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The Children's Computerized Physical Activity Reporter: Reliability and Validity

Date: 2007 - 2009
Principal Investigator: Pearce, Patricia F., MPH, PhD, APRN, FNP-BC
Funding: NIH/NINR

Purpose: The purpose of this descriptive, comparative study will be to: (a) evaluate the test-retest reliability and (b) concurrent validity of an innovative, computer-based self-report questionnaire, the Children's Computerized Physical Activity Reporter (C-CPAR), compared with a commonly used paper-based questionnaire and objective criterion of accelerometry.

Background: Physical inactivity is linked to obesity, metabolic syndrome, and early cardiovascular risk. There are global directives to better understand children's physical activity, but physical activity measurement is difficult, especially with self-report. Currently available self-report questionnaires provide adequate reliability, but less than robust validity. The inconsistent validity of currently available physical activity questionnaires may be due the lack of attention to matching the questionnaire content and format to children's understandings of the underlying constructs, or to the form and structure that children need for precise recall. The C-CPAR was developed with children, for children, in a study aimed at identifying children's understanding of physical activity, their needs for reporting, and their perspectives on currently available questionnaires. Usability and feasibility of the C-CPAR were excellent in the original study. In a pilot feasibility study (N=31), with the National Youth Sports Program (NYSP), comparison of MET minutes of NYSP camp activity reported for two 1-day reports demonstrated strong reliability (r=0.64, p<.0001). Average MET level for scheduled NYSP activities and C-CPAR reported activities for the NYSP time period, correlations were significant, ranging between r=0.66 (p<.01 Day 1) and r=0.37 (p<.01 Day 2). Comparisons of total NYSP activity reports to crude pedometer counts were not significant (r=0.33).77 Time to completion for the C-CPAR was significantly faster on Day 2 of the study. A Spanish language alternative is being developed. However, C-CPAR reliability and validity must be assessed further, to determine the relevance of the C-CPAR for clinical or research venues.

Participants: Participants will be 180 junior-high school students from a single, ethnically-diverse public junior high school using, selected with stratified random sampling (grade and gender).

Methods: Children will be randomly assigned to two groups in a crossover design to control for questionnaire sequencing effect. Participants will wear an Actical® accelerometer for three days (Friday to Monday), complete one self-report (C-CPAR or PD-PAR) on each of the two following consecutive days, followed by crossover to the alternate report daily for two subsequent days. Analyses will include Pearson correlations for test-retest reliability and validity, Bland Altman plots to evaluate associations between measures, and differences in correlations for test of accuracy. Differences in age, gender, and ethnicity will be evaluated.

Implications: The C-CPAR may provide the format and content that matches children's understanding and needs for accurately reporting their activities. If reliability and validity are found adequate, the C-CPAR potentially can be used to assess children's activities in clinical and research venues. Improved measurement will translate to improved understanding and provide a stronger foundation for intervention. The long-term goal of this program of research is to develop intervention studies, specifically contributing to knowledge of physical activity and its behavioral components, while maximizing the use of technology. Future research will focus on the utility of the C-CPAR for therapeutic application in research and practice.