Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians

Kriska, Andrea M; Knowler, William C; LaPorte, Ronald E; Drash, Allan L; Wing, Rena R; Blair, Steven N; Bennett, Peter H; Kuller, Lewis H

doi:10.2337/diacare.13.4.401

Cited by 758Physical Activity and HealthIndigenous Health and EducationDiabetes, Cardiovascular Risks, and Lipoproteins

Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians

Kriska, Andrea M, Knowler, William C, LaPorte, Ronald E, Drash, Allan L, Wing, Rena R, Blair, Steven N, Bennett, Peter H, Kuller, Lewis H·1990·Diabetes Care

DOI 10.2337/diacare.13.4.401

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Abstract

There was a need to design a questionnaire that could accurately assess the activity patterns of Native Americans to evaluate the relationship between physical activity and diabetes. Such a questionnaire was developed and implemented into the data collection scheme of the prospective Pima Indian Study of Arizona. The questionnaire, which assesses historical, past-year, and past-week leisure and occupational activity, was examined in 29 Pima individuals aged 21-36 yr and was shown to be reliable with test-retest correlations (rank-order correlations ranged from 0.62 to 0.96 for leisure and occupational activity). Reproducibility of the past-year leisure physical-activity estimate was determined in 69 participants aged 10-59 yr and was found to be reliable in all age-groups with the exception of the 10- to 14-yr-old age-group (rank-order correlations were 0.31 in the 10- to 14-yr-old age-group compared to 0.88 to 0.92 in those greater than 20 yr of age). Validity of the current-activity section of the questionnaire was demonstrated indirectly through comparisons with activity monitors. The past-week leisure-activity estimate was related to the Caltrac activity monitor counts per hour (rho = 0.62, P less than 0.05, n = 17). In summary, a physical-activity questionnaire has been developed that is both reliable and feasible to use in the Pima Indian population to evaluate the relationship of physical activity to non-insulin-dependent diabetes mellitus.

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The MAQ assesses past-year moderate/vigorous-intensity leisure physical activities common to the population in question.
“The MAQ assesses past year, moderate/vigorous-intensity leisure PAs common to the population in question (7,8).”
From The impact of physical activity on the prevention of type 2 diabetes: Evidence and lessons learned from the Diabetes Prevention Program, a long-standing clinical trial incorporating subjective and objective activity measures (2021) · cites this paper as [8]
All subjects were administered an activity questionnaire.
“All subjects were administered an activity questionnaire (13).”
From Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S. (2006) · cites this paper as [13]

