Theme: The science of sedentary behavior
Measurement of Adults' Sedentary Time in Population-Based Studies

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Abstract

Sedentary time (too much sitting) increasingly is being recognized as a distinct health risk behavior. This paper reviews the reliability and validity of self-reported and device-based sedentary time measures and provides recommendations for their use in population-based studies. The focus is on instruments that have been used in free-living, population-based research in adults. Data from the 2003–2006 National Health and Nutrition Examination Survey are utilized to compare the descriptive epidemiology of sedentary time that arises from the use of different sedentary time measures. A key recommendation from this review is that, wherever possible, population-based monitoring of sedentary time should incorporate both self-reported measures (to capture important domain- and behavior-specific sedentary time information) and device-based measures (to measure both total sedentary time and patterns of sedentary time accumulation).

Introduction

Sedentary behaviors are those pursuits undertaken while awake that involve sitting or reclining and that result in little or no physical activity energy expenditure—typically 1 to 1.5 times the resting metabolic rate.1, 2 Common sedentary behaviors include sitting or lying down while watching TV, using a computer, or driving. Sedentary time can be measured in three ways: (1) in terms of these specific behaviors (e.g., TV viewing time); (2) the amount of sedentary time occurring in a specific domain (e.g., work, leisure, domestic, transport); and (3) the overall sedentary time across the day. As the term sedentary encompasses both sitting and reclining, the broader term sedentary is used in this article, except when sitting specifically is measured.

This paper provides an overview of current methods used to measure sedentary time in free-living, population-based research in adults. The first section provides information on the reliability and validity of self-reported measures, and extends from previous reviews3 to encompass multiple domains of sedentary time. The second section describes device-based measures, with a particular focus on the interpretation and validity of data from the Actigraph activity monitor. The final section uses data from the U.S. National Health and Nutrition Examination Survey (NHANES) to provide an example of how the descriptive epidemiology of sedentary time may differ depending on how it is measured.

Section snippets

Self-Reported Measurement of Sedentary Time

Overall sedentary time can be assessed with either a single item (sometimes asked separately for weekend and weekdays), or by summing responses for the various behaviors or domains (composite measure). Key self-reported methods used are questionnaires (self-administered or interviewer-administered); behavioral logs; and short-term recalls. Questionnaires are a popular method3 because they can be implemented on a large scale, are relatively inexpensive, and do not alter the behavior under

Device-Based Measures of Sedentary Time

Given the errors associated with self-report, the ideal measure of sedentary time would

  • be accurate and reliable across different population groups;

  • distinguish among sleeping, reclining, sitting, and standing;

  • distinguish among different domains and specific behaviors;

  • be low-cost, have low participant burden, and be able to be worn continuously for extended periods of time;

  • produce data that are easily analyzed and interpreted and can be provided in real time.

No such instrument currently exists.

Descriptive Epidemiology of Sedentary Time in the U.S. As Measured by Self-Report and Accelerometry

In 2003–2004 and 2005–2006, the large, population-representative NHANES included both self-reported (global sitting time, TV viewing time, computer time) and device-based (accelerometer) measures of sedentary time. These data provide the unique opportunity to examine, within one sample, the descriptive epidemiology of sedentary time in the U.S. using a variety of measures. Rather than reporting the relationships of the various sedentary measures (which have been described previously73), the aim

Methods

The relevant NHANES methods are described in at www.cdc.gov/nchs/nhanes.htm.45 The National Centre for Health Statistics Ethics Review Board approved the protocols and written informed consent was obtained. For the current study, 2003–2006 data from adult participants (≥20 years) were used. The study did not vary in protocol and had high response rates across this period.45

Gender Differences

After adjusting for age and race/ethnicity, there were significant gender differences in all measures of sedentary time, with the direction and magnitude of the difference depending on the measure. For the domain-specific measures, prevalence was lower in women than men for high TV time (64.9% [95% CI=63.0%, 66.8%] vs 69.2% [67.6%, 70.7%], p<0.001); computer use (27.1% [25.1%, 29.1%] vs 31.3% [27.9%, 32.8%], p=0.034); and screen time (48.3% [46.2%, 50.3%] vs 52.0% [49.7%, 54.4%], p=0.012).

Summary

In summary, the sedentary measures were consistent to some extent in identifying populations comparatively more or less sedentary, with older (≥60) adults generally the most sedentary and Mexican Americans generally the least sedentary. However, these subgroup differences are not apparent if only a single sedentary time measure is assessed. For example, if NHANES had measured only TV time, then the strong and largely consistent differences between Mexican Americans and non-Hispanic whites would

Conclusion

This paper provides an overview of the reliability and validity of current self-reported and device-based (primarily the Actigraph activity monitor) population-based measures of time spent sedentary. The 2003–2006 NHANES was utilized as an example of how various measures of sedentary time identify different populations as “at risk.”

