Measuring change in trials of physical activity interventions: a comparison of self-report questionnaire and accelerometry within the PACE-UP trial
Open accessAbstract
BACKGROUND: Few trials have compared estimates of change in physical activity (PA) levels using self-reported and objective PA measures when evaluating trial outcomes. The PACE-UP trial offered the opportunity to assess this, using the self-administered International Physical Activity Questionnaire (IPAQ) and waist-worn accelerometry. METHODS: The PACE-UP trial (N = 1023) compared usual care (n = 338) with two pedometer-based walking interventions, by post (n = 339) or with nurse support (n = 346). Participants wore an accelerometer at baseline and 12 months and completed IPAQ for the same 7-day periods. Main outcomes were weekly minutes, all in ≥10 min bouts as per UK PA guidelines of: i) accelerometer moderate-to-vigorous PA (Acc-MVPA) ii) IPAQ moderate+vigorous PA (IPAQ-MVPA) and iii) IPAQ walking (IPAQ-Walk). For each outcome, 12 month values were regressed on baseline to estimate change. RESULTS: Analyses were restricted to 655 (64%) participants who provided data on all outcomes at baseline and 12 months. Both intervention groups significantly increased their accelerometry MVPA minutes/week compared with control: postal group 42 (95% CI 22, 61), nurse group 43 (95% CI 24, 63). IPAQ-Walk minutes/week also increased: postal 57 (95% CI 2, 112), nurse 43 (95% CI -11, 97) but IPAQ-MVPA minutes/week showed non-significant decreases: postal -11 (95% CI -65, 42), nurse -34 (95% CI -87, 19). CONCLUSIONS: Our results demonstrate the necessity of using a questionnaire focussing on the activities being altered, as with IPAQ-Walk questions. Even then, the change in PA was estimated with far less precision than with accelerometry. Accelerometry is preferred to self-report measurement, minimising bias and improving precision when assessing effects of a walking intervention. TRIAL REGISTRATION: ISRCTN, ISRCTN98538934 . Registered 2 March 2012.
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Self-reported outcomes have a higher risk of over-estimation.
“We analyzed objective and self-reported measures separately because self-reported outcomes have a higher risk of over-estimation [58,59].”
From Fitbit-based interventions for healthy lifestyle outcomes: systematic review and meta-analysis (2020) · cites this paper as [59]
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- Authors
- Limb, E. S., Ahmad, S., Cook, D. G., Kerry, S. M., Ekelund, U., Whincup, P. H., Victor, C. R., Iliffe, S., Ussher, M., Fox-Rushby, J., Furness, C., Ibison, J., DeWilde, S., & Harris, T.
- Affiliations
- St George's, University of London (GB)
- Queen Mary University of London (GB)
- Norwegian School of Sport Sciences (NO)
- Brunel University of London (GB)
- University College London (GB)
- King's College London (GB)
- Corresponding author
- Cook, Derek G.
- ORCID
- Venue
- International Journal of Behavioral Nutrition and Physical Activity
- Published
- 2019-01-22
- Volume
- 16
- Issue
- 1
- Pages
- 10-10
- ISSN
- 1479-5868 (ISSN-L)
- PMC
- PMC6341662
- OpenAlex
- W2919527811
- Cited by
- 67
- References
- 30
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 7 · 2023: 6 · 2022: 10 · 2021: 6 · 2020: 23 · 2019: 5
- FWCI
- 7.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Behavioral Nutrition and Physical Activity (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Portal (King's College London) (publishedVersion, other-oa)
- St George's Online Research Archive (St George's University of London) (acceptedVersion)
- Brunel University Research Archive (BURA) (Brunel University London) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Stirling Online Research Repository (University of Stirling) (submittedVersion, cc-by)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion, cc-by)
- Funders
- Health Technology Assessment Programme (HTA 10/32/02)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- physical activity measurement, accelerometry, self-report questionnaire, International Physical Activity Questionnaire, moderate-to-vigorous physical activity, walking, measurement precision, nursing support
- MeSH terms
- Aged, Female, Health Promotion, Humans, Male, Middle Aged, Surveys and Questionnaires, Exercise, Walking, Outcome Assessment, Health Care, Actigraphy, Self Report, Accelerometry
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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