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

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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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Background
Construct Validity of Self-reported Historical Physical Activity
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BackgroundMethodSelf-citation
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Method
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Self-citation
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Method
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Effect of Tesamorelin on Visceral Fat and Liver Fat in HIV-Infected Patients With Abdominal Fat Accumulation
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“An introductory paragraph about free time recreation, sport and fitness activities and a modified list of physical activities from the Historical Leisure Activity Questionnaire (Kriska et al., 1990) were provided to orient the respondents to the questions about physically active leisure.”
Application of the transtheoretical model to sedentary behaviors and its association with physical activity status
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Prevention of overweight and obesity in children under the age of 6 yearsA report commissioned by the Canadian Council of Food and Nutrition.
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Background
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MethodSelf-citation
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Development and validation of a questionnaire for the assessment of physical activity in epidemiological studies in Sub-Saharan Africa
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BackgroundMethodInfluential
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BackgroundMethod
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Han, J. L., Dinger, M. K., Hull, H. R., Randall, N. B., Heesch, K. C., & Fields, D. A. (2008) · American Journal of Health Education · doi:10.1080/19325037.2008.10599038 · Cited by 75
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Method
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“Physical activity was measured using the Modifiable Physical Activity questionnaire previously used in multi-ethnic populations and determined by self-report [50,51].”
Method
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Self-citation
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“[27] questionnaires.”
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Method
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BackgroundMethod
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Stevens, J., Suchindran, C., Ring, K., Baggett, C. D., Jobe, J. B., Story, M. T., Thompson, J. L., Going, S. B., & Caballero, B. H. (2004) · Obesity Research · doi:10.1038/oby.2004.248 · Cited by 71
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Background
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BackgroundSelf-citation
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Method
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BackgroundSelf-citation
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Background
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Method
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BackgroundMethodInfluential
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InfluentialSelf-citation
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Jacobi, D., Charles, M.-A., Tafflet, M., Lommez, A., Borys, J.-M., & Oppert, J.-M. (2009) · European Journal of Epidemiology · doi:10.1007/s10654-009-9329-8 · Cited by 64
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BackgroundMethodResultInfluential
Inverse association between fruit, legume, and cereal fiber and the risk of metabolic syndrome: Tehran Lipid and Glucose Study
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Method
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Gabriel, K. P., Rankin, R. L., Lee, C., Charlton, M. E., Swan, P. D., & Ainsworth, B. E. (2010) · Journal of Physical Activity and Health · doi:10.1123/jpah.7.5.649 · Cited by 64
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“Activity Questionnaire with high reliability and moderate validity (Kriska et al., 1990; Momenan et al., 2012).”
BackgroundMethod
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Roeykens, J., Rogers, R. K. L., MEEUSEN, R. R., Magnus, L., Borms, J., & Meirleir, K. D. (1998) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199807000-00008 · Cited by 67
Issues in accelerometer methodology: the role of epoch length on estimates of physical activity and relationships with health outcomes in overweight, post-menopausal women
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Self-citation
Relationship Between Neck Circumference and Cardiometabolic Parameters in HIV-Infected and non–HIV-Infected Adults
Fitch, K. V., Stanley, T. L., Looby, S. E. D., Rope, A. M., & Grinspoon, S. K. (2011) · Diabetes Care · doi:10.2337/dc10-1983 · Cited by 62
“In one of the cohorts, physical activity was assessed using the Modifiable Activity Questionnaire (12).”
MethodInfluential
Untitled work
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Dynamic Relations Between Sedentary Behavior, Physical Activity, and Body Composition After Bariatric Surgery
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“The questionnaire has been described in detail elsewhere [23–25].”
Method
Association between dietary phytochemical index and 3-year changes in weight, waist circumference and body adiposity index in adults: Tehran Lipid and Glucose study
Mirmiran, P., Bahadoran, Z., Golzarand, M., Shiva, N., & Azizi, F. (2012) · Nutrition & Metabolism · doi:10.1186/1743-7075-9-108 · Cited by 60
“High reliability and relatively moderate validity were reported for the Persian translated MAQ in Tehranian adults [26].”
Method
Is food portion size a risk factor of childhood overweight?
