Bouchard & Shephard 1994 LaMonte & Ainsworth 2001 Pettee Gabriel & Morrow 2010 Main Construct Health-Related Fitness Movement Movement Sedentary Behavior No No Yes Relationship between Behavior & Attributes No No Yes Physical Activity Energy Expenditure Behavior Human Movement Physiological Attributes Sedentary Physical Fitness 10

11 DEFINITIONS 11

12 DEFINITIONS 12

13 DEFINITIONS Page 20 Page 21 13

14 DEFINITIONS Physical activity is defined as any bodily movement produced by skeletal muscles that results in energy expenditure above resting level (Caspersen et al., 1985). Health Enhancing Physical Activity is any form of activity that benefits health. Health Enhancing Physical Activity is any form of physical activity that benefits health and fitness without undue harm or risk (Foster, 2000). This can be all daily activities and can, but does not necessarily, include sports. Not all physical activity is beneficial for health (Hagströmer, 2007). To be beneficial for health, physical activity should be moderate or vigorous : Moderate-intensity physical activity raises the heart-beat and leaves the person feeling warm and slightly out of breath. It increases the body s metabolism to 3-6 times the resting level (3-6 MET s) (Cavill et al., 2006). Brisk walking, for example, has an equivalent of 4.5 MET s (Ainsworth et al., 2000). Vigorous-intensity physical activities enable people to work up a sweat and become out of breath. They usually involve sports or exercise, like running or fast cycling. They raise the metabolism to at least six times its resting level. EUPHIX:EU Public Health Information & Knowledge System, version 1.11, 17 December

15 WHAT S MISSING? o Recognition that PA is a Complex Behavior o Sedentary Behavior o PA in Context of Other Constructs of HM o Appropriate Use of Measurement Tool(s) 15

16 Conceptual Framework Human Movement Physical Activity Physical Activity: The behavior that drives human movement which results in physiological attributes including increased Behavior physical activity-related energy expenditure and improved physical fitness. Human Movement Physiological Attributes Health Enhancing PA: Activity that, when added to the lightintensity Energy activities Expenditure of daily life, produces health benefits. Sedentary Physical Fitness Sedentary: Behavior that produces little to no human movement resulting in minimal (or no) physiological gain. 16

17 FRAMEWORK COMPONENTS 17

18 PHYSIOLOGICAL ATTRIBUTES Energy Expenditure Basal Metabolic Rate Resting Thermic Effect of Food Human Movement Physiological Attributes PA Related EE Direct Cardiorespiratory Measures Strength Muscular Fitness Endurance Physical Fitness Body Composition Flexibility Balance and Coordination 18

19 Behavior Leisure Frequency Occupational/School Intensity Physical Activity Household/Caretaking/Domestic Transportation Sitting Non-Occupational & School Computer Use Duration Discretionary Behavior Human Movement Media Use Frequency Sleeping Duration Sedentary Occupation/School Non-Discretionary Driving Riding Sitting 19

20 PHYSICAL ACTIVITY DOMAINS Physical Activity Household Leisure Caretaking Domestic Occupational School Transportation 20

21 BEHAVIOR Leisure Physical fitness often Occupational/School inferred with physical activity assessment Household/Caretaking/Domestic Transportation Sitting Non-Occupational & School Computer Use Media Use Discretionary Physical Activity Physical inactivity is not the inverse of physical activity Behavior Human Movement Sleeping Sedentary Occupation/School Non-Discretionary Driving Riding Sitting 21

22 BEHAVIOR Leisure Occupational/School Physical Activity Household/Caretaking/Domestic Transportation Sitting Non-Occupational & School computer use Media Use Perceived Discretionary Behavior Behavior Human Movement Sleeping Sedentary Occupation/School Non-Discretionary Driving Riding Sitting 22

23 CONSIDERATIONS 23

24 METHODOLOGICAL ISSUES Physical Activity Activity Characteristics Population/Sample Characteristics Study Characteristics Instrument Characteristics 24

25 METHODOLOGICAL ISSUES STUDY CHARACTERISTICS Budget Staff Resources Study Characteristics Study Design Population Sample Size Study Objectives Outcomes and Confounders Geographical Location/Seasonality Temperature, Precipitation, Daylight Hours 25

26 METHODOLOGICAL ISSUES POPULATION CHARACTERISTICS Age Gender Race Ethnicity Population Characteristics Primary Language Cultural Norms Socio-Economic Status Educational Attainment Health Status Cognition Disability Status Functional Ability 26

27 METHODOLOGICAL ISSUES INSTRUMENT CHARACTERISTICS Activity v Intensity Specific Psychometric Properties Reliability, Validity, Sensitivity Instrument Characteristics Measured Constructs Relevant to Study Population and Outcomes Mode of Administration Interviewer, Self, Computer/Electronic Recall Time Frame Specific, Historical, Usual 27

28 METHODOLOGICAL ISSUES ACTIVITY CHARACTERISTICS Aerobic (BRFSS) Moderate (BRFSS) Vigorous (BRFSS) Activity Characteristics Walking (BRFSS) Sedentary (NHANES) Muscular Strengthening (HP2010) Flexibility (HP2010) Balance & Coordination Sports (YBRS) 28

29 METHODOLOGICAL ISSUES Physical Activity Activity Characteristics Population/Sample Characteristics Study Characteristics Instrument Characteristics 29

30 HUMAN MOVEMENT FRAMEWORK A Complex and Multidimensional Behavior with a Simple Message THINK o o o Assessing Component(s) of Human Movement v Measuring the Whole of Human Movement and the Possible Implications. Consider what Physical Activity Connotes to the Health Outcomes of the General Population. Consider what Physical Activity Denotes to the Researcher or Health Practitioner. 30

31 SPECIAL ACKNOWLEDGEMENT Anne-Lorraine T. Woolsey University of North Texas 31