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Initial Validation of an Exercise “Vital Sign” in Electronic Medical Records
Abstract
PURPOSE: The objective of this study is to describe the face and discriminant validity of an exercise vital sign (EVS) for use in an outpatient electronic medical record. METHODS: Eligible patients were 1,793,385 adults 18 yr and older who were members of a large health care system in Southern California. To determine face validity, median total self-reported minutes per week of exercise as measured by the EVS were compared with findings from national population-based surveys. To determine discriminant validity, multivariate Poisson regression models with robust variance estimation were used to examine the ability of the EVS to discriminate between groups of patients with differing physical activity (PA) levels on the basis of demographics and health status. RESULTS: After 1.5 yr of implementation, 86% (1,537,798) of all eligible patients had an EVS in their electronic medical record. Overall, 36.3% of patients were completely inactive (0 min of exercise per week), 33.3% were insufficiently active (more than 0 but less than 150 min·wk), and 30.4% were sufficiently active (150 min or more per week). As compared with national population-based surveys, patient reports of PA were lower but followed similar patterns. As hypothesized, patients who were older, obese, of a racial/ethnic minority, and had higher disease burdens were more likely to be inactive, suggesting that the EVS has discriminant validity. CONCLUSIONS: We found that the EVS has good face and discriminant validity and may provide more conservative estimates of PA behavior when compared with national surveys. The EVS has the potential to provide information about the relationship between exercise and health care use, cost, and chronic disease that has not been previously available at the population level.
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“However, this assessment of PA has previously been validated, 18 19”
From Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients (2021) · cites this paper as [18]
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Exercise is medicine and physicians need to prescribe it!
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Self-citationReliability and Validity of the Instrument Used in BRFSS to Assess Physical Activity
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The physical activity vital sign: a primary care tool to guide counseling for obesity
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Developing healthcare systems to support exercise: exercise as the fifth vital sign
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Schmitz, K. H., Campbell, A. M., Stuiver, M. M., Pinto, B. M., Schwartz, A. L., Morris, G. S., Ligibel, J. A., Cheville, A., Galvão, D. A., Alfano, C. M., et al. (2019) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21579 · Cited by 789
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Lobelo, F., Rohm Young, D., Sallis, R., Garber, M. D., Billinger, S. A., Duperly, J., Hutber, A., Pate, R. R., Thomas, R. J., Widlansky, M. E., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000559 · Cited by 402
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Metadata
- Authors
- COLEMAN, K. J., NGOR, E., REYNOLDS, K., QUINN, V. P., KOEBNICK, C., YOUNG, D. R., STERNFELD, B., & SALLIS, R. E.
- Affiliations
- Kaiser Permanente (US)
- Kaiser Permanente Fontana Medical Center (US)
- ORCID
- Venue
- Medicine & Science in Sports & Exercise
- Published
- 2012-11
- Volume
- 44
- Issue
- 11
- Pages
- 2071-2076
- ISSN
- 0195-9131 (ISSN-L)
- OpenAlex
- W2066565684
- Cited by
- 376
- References
- 8
- Citations by year
- 2026: 27 · 2025: 29 · 2024: 37 · 2023: 34 · 2022: 34 · 2021: 34 · 2020: 39 · 2019: 26 · 2018: 21 · 2017: 21 · 2016: 19 · 2015: 19 · 2014: 26 · 2013: 8 · 2012: 1
- FWCI
- 11.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medicine & Science in Sports & Exercise (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- physical activity, electronic health records, face validity, discriminant validity, self-reported exercise, physical inactivity, health disparities, obesity, chronic disease burden, outpatient care
- MeSH terms
- Adolescent, Adult, Aged, Ambulatory Care, California, Counseling, Female, Humans, Male, Middle Aged, Physical Fitness, Surveys and Questionnaires, Health Behavior, Exercise, Discriminant Analysis, Poisson Distribution, Young Adult, Electronic Health Records
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