Non-response bias in physical activity trend estimates

Evaluation of a Workplace Active Rest Program in Office Workers With Comparison of a Prospective and Retrospective Survey

Physical activity-related workplace interventions can be counterstrategies for physical inactivity due to office work. Newly introduced programs should be evaluated for success. This study aimed to evaluate the intervention of a workplace active rest program and to compare a prospective and retrospective design of evaluation. A Germany-wide multicenter evaluation of a 3-month workplace active rest program (30 min, once a week) was carried out at 14 locations with a longitudinal pre/post design by means of an anonymous questionnaire (npre = 405, npost = 369). The participants' program-related changes in targeted characteristics regarding posture, function, complaints and physical awareness were collected with a questionnaire in a prospective design and afterward retrospectively. The prospective evaluation showed a significant improvement in the target characteristic "postural muscles in the neck area". In the retrospective survey, all target characteristics improved significantly. There were no differences between locations. The workplace active rest program in this study had positive effects on the perception of postural neck muscle status regardless of prospective or retrospective approach. Selection of survey mode should depend on desired outcome and consecutive influencing factors. In this specific case, retrospective survey could give more indirect information about overall satisfaction with the program and job although being influenced by response bias. Recall bias should be relatively small for shorter time periods assessed. Future studies should account for corresponding bias and specifics of target characteristics regardless of the chosen approach to survey.

Time Trends in Physical Activity Using Wearable Devices: A Systematic Review and Meta-analysis of Studies from 1995 to 2017

INTRODUCTION

Conflicting evidence exists on whether physical activity (PA) levels of humans have changed over the last quarter-century. The main objective of this study was to determine if there is evidence of time trends in PA, from cross-sectional studies that assessed PA at different time points using wearable devices (e.g., pedometers and accelerometers). A secondary objective was to quantify the rate of change in PA.

METHODS

A systematic literature review was conducted of English-language studies indexed in PubMed, SPORTDiscus, and Web of Science (1960-2020) using search terms (time OR temporal OR secular) AND trends AND (steps per day OR pedometer OR accelerometer OR MVPA). Subsequently, a meta-analytic approach was used to aggregate data from multiple studies and to examine specific factors (i.e., sex, age-group, sex and age-group, and PA metric).

RESULTS

Based on 16 peer-reviewed scientific studies conducted between 1995 and 2017, levels of ambulatory PA are trending downward in developed countries. Significant declines were seen in both males and females (P < 0.001) as well as in children (P = 0.020), adolescents (P < 0.001), and adults (P = 0.004). The average study duration was 9.4 yr (accelerometer studies, 5.3 yr; pedometer studies, 10.8 yr). For studies that assessed steps, the average change in PA was -1118 steps per day over the course of the study (P < 0.001), and adolescents had the greatest change in PA at -2278 steps per day (P < 0.001). Adolescents also had the steepest rate of change over time, expressed in steps per day per decade.

CONCLUSIONS

Evidence from studies conducted in eight developed nations over a 22-yr period indicates that PA levels have declined overall, especially in adolescents. This study emphasizes the need for continued research tracking time trends in PA using wearable devices.

Individualized Efficiency of Traditional Chinese Medicine for Non-ST Segment Elevation Acute Coronary Syndrome: Study Protocol for Observational Research by the Evidence-Based Goal Attainment Scale

Background

Non-ST segment elevation acute coronary syndrome has been one of the most serious diseases threatening human health. Long-term cardiac rehabilitation and secondary prevention is the essential method to control the recurrence and mortality of the disease. Traditional Chinese medicine has proved the efficiency on the treatment of non-ST segment elevation acute coronary syndrome, but there is a lack of appropriate methodological design to reflect the characteristics of individualized diagnosis and treatment of it. Therefore, this study used the evidenced-based Goal Attainment Scale to evaluate the clinical effectiveness of traditional Chinese medicine on the treatment of non-ST segment elevation acute coronary syndrome.

Method

This is observational research with the prospective feature. A total of 200 patients will be recruited and observed in the three months by telephone or door visit, collecting the individualized intervention of traditional Chinese medicine and evaluating through the method of evidence-based Goal Attainment Scale. Participants will be included according to the inclusion and exclusion criteria. Any reasons for loss to follow-up and adverse events will be recorded strictly. Discussion. The evidence-based Goal Attainment Scale provides a personalized method of evaluation based on the Goal Attainment Scale and combined with evidence-based medicine, which can better reflect the characteristics and superiority of individualized and dynamic intervention for traditional Chinese medicine on the long-term prevention and treatment of non-ST segment elevation acute coronary syndrome than other methods of design. It is of great significance to explore and promote this method of design in the future.

