Systematic comparative validation of self-report measures of sedentary time against an objective measure of postural sitting (activPAL)

S F M Chastin, M L Dontje, D A Skelton, I Čukić, R J Shaw, J M R Gill, C A Greig, C R Gale, I J Deary, G Der, P M Dall, Seniors USP team, Dawn A Skelton, Sebastien Chastin, Simon Cox, Elaine Coulter, Iva Čukić, Philippa Dall, Ian Deary, Geoff Der, Manon Dontje, Claire Fitzsimons, Catharine Gale, Jason Gill, Malcolm Granat, Cindy Gray, Carolyn Greig, Elaine Hindle, Karen Laird, Gillian Mead, Nanette Mutrie, Victoria Palmer, Ratko Radakovic, Naveed Sattar, Richard Shaw, John Starr, Sally Stewart, Sally Wyke, S F M Chastin, M L Dontje, D A Skelton, I Čukić, R J Shaw, J M R Gill, C A Greig, C R Gale, I J Deary, G Der, P M Dall, Seniors USP team, Dawn A Skelton, Sebastien Chastin, Simon Cox, Elaine Coulter, Iva Čukić, Philippa Dall, Ian Deary, Geoff Der, Manon Dontje, Claire Fitzsimons, Catharine Gale, Jason Gill, Malcolm Granat, Cindy Gray, Carolyn Greig, Elaine Hindle, Karen Laird, Gillian Mead, Nanette Mutrie, Victoria Palmer, Ratko Radakovic, Naveed Sattar, Richard Shaw, John Starr, Sally Stewart, Sally Wyke

Abstract

Background: Sedentary behaviour is a public health concern that requires surveillance and epidemiological research. For such large scale studies, self-report tools are a pragmatic measurement solution. A large number of self-report tools are currently in use, but few have been validated against an objective measure of sedentary time and there is no comparative information between tools to guide choice or to enable comparison between studies. The aim of this study was to provide a systematic comparison, generalisable to all tools, of the validity of self-report measures of sedentary time against a gold standard sedentary time objective monitor.

Methods: Cross sectional data from three cohorts (N = 700) were used in this validation study. Eighteen self-report measures of sedentary time, based on the TAxonomy of Self-report SB Tools (TASST) framework, were compared against an objective measure of postural sitting (activPAL) to provide information, generalizable to all existing tools, on agreement and precision using Bland-Altman statistics, on criterion validity using Pearson correlation, and on data loss.

Results: All self-report measures showed poor accuracy compared with the objective measure of sedentary time, with very wide limits of agreement and poor precision (random error > 2.5 h). Most tools under-reported total sedentary time and demonstrated low correlations with objective data. The type of assessment used by the tool, whether direct, proxy, or a composite measure, influenced the measurement characteristics. Proxy measures (TV time) and single item direct measures using a visual analogue scale to assess the proportion of the day spent sitting, showed the best combination of precision and data loss. The recall period (e.g. previous week) had little influence on measurement characteristics.

Conclusion: Self-report measures of sedentary time result in large bias, poor precision and low correlation with an objective measure of sedentary time. Choice of tool depends on the research context, design and question. Choice can be guided by this systematic comparative validation and, in the case of population surveillance, it recommends to use a visual analog scale and a 7 day recall period. Comparison between studies and improving population estimates of average sedentary time, is possible with the comparative correction factors provided.

Keywords: Measurement; Physical activity; Questionnaires; Sedentary behaviour; Sitting; Surveillance; Validation; activPAL.

Conflict of interest statement

Ethics approval and consent to participate

The Seniors USP project was approved by the Scotland A NHS research ethics committee (for LBC1936 participants) and the University of Glasgow Ethics Committee (for T07 participants). All participants gave written informed consent.

Consent for publication

Not applicable.

Competing interests

Philippa M. Dall has received funding from PAL technologies (who produce the activPAL monitor) for an unrelated study. The other authors have no competing interests to declare.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The TASTT taxonomy (reproduced from [8])
Fig. 2
Fig. 2
Example of self-report assessment of the proportion of the day spent sitting using a visual analogue scale (VAS)
Fig. 3
Fig. 3
Bland and Altman plot comparing: a direct measure of total sitting time, b direct measure using a visual analogue scale, c direct measure using a proxy measure (TV time) and d composite measure based on sum of behaviours for a previous day recall with the average recorded daily sitting time recorded with activPAL
Fig. 4
Fig. 4
Comparative plot of data loss and random error in sedentary time for eighteen self-report measures
Fig. 5
Fig. 5
Decision flow chart for choice of self-report instrument to measure sedentary time

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