Lioret, S., Volatier, J.-L., Lafay, L., Touvier, M., & Maire, B. (2007) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1602958 · Cited by 65
“The physical activity questionnaire was derived from the French translation (Deheeger et al., 1997) of the Modifiable Activity Questionnaire designed for adolescents by Kriska et al. (1990) and adapted for children (Fontvieille et al., 1993).”
Method
The Effects of Aerobic Exercise on Estrogen Metabolism in Healthy Premenopausal Women
Smith, A. J., Phipps, W. R., Thomas, W. T. B., Schmitz, K. H., & Kurzer, M. S. (2013) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-12-1325 · Cited by 63
“Self-reported physical activity conducted a year before the study and during the 4-month follow-upperiodwas assessed by a research staff using amodified version of theModifiable Activity Questionnaire (35).”
Method
Major dietary patterns, ethnicity, and prevalence of type 2 diabetes in rural Hawaii
Kim, H.-S., Park, S., Grandinetti, A., Holck, P. S., & Waslien, C. (2008) · Nutrition · doi:10.1016/j.nut.2008.05.008 · Cited by 61
“The average energy expenditure from leisure and occupational activities for the past month and past year were estimated using the Pima Indian Physical Activity Questionnaire (18), adapted to include activities unique to Hawaii customs.”
Method
Ethnic‐Specific Differences in Abdominal Subcutaneous Adipose Tissue Compartments
Kohli, S., Sniderman, A. D., Tchernof, A., & Lear, S. A. (2010) · Obesity · doi:10.1038/oby.2010.94 · Cited by 61
“Leisuretime physical activity was also assessed via selfreport and was recorded in minutes per week of activity over the previous year using the Modifiable Activity Questionnaire (19).”
Method
Family history of coronary heart disease and pre-clinical carotid artery atherosclerosis in African Americans and whites: The ARIC study
Bensen, J. T., Li, R., Hutchinson, R. G., Province, M. A., & Tyroler, H. A. (1999) · Genetic Epidemiology · doi:10.1002/(sici)1098-2272(1999)16:2 · Cited by 42
Association of lifestyle and other risk factors with breast cancer according to menopausal status: a case-control study in the Region of Western Pomerania (Poland).
Kruk, J. (2007) · PubMed · Cited by 60
Explosive Force and Fractionated Reaction Time in Elderly Low- and High-Active Women
LaRoche, D. P., Knight, C. A., DICKIE, J. L., Lussier, M., & ROY, S. J. (2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318074ccd9 · Cited by 58
A Preliminary Study to Determine Instrument Responsiveness to Change with a Walking Program: Physical Activity Logs versus Pedometers
Tudor-Locke, C. E. (2001) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2001.10608962 · Cited by 60
“As stated earlier, capturing walking behaviors accurately using self-report methods is problematic (Ainsworth et al., 1993; Kriska et al., 1990; Richardson et al., 1994).”
Background
Recruitment strategies for black women at risk for noninsulin-dependent diabetes mellitus into exercise protocols: a qualitative assessment.
Carter-Nolan, P. L., Adams-Campbell, L. L., & Williams, J. S. (1996) · PubMed · Cited by 60
Modifiable Activity Questionnaire
&NA; (1997) · Medicine& Science in Sports & Exercise · doi:10.1097/00005768-199706001-00015 · Cited by 59
Randomized controlled trial to evaluate the effects of combined progressive exercise on metabolic syndrome in breast cancer survivors: rationale, design, and methods
Dieli-Conwright, C. M., Mortimer, J. E., Schroeder, E. T., Courneya, K. S., Demark‐Wahnefried, W., Buchanan, T. A., Tripathy, D., & Bernstein, L. (2014) · BMC Cancer · doi:10.1186/1471-2407-14-238 · Cited by 60
“Physical activity history is assessed at baseline using an interviewer-administered physical activity questionnaire [53].”