Non-response bias in estimates of prevalence of club-based sport participation from an Australian national physical activity, recreation and sport survey

Background

An estimate of the prevalence of an activity derived from a sample survey is potentially subject to non-response bias, whereby people not involved in the activity are less likely to respond than those involved. Quantifying the extent of non-response bias is generally difficult, since it involves estimating differences between respondents for whom data is directly available from the survey, and non-respondents, for whom data is generally not directly or readily available. However, in the case of the Australian Exercise Recreation and Sport Survey (ERASS), comparative “gold standard” benchmarks exist for some aspects of the survey, in the form of state sporting association (SSA) registration databases, each of which purports to constitute a complete enumeration of club-based players of a particular sport.

Methods

ERASS estimates of the prevalence of participation in four major club-based team sports in the Australian state of Victoria in the year 2010 were compared with prevalences based on numbers of registered participants in the corresponding SSA databases. Comparisons were made for the adult population as a whole (ERASS scope being 15+ years of age), and for strata defined by age and geographical region. Because three of the four sports investigated are strongly sex-specific, no sex breakdowns were conducted. In each case the proportion of ERASS respondents reporting participation, with associated confidence limits, was compared with the corresponding SSA count expressed as a proportion of the population, to form an ERASS/SSA prevalence ratio with associated confidence limits.

Results

The 24 ERASS/SSA ratios ranged from 1.72 to 7.80. Most ratios lay in the range 2 to 3. The lower 95% confidence bound for the ratio was greater than 1.0 in 23 out of 24 cases.

Conclusions

ERASS estimates of prevalence of these particular aspects of sport participation were higher than SSA estimates, to statistically significant degrees. The effect sizes (i.e. the discrepancies represented by the ratios) were large enough to be of great practical importance. It is conjectured that non-response bias is the most likely explanation for the discrepancies.

CANPLAY study: Secular trends in steps/day amongst 5-19year-old Canadians between 2005 and 2014

INTRODUCTION

The Canadian Physical Activity Levels Among Youth (CANPLAY) study collected pedometer data from eight surveys between 2005 and 2014, making it a unique database of objective population physical activity surveillance. The purpose of this study was to describe secular physical activity trends for 5-19year olds.

METHODS

Canadian children from nationally representative samples (10,000 recruited, n≅5500 per survey) were mailed a pedometer kit, asked to wear the pedometer for 7 consecutive days, log steps daily, then return the log by mail. Weighted medians and prevalence estimates were calculated. Trends were tested by χ(2) test of independence.

RESULTS

An overall median of 10,935 steps/day was taken by Canadian children 5-19years of age (n=43,806) across the eight surveys. Steps/day increased between 2005-06 and 2007-08, then decreased in 2012-14. The prevalence of taking sufficient steps/day (defined as ≥10,000 steps/day for 5year olds, ≥13,000 steps/day for 6-11year-old boys; ≥11,000 steps/day for 6-11year-old girls; and ≥10,000 steps/day for 12-19year olds;) also increased then decreased over time, whereas the prevalence of accumulating <7000 steps/day generally increased over time. Trends were significant for boys, girls and each age group.

DISCUSSION

The CANPLAY surveillance system provided comparable data at multiple time points over 9years. An overall shift in the distribution of steps/day towards a less active lifestyle occurred between 2005-06 and 2012-14 for boys, girls and each age group. This provides evidence that the national policy goal to increase children's steps/day by 2015 has not been met.

A study protocol for applying the co-creating knowledge translation framework to a population health study

BACKGROUND

Population health research can generate significant outcomes for communities, while Knowledge Translation (KT) aims to expressly maximize the outcomes of knowledge producing activity. Yet the two approaches are seldom explicitly combined as part of the research process. A population health study in Port Lincoln, South Australia offered the opportunity to develop and apply the co-KT Framework to the entire research process. This is a new framework to facilitate knowledge formation collaboratively between researchers and communities throughout a research to intervention implementation process.

DESIGN

This study employs a five step framework (the co-KT Framework) that is formulated from engaged scholarship and action research principles. By following the steps a knowledge base will be cumulatively co-created with the study population that is useful to the research aims. Step 1 is the initiating of contact between the researcher and the study contexts, and the framing of the research issue, achieved through a systematic data collection tool. Step 2 refines the research issue and the knowledge base by building into it context specific details and conducting knowledge exchange events. Step 3 involves interpreting and analysing the knowledge base, and integrating evidence to inform intervention development. In Step 4 the intervention will be piloted and evaluated. Step 5 is the completion of the research process where outcomes for improvement will be instituted as regular practice with the facilitation of the community.In summary, the model uses an iterative knowledge construction mechanism that is complemented by external evidence to design interventions to address health priorities within the community.

DISCUSSION

This is a systematic approach that operationalises the translational cycle using a framework for KT practice. It begins with the local context as its foundation for knowledge creation and ends with the development of contextually applicable interventions. It will be of interest to those involved in KT research, participatory action research, population health research and health care systems studies. The co-KT Framework is a method for embedding the principles of KT into all stages of a community-based research process, in which research questions are framed by emergent data from each previous stage.