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“Physical activity level was determined using a version of the Modifiable Activity Questionnaire (MAQ) (26), which collects information on both leisure and occupational activity over the past year (including measures of frequency and duration).”
BackgroundInfluential
Reproducibility of a Self-administered Lifetime Physical Activity Questionnaire among Female College Alumnae
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“While prior studies have not assessed the reproducibility of lifetime physical activity questionnaires that used a selfadministered format, the reproducibility of two comparable, interviewer-administered lifetime questionnaires has been measured (9, 10, 13).”
BackgroundMethodResultInfluential
Measuring Physical Activity in Midlife, Older, and Minority Women: Issues from an Expert Panel
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The association of physical activity with obesity, fat distribution and glucose intolerance in Pima Indians
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Cross‐sectional Relationship of Pedometer‐Determined Ambulatory Activity to Indicators of Health
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Impact of periodic follow-up testing among urban American Indian women with impaired fasting glucose.
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“The Modified Activity Questionnaire[34,35] assessed daily and leisure activities and provided a measure of adherence to the physical activity protocol.”
Background
A Prospective Examination of Exercise and Barrier Self-efficacy to Engage in Leisure-Time Physical Activity During Pregnancy
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“The Modifiable Activity Questionnaire (MAQ; [31]) was used to measure participants' LTPA.”
Method
Effects of a lifestyle modification program in HIV-infected patients with the metabolic syndrome
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“5.4 0.1 0.1 0.1 Cardiorespiratory fitness MAQ (MET-hours/week) 33.2 12.1 17.7 14.3 VO2max 19.8 1.6 0.2 1.2 Lipodystrophy score 3.9 0.4 1.2 0.3 Immune function Viral load (log) 2.8 0.1 0.1 0.1 CD4 cell count 556 67 32 43 MAQ, Modifiable Activity Questionnaire; MET, metabolic equivalent; VO2 Discussion The modification…”
MethodInfluential
Dietary total antioxidant capacity and the occurrence of metabolic syndrome and its components after a 3-year follow-up in adults: Tehran Lipid and Glucose Study
Bahadoran, Z., Golzarand, M., Mirmiran, P., Shiva, N., & Azizi, F. (2012) · Nutrition & Metabolism · doi:10.1186/1743-7075-9-70 · Cited by 126 · see citing works
Longitudinal study of recreational physical activity in breast cancer survivors
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“Recreational PA was assessed at baseline and at each of the follow-up visits using the Modifiable Activity Questionnaire [9, 10 ].”
Method
The association of physical activity and diabetic complications in individuals with insulin-dependent diabetes mellitus: The epidemiology of diabetes complications study—VII
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“Participants completed an interview-administered PA questionnaire, assessing the past 3 months of PA including the type, frequency, and duration of 20 activities.(12)”
An observational study to examine changes in metabolic syndrome components in patients with breast cancer receiving neoadjuvant or adjuvant chemotherapy
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Carmack, C. L., de Moor, C., Boudreaux, E. D., Amaral-Melendez, M., & Brantley, P. J. (1999) · Annals of Behavioral Medicine · doi:10.1007/bf02884842 · Cited by 99 · see citing works
“The Physical Activity Questionnaire (Kriska et al., 1990) is a physical activity assessment instrument designed to assess historical,”
Background
The validation of physical activity instruments for measuring energy expenditure: problems and pitfalls
Rennie, K. L., & Wareham, N. J. (1998) · Public Health Nutrition · doi:10.1079/phn19980043 · Cited by 117 · see citing works
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Ghanbarian, A., Delshad, M., Ghaleh, N. A. R., Amirshekari, G., Askari, S., & Azizi, F. (2015) · International Journal of Preventive Medicine · doi:10.4103/2008-7802.151433 · Cited by 116 · see citing works
“[8] Some other population‑based studies have reported reliability and validity of the MAQ.”
BackgroundInfluential
Association of 25(OH)D and PTH with Metabolic Syndrome and Its Traditional and Nontraditional Components
Kayaniyil, S., Vieth, R., Harris, S. B., Retnakaran, R. R., Knight, J. A., Gerstein, H. C., Perkins, B. A., Zinman, B., & Hanley, A. J. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-1439 · Cited by 114 · see citing works
Explaining Long-Term Exercise Adherence in Women Who Complete a Structured Exercise Program
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“The MAQ assesses historical, past year, and past week activity and is reliable and valid for adults (Kriska et al., 1990).”
Background
Reliability and Validity of the Flemish Physical Activity Computerized Questionnaire in Adults
Matton, L., Wijndaele, K., Duvigneaud, N., Duquet, W., Philippaerts, R. M., Thomis, M. A., & Lefevre, J. (2007) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2007.10599427 · Cited by 113 · see citing works
“…et al., 2003), the Baecke Questionnaire of Habitual Physical Activity (Baecke, Burema, & Frijters, 1982), the Tecumseh Community Health Questionnaire (Reiff et al., 1967), the Seven-Day Physical Activity Recall (Sallis et al., 1985), and the Modifiable Activity Questionnaire (Kriska et al., 1990).”