Method
Does Dietary Intake by Tehranian Adults Align with the 2005 Dietary Guidelines for Americans? Observations from the Tehran Lipid and Glucose Study
Mirmiran, P., Hosseini‐Esfahani, F., Jessri, M., Mahan, L. K., Shiva, N., & Azizi, F. (2011) · Journal of Health Population and Nutrition · doi:10.3329/jhpn.v29i1.7564 · Cited by 57
Association between interaction and ratio of ω-3 and ω-6 polyunsaturated fatty acid and the metabolic syndrome in adults
Mirmiran, P., Hosseinpour‐Niazi, S., Naderi, Z., Bahadoran, Z., Sadeghi, M., & Azizi, F. (2012) · Nutrition · doi:10.1016/j.nut.2011.11.031 · Cited by 61
Dietary phytochemical index is inversely associated with the occurrence of hypertension in adults: a 3-year follow-up (the Tehran Lipid and Glucose Study)
Golzarand, M., Bahadoran, Z., Mirmiran, P., Sadeghian-Sharif, S., & Azizi, F. (2014) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2014.233 · Cited by 57
Mitochondrial Function and Insulin Resistance in Overweight and Normal-Weight Children
Fleischman, A., Kron, M., Systrom, D. M., Hrovat, M. I., & Grinspoon, S. K. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-1590 · Cited by 59
Energy Expenditure in People with Diabetes Mellitus: A Review
Caron, N., Peyrot, N., Caderby, T., Verkindt, C., & Dalleau, G. (2016) · Frontiers in Nutrition · doi:10.3389/fnut.2016.00056 · Cited by 58
“The Modifiable Activity Questionnaire is a short survey created for the assessment of PA level (average hour/week of occupational and leisure activities over the past year) or energy expenditure in a variety of populations and age groups (86).”
Effects of exercise and lifestyle modification on fitness, insulin resistance, skeletal muscle oxidative phosphorylation and intramyocellular lipid content in obese children and adolescents
McCormack, S. E., McCarthy, M. A., Harrington, S. G., Farilla, L., Hrovat, M. I., Systrom, D. M., Thomas, B. J., Torriani, M., McInnis, K. J., Grinspoon, S. K., et al. (2013) · Pediatric Obesity · doi:10.1111/j.2047-6310.2013.00180.x · Cited by 57
“Self-reported levels of physical activity were assessed with paediatric-specific modifications made to the Modifiable Activity Questionnaire (15).”
Method
Factors associated with health‐related quality of life among overweight or obese adults
Wang, J., Sereika, S. M., Styn, M. A., & Burke, L. E. (2013) · Journal of Clinical Nursing · doi:10.1111/jocn.12280 · Cited by 57
Low levels of physical activity in 5-year-old children
Salbe, A. D., Fontvieille, A. M., Harper, I. T., & Ravussin, É. (1997) · The Journal of Pediatrics · doi:10.1016/s0022-3476(97)80069-8 · Cited by 55
Premorbid physical activity predicts disability progression in relapsing–remitting multiple sclerosis
Motl, R. W., Dlugonski, D., Pilutti, L. A., Sandroff, B. M., & McAuley, E. (2012) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2012.08.033 · Cited by 57
Synthesis of Intervention Research to Modify Physical Activity and Dietary Behaviors
Blue, C. L., & Black, D. R. (2005) · Research and theory for nursing practice · doi:10.1891/rtnp.19.1.25.66333 · Cited by 53
“%) studies, one focusing on native Hawaiians (Mau et al., 2000) and the other on Pima Indians (Narayan et al., 1998), used physical activity questionnaires adapted to the activities of those cultures.”
BackgroundInfluential
Reducing Diabetes Risk in American Indian Women
Thompson, J. L., Allen, P. M., Helitzer, D., Qualls, C., Whyte, A. N., Wolfe, V. K., & Herman, C. J. (2008) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2007.11.014 · Cited by 56
Past recreational physical activity, body size, and all-cause mortality following breast cancer diagnosis: results from the breast cancer family registry
Keegan, T. H. M., Milne, R. L., Andrulis, I. L., et al. (2010) · Breast Cancer Research and Treatment · doi:10.1007/s10549-010-0774-6 · Cited by 54
“While we cannot rule out misclassification of physical activity levels, either by race/ethnicity [40] or longer time between diagnosis and study enrollment, previous studies have found self-reported lifetime physical activity to be reliable and highly reproducible [43-46].”