Given that both self-reported and device-based instruments capture important aspects of sedentary behavior, it is recommended that wherever possible, both measures

References (75)

  • J.F. Sallis et al.

    Assessment of physical activity by self-report: status, limitations, and future directions

    Res Q Exerc Sport

    (2000)
  • R.C. Klesges et al.

    The accuracy of self-reports of physical activity

    Med Sci Sports Exerc

    (1990)
  • A. Schatzkin et al.

    Observational epidemiologic studies of nutrition and cancer: the next generation (with better observation)

    Cancer Epidemiol Biomarkers Prev

    (2009)
  • A. Bauman et al.

    Physical activity measurement—a primer for health promotion

    Promot Educ

    (2006)
  • L. Matton et al.

    Reliability and validity of the Flemish Physical Activity Computerized Questionnaire in adults

    Res Q Exerc Sport

    (2007)
  • D.E. Rosenberg et al.

    Assessment of sedentary behavior with the International Physical Activity Questionnaire

    J Phys Act Health

    (2008)
  • T.L. Kolbe-Alexander et al.

    Comparison of two methods of measuring physical activity in South African older adults

    J Aging Phys Act

    (2006)
  • C.L. Craig et al.

    International physical activity questionnaire: 12-country reliability and validity

    Med Sci Sports Exerc

    (2003)
  • R. Miller et al.

    Steps and sitting in a working population

    Int J Behav Med

    (2004)
  • M. Zhang et al.

    Sedentary behaviours and epithelial ovarian cancer risk

    Cancer Causes Control

    (2004)
  • B.S. Fjeldsoe et al.

    Measurement properties of the Australian Women's Activity Survey

    Med Sci Sports Exerc

    (2009)
  • R.C. Brownson et al.

    Measuring the environment for friendliness toward physical activity: a comparison of the reliability of 3 questionnaires

    Am J Public Health

    (2004)
  • O.T. Trinh et al.

    Test–retest repeatability and relative validity of the Global Physical Activity Questionnaire in a developing country context

    J Phys Act Health

    (2009)
  • N. Kurtze et al.

    Reliability and validity of the international physical activity questionnaire in the Nord-Trondelag health study (HUNT) population of men

    BMC Med Res Methodol

    (2008)
  • A.L. Marshall et al.

    Measuring total and domain-specific sitting: a study of reliability and validity

    Med Sci Sports Exerc

    (2010)
  • M.J. Chinapaw et al.

    Reliability and validity of the Activity Questionnaire for Adults and Adolescents (AQuAA)

    BMC Med Res Methodol

    (2009)
  • P.A. Gardiner et al.

    Measuring older adults' sedentary time: reliability, validity and responsiveness

    Med Sci Sports Exerc

    (2011)
  • N.J. Wareham et al.

    Validity and repeatability of the EPIC-Norfolk Physical Activity Questionnaire

    Int J Epidemiol

    (2002)
  • H.B. Deng et al.

    Reliability and validity of the IPAQ-Chinese: the Guangzhou Biobank Cohort study

    Med Sci Sports Exerc

    (2008)
  • G. Papathanasiou et al.

    Reliability measures of the short International Physical Activity Questionnaire (IPAQ) in Greek young adults

    Hellenic J Cardiol

    (2009)
  • A. Rutten et al.

    Using different physical activity measurements in eight European countriesResults of the European Physical Activity Surveillance System (EUPASS) time series survey

    Public Health Nutr

    (2003)
  • D.E. Rosenberg et al.

    Reliability and validity of the sedentary behavior questionnaire (SBQ) for adults

    J Phys Act Health

    (2010)
  • J. Salmon et al.

    Physical activity and sedentary behavior: a population-based study of barriers, enjoyment, and preference

    Health Psychol

    (2003)
  • K.K. Pettee et al.

    The reliability of a survey question on television viewing and associations with health risk factors in U.S. adults

    Obesity

    (2009)
  • D. Macfarlane et al.

    Examining the validity and reliability of the Chinese version of the International Physical Activity Questionnaire, long form (IPAQ-LC)

    Public Health Nutr

    (2011)
  • L. Criniere et al.

    Reproducibility and validity of the French version of the long International Physical Activity Questionnaire in patients with type 2 diabetes

    J Phys Act Health

    (2011)
  • M. Hagströmer et al.

    Comparison of a subjective and an objective measure of physical activity in a population sample

    J Phys Act Health

    (2010)
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