Background
Pedometer-determined ambulatory activity in individuals with type 2 diabetes
Tudor-Locke, C. E., Bell, R. C., Myers, A. M., Harris, S. B., Lauzon, N., & Rodger, N. W. (2002) · Diabetes Research and Clinical Practice · doi:10.1016/s0168-8227(01)00317-5 · Cited by 108 · see citing works
“However, walking is considered the least reliably recalled physical activity [2–4].”
Background
Physical Activity Self-Monitoring and Weight Loss
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“Reported PA was measured using a past 6 month version of the Modifiable Activity Questionnaire (MAQ), a reliable (24, 27) and valid (24, Conroy et al.”
MethodSelf-citation
Massive obesity in adolescents: dietary interventions and behaviours associated with weight regain at 2 y follow-up
Rolland‐Cachera, M., Thibault, H., Souberbielle, J., Soulié, D., Carbonel, P., Deheeger, M., Roinsol, D., Longueville, E., Bellisle, F., & Serog, P. (2004) · International Journal of Obesity · doi:10.1038/sj.ijo.0802605 · Cited by 107 · see citing works
Racial Differences in Insulin Secretion and Sensitivity in Prepubertal Children: Role of Physical Fitness and Physical Activity
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“(29), which was designed to investigate the relationship between physical activity and type 2 diabetes in Pima Indians.”
Background
Primary prevention of non‐insulin‐dependent diabetes mellitus
Tuomilehto, J., Knowler, W. C., & Zimmet, P. (1992) · Diabetes/Metabolism Reviews · doi:10.1002/dmr.5610080403 · Cited by 107 · see citing works
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Pregnancy as a Window to Future Cardiovascular Health: Design and Implementation of the nuMoM2b Heart Health Study
Haas, D. M., Ehrenthal, D. B., Koch, M. A., Catov, J. M., Barnes, S. E., Facco, F., Parker, C. B., Mercer, B. M., Merz, C. N. B., Silver, R. M., et al. (2016) · American Journal of Epidemiology · doi:10.1093/aje/kwv309 · Cited by 107 · see citing works
The effect of exercise on body composition and bone mineral density in breast cancer survivors taking aromatase inhibitors
Thomas, G. A., Cartmel, B., Harrigan, M., Fiellin, M. G., Capozza, S. J., Zhou, Y., Ercolano, E. A., Gross, C. P., Hershman, D. L., Ligibel, J. A., et al. (2016) · Obesity · doi:10.1002/oby.21729 · Cited by 107 · see citing works
“Participants also completed an interviewer administered physical activity questionnaire, which assessed the past 6 months of recreational activity including the type, frequency, and duration of activities (27).”
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Assessing gene–treatment interactions at the FTO and INSIG2 loci on obesity-related traits in the Diabetes Prevention Program
Franks, P. W., Jablonski, K. A., Delahanty, L. M., McAteer, J. B., Kahn, S. E., Knowler, W. C., & Florez, J. C. (2008) · Diabetologia · doi:10.1007/s00125-008-1158-x · Cited by 106 · see citing works
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Ethnic and Cultural Issues in Assessing Physical Activity
Kriska, A. M. (2000) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2000.11082786 · Cited by 105 · see citing works
“Specifically walking is often found to be one of the most popular activities cited (Kriska et al., 1990; Rohm-Young, 1998).”
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Longitudinal 5-Year Evaluation of Bone Density and Microarchitecture After Roux-en-Y Gastric Bypass Surgery
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Investigation and analysis on the status of diabetes cognition among COPD patients complicated with diabetes mellitus
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Diabetes status affects long-term changes in coronal caries - The SHIP Study
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Authors: Kriska, A. M., Knowler, W. C., LaPorte, R. E., Drash, A. L., Wing, R. R., Blair, S. N., Bennett, P. H., & Kuller, L. H.
Affiliations: University of Pittsburgh (US)
ORCID: Kriska, Andrea M
Knowler, William C
Wing, Rena R
Blair, Steven N
Bennett, Peter H
Kuller, Lewis H
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 1990-04-01
Volume: 13
Issue: 4
Pages: 401-411
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/diacare.13.4.401
OpenAlex: W2004395090
Cited by: 755
References: 0
Citations by year: 2026: 9 · 2025: 18 · 2024: 19 · 2023: 31 · 2022: 20 · 2021: 36 · 2020: 35 · 2019: 29 · 2018: 30 · 2017: 28 · 2016: 31 · 2015: 37 · 2014: 36 · 2013: 42 · 2012: 39
FWCI: 1.88
Type: journal article
Language: en
Open access: closed
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
Scholar Commons (University of South Carolina) (submittedVersion)
Funders: Centers for Disease Control and Prevention
Topics: Health Sciences › Medicine › Physiology › Physical Activity and Health
Health Sciences › Health Professions › General Health Professions › Indigenous Health and Education
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: physical activity, diabetes mellitus, Pima Indians, questionnaire development, leisure-time physical activity, occupational physical activity, test-retest reliability, validity, wearable activity trackers, type 2 diabetes, Native Americans
MeSH terms: Adolescent, Adult, Arizona, Child, Diabetes Mellitus, Type 2, Female, Humans, Indians, North American, Male, Middle Aged, Physical Fitness, Surveys and Questionnaires, Reproducibility of Results

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Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians

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