Systematic review to identify and appraise outcome measures used to evaluate childhood obesity treatment interventions (CoOR): evidence of purpose, application, validity, reliability and sensitivity
Bryant, M., Ashton, L., Brown, J. M., Jebb, S. A., Wright, J. M., Roberts, K. E., & Nixon, J. (2014) · Health Technology Assessment · doi:10.3310/hta18510 · Cited by 54
Association of Physical Activity and Visceral Adipose Tissue in Older Women and Men
Riechman, S. E., Schoen, R. E., Weissfeld, J. L., Thaete, F. L., & Kriska, A. M. (2002) · Obesity Research · doi:10.1038/oby.2002.144 · Cited by 54
Self-citation
Changes in physical activity explain paradoxical relationship between baseline physical activity and adiposity changes in adolescent girls: the FLVS II study
Kettaneh, A., Oppert, J., Heude, B., Deschamps, V., Borys, J. M., Lommez, A., Ducimetière, P., & Charles, M.-A. A. (2005) · International Journal of Obesity · doi:10.1038/sj.ijo.0802992 · Cited by 53
Diabetes mellitus among native Americans in Canada and the United States: An epidemiological review
Young, T. K. (1993) · American Journal of Human Biology · doi:10.1002/ajhb.1310050405 · Cited by 54
Effects of exercise during pregnancy on maternal heart rate and heart rate variability
May, L. E., Knowlton, J., Hanson, J., Suminski, R., Paynter, C., Fang, X., & Gustafson, K. M. (2016) · PM&R · doi:10.1016/j.pmrj.2015.11.006 · Cited by 49
“The Modifiable Physical Activity Questionnaire is a reliable and valid instrument for assessing the intensity and duration of exercise performed during the preceding 12 months in various populations, including pregnant women [32-39].”
Method
Ideal Cardiovascular Health and the Prevalence and Progression of Coronary Artery Calcification in Adults With and Without Type 1 Diabetes
Alman, A. C., Maahs, D. M., Rewers, M., & Snell‐Bergeon, J. K. (2013) · Diabetes Care · doi:10.2337/dc13-0997 · Cited by 53
“Physical activity was obtained from the validated Modifiable Activity Questionnaire designed for the Pima Indian study (16).”
Effects of Aerobic Exercise during Pregnancy on 1-Month Infant Neuromotor Skills
McMillan, A. G., May, L. E., GAINES, G. G., Isler, C. M., & Kuehn, D. (2019) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000001958 · Cited by 53
“This questionnaire also provided participant demographic information (age, prepregnancy weight, number of pregnancies, number of live children, breastfeeding, highest degree obtained, race) (20,21,23).”
BackgroundMethod
Physical activity and lipids and lipoproteins in American Indians ages 45-74
Yurgalevitch, S. M., Kriska, A. M., Welty, T. K., Go, O. T., Robbins, D. C., & Howard, B. V. (1998) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199804000-00012 · Cited by 52
Self-citation
Dietary behavior and type 2 diabetes care
Albarran, N. B., Ballesteros, M. N., Figueroa, G. G. M., & Ortega, M. I. F. (2005) · Patient Education and Counseling · doi:10.1016/j.pec.2005.03.008 · Cited by 53
“[8], and adapted by Esparza for Mexican population [9].”
Background
Stressor-induced increase in muscle fatigability of young men and women is predicted by strength but not voluntary activation
Keller‐Ross, M. L., Pereira, H. M., Pruse, J., Yoon, T., Schlinder-Delap, B., Nielson, K. A., & Hunter, S. K. (2014) · Journal of Applied Physiology · doi:10.1152/japplphysiol.01129.2013 · Cited by 52
“The physical-activity level for each participant was assessed with a questionnaire that estimated the relative kilocalorie expenditure/wk (23).”
Method
Total energy expenditure and physical activity in prepubertal children: recent advances based on the application of the doubly labeled water method
Michael, I., & Min, S. (1998) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/68.4.944s · Cited by 52
“In 101 white children, physical activity in hours per week with use of the Kriska questionnaire (44) was not related to freeliving AEE.”
Method

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 › Public Health, Environmental and Occupational Health › Physical Activity and Health
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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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