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Agreement between questions about physical activity and sitting time, and device-based measures, used in Swedish targeted health dialogues in the context of primary health care
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Unit for Research and Development in Primary Care, Futurum—Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.ORCID iD: 0000-0001-5834-7494
Unit for Research and Development in Primary Care, Futurum—Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.
Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.ORCID iD: 0000-0002-0156-6677
Unit for Research and Development in Primary Care, Futurum—Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.
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2023 (English)In: BMC Sports Science, Medicine and Rehabilitation, ISSN 2052-1847, Vol. 15, no 1, article id 76Article in journal (Refereed) Published
Abstract [en]

Background: It is important that easy-to-use measures like subjective questions about physical activity (PA) and sedentary behaviour are valid and reliable providing accurate measures, when they are used in health promotion work aiming to support people to improve their lifestyle habits such as PA. The aim of this study was to evaluate the concurrent validity of a structured interview form estimating self-reported PA and a question about sitting time used in Swedish targeted health dialogues in the context of primary health care. Method: The study was conducted in the southern part of Sweden. To evaluate concurrent validity of the interview form, time spent in moderate-to-vigorous physical activities (MVPA) and energy expenditure related to MVPA estimated by an interview form was compared with the same measures assessed by an ActiGraph GT3X-BT accelerometer. To evaluate a question about sitting time, the Swedish School of Sport and Health Sciences’ single-item question about sitting time (SED-GIH) was compared with measures from an activPAL inclinometer. Statistical analyses included deriving Bland‒Altman plots and calculating Spearman’s rank correlation coefficients. Result: Bland‒Altman plots indicated lower absolute variation in the difference between self-reported and device-based PA measures for lower PA levels, both for energy expenditure and time spent in MVPA. No systematic over- or underestimation was observed. The Spearman’s correlation coefficient between self-reported and device-based PA measures was 0.27 (p = 0.014) for time spent in MVPA and 0.26 (p = 0.022) for energy expenditure. The correlation coefficient between the single item question and device-based sitting time measures was 0.31 (p = 0.002). Sitting time was underestimated by 74% of the participants. Conclusion: The PA interview form and the SED-GIH question on sitting time may be of value in targeted health dialogues in primary health care with the intention to support sedentary and insufficiently physically active persons in increasing their physical activity and limiting their sitting time. The questionnaires are easy to use and are more cost effective than device-based measures, especially regarding population-based interventions conducted in primary health care for thousands of participants such as targeted health dialogues. Clinical trial registration: Not applicable.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023. Vol. 15, no 1, article id 76
Keywords [en]
Accelerometry, Bland-Altman plot, Evaluation, Physical activity interview form, Targeted health dialogue, active transport, adult, aged, Article, autumn, concurrent validity, controlled study, degree of freedom, energy expenditure, female, human, human experiment, indirect calorimetry, interview, male, middle aged, physical activity, primary health care, running, sedentary lifestyle, sedentary time, sitting, social psychology, spring, standing, structured interview, summer, Swedish citizen, walking, winter
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hj:diva-62175DOI: 10.1186/s13102-023-00690-8ISI: 001020017300001PubMedID: 37403124Scopus ID: 2-s2.0-85164119970Local ID: GOA;;897251OAI: oai:DiVA.org:hj-62175DiVA, id: diva2:1788855
Funder
Medical Research Council of Southeast Sweden (FORSS)Futurum - Academy for Health and Care, Jönköping County Council, SwedenAvailable from: 2023-08-17 Created: 2023-08-17 Last updated: 2024-03-07Bibliographically approved
In thesis
1. To do or not to do? Physical activity in relation to socioeconomic status and health – a salutogenic perspective in the context of targeted health dialogues
Open this publication in new window or tab >>To do or not to do? Physical activity in relation to socioeconomic status and health – a salutogenic perspective in the context of targeted health dialogues
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

It is well known that physical activity (PA) has a major positive impact on health and that the performance of PA is lower in low socioeconomic groups. However, more knowledge about the relationship between PA and health is needed especially between and within socioeconomic groups.

This thesis aimed, from a salutogenic perspective, to increase the understanding of the relationship between physical activity and health in the adult population, with a particular focus on people with economic difficulties. A further aim was to validate questions about physical activity and to explore the people’s experiences of PA from a sense of coherence perspective, all in the context of targeted health dialogues.

The first study in this thesis is a validation study. It validates a PA interview form and questions about sedentary time used in the targeted health dialogues. Studies II and III comprise quantitative analyses of PA, health and psychological factors in the population, especially in groups with low socioeconomic status (SES). Study IV is a qualitative deductive study based on interviews with participants with low SES in the targeted health dialogues. The deductive analysis contains the participants’ experiences of PA from a sense of coherence perspective.

The findings in study I showed that the interview form and the single-item question about sedentary time could be considered as acceptable to use in Swedish targeted health dialogues. In study II, physically active people with low SES were shown to have the same odds of reporting good self-rated health compared to those with low PA and high SES. The findings in study III showed that within the group of people with self-reported economic difficulties, higher levels of PA were related to better mastery and more vitality. Study IV showed that it is essential for the participants to have an awareness of the health benefits of PA and their challenges in performing PA. The participants also constructed a plan to follow while utilising their resources, and their intrinsic motivation to achieve the PA recommendations and the PA benefits.

This thesis brings a deeper knowledge and understanding of the healthperspective of PA. This knowledge can be used to further develop thetargeted health dialogues in a salutogenic way. It will give people,especially those with lower SES, the opportunity to use their resourcesto increase PA and thereby improve their future health.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2024. p. 93
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 133
Keywords
health, mastery, physical activity, quality of life, salutogenesis, self-rated health, sense of coherence, targeted health dialogues, vitality
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hj:diva-63764 (URN)978-91-88669-41-4 (ISBN)978-91-88669-42-1 (ISBN)
Public defence
2024-04-05, Forum Humanum, School of Health and Welfare, Jönköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2024-03-07 Created: 2024-03-07 Last updated: 2024-03-07Bibliographically approved

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Johansson, LisbethGolsäter, MarieFransson, Eleonor I.

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