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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“[17] This questionnaire is a well‐established questionnaire to evaluate past physical history and allows robust analysis of data in retrospective studies.[18] In this questionnaire, 14 leisure physical activities were assessed, including slow easy walking, brisk walking, Yoga, swimming, and cycling.”
Background
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Self-citation
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Background
Assessment of Lifestyle Factors Helps to Identify Liver Fibrosis Due to Non-Alcoholic Fatty Liver Disease in Obesity
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Method
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Salbe, A. D., Fontvieille, A. M., Pettitt, D. J., & Ravussin, É. (1998) · Diabetologia · doi:10.1007/s001250051045 · Cited by 16
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“23 This questionnaire assesses daily ST and MVPA during leisure and occupational time during the past 12 months.”
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“These studies are important, as researchers increasingly use historical and lifetime measures to examine exposure to PA over the life course in relation to health outcomes [5,6,8,16].”
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Method
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MethodSelf-citation
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Self-citation
Modifiable Activity Questionnaire for Adolescents
&NA; (1997) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199706001-00016 · Cited by 14
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“[33] Kriska AM, Knowler WC, LaPorte RE, et al.”
BackgroundMethod
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“The results were reported as the mean MET-min per week (Kriska et al., 1990).”
Background
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“High reliability and relatively moderate validity were reported for the Persian translated MAQ in Tehranian adults (22).”
Method
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Method
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Method
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Method
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“PAL was assessed using the modifiable activity questionnaire (MAQ) that included a list of activities including leisure time, job, and household activities; the frequency and amount of time spent per week engaged in physical activity over the last year were recorded [23].”
Method
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“We used the Modifiable Activity Questionnaire (MAQ) to collect data on physical activity [29]; the psychometric properties of the Iranian version of MAQ have been examined among the population from TLGS, with high reliability and acceptable validity [30].”
Method
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Mansuri, S., Badawi, A. F., Kayaniyil, S., Cole, D. E. C., Harris, S. B., Mamakeesick, M., Wolever, T. M. S., Gittelsohn, J., Maguire, J. L., Connelly, P. W., et al. (2016) · International Journal of Circumpolar Health · doi:10.3402/ijch.v75.31956 · Cited by 11
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“Physical activity was assessed using modifiable activity questionnaire (MAQ) that included a list all three forms of activities, including leisure time, job, and household activities; the frequency and amount of time spent per week engaged in physical activity over the last year were recorded [34].”
Method
Does weight change modify the association between the consumption of sugar-sweetened beverages and 100% fruit juice and the risk of metabolic syndrome?
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Physical Activity as a Moderator of the Relationship Between Aging and Inductive Reasoning
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“We confirmed our classification assessments using the interviewer-administered Modifiable Activity Questionnaire (MAQ; Kriska et al., 1990), which assesses current (i.e., past year) physical activity in different activity categories practiced at least 10 times per year.”
MethodInfluential
Elevated total plasma homocysteine levels are associated with type 2 diabetes in women with hypertension.
Wang, C., Wu, Q., Zhang, L., Hao, Y., Fan, R., Peng, X., Liu, S., Chen, Z., Zhang, T., Chen, S., et al. (2015) · PubMed · doi:10.6133/apjcn.2015.24.4.09 · Cited by 11
“Both leisure and occupational physical activity levels were assessed, as in previous studies.(12,13) Physical activities were classified as no exercise, and light, moderate, and vigorous intensity.”
Method
Football Increases Future Risk of Symptomatic Radiographic Knee Osteoarthritis
Lo, G. H., McAlindon, T. E., Kriska, A. M., Price, L. L., Rockette‐Wagner, B., Mandl, L. A., Eaton, C. B., Hochberg, M. C., Jackson, R. D., Kwoh, C. K., et al. (2019) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002189 · Cited by 11
“Between September 12, 2012, and October 31, 2014, participants were asked to complete a self-administeredmodified version of the historical physical activity survey instrument (6,7) before their OAI 96-month visit.”
Self-citation
Association between physical activity, adiposity, and lipid abnormalities in children with familial hyperlipidemia
Thavendiranathan, P., Jones, E. J., Han, R. K., et al. (2007) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/01.hjr.0000230101.48030.f4 · Cited by 11
Iranian Endocrine Society Guidelines for Screening, Diagnosis, and Management of Gestational Diabetes Mellitus
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Clotting factor activity levels and bleeding risk in people with haemophilia playing sports
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Gender differences in the impact of 3-year status changes of metabolic syndrome and its components on incident type 2 diabetes mellitus: a decade of follow-up in the Tehran Lipid and Glucose Study
Hadaegh, F., Abdi, A., Kohansal, K., Hadaegh, P., Azizi, F., & Tohidi, M. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1164771 · Cited by 10
“The Modifiable Activity Questionnaire (MAQ) has been used to assess physical activity levels from phase 2, which measures all three types of activity, including leisure time, job, and household activities in the past year (24).”
Method
Study Design of the Maycoba Project: Obesity and Diabetes in Mexican Pimas
Urquídez-Romero, R., Esparza‐Romero, J., Chaudhari, L. S., Begay, R. C., Giraldo, M. A., Ravussin, É., Knowler, W. C., Hanson, R. L., Bennett, P. H., Schulz, L. O., et al. (2014) · American Journal of Health Behavior · doi:10.5993/ajhb.38.3.6 · Cited by 10
Self-citation
Dietary Protein, Protein to Carbohydrate Ratio and Subsequent Changes in Lipid Profile after a 3-Year Follow-Up: Tehran Lipid and Glucose Study.
Bahadoran, Z., Mirmiran, P., Hosseini‐Esfahani, F., Sadeghi, M., & Azizi, F. (2013) · PubMed Central · Cited by 10
Does the diet of Tehranian adults ensure compliance with nutritional targets? Observations from the Tehran Lipid and Glucose Study
Hosseini‐Esfahani, F., Jessri, M., Mirmiran, P., Sadeghi, M., & Azizi, F. (2011) · Public Health Nutrition · doi:10.1017/s1368980011000711 · Cited by 10
Physical Activity Levels in a Community Lifestyle Intervention
Eaglehouse, Y. L., Rockette‐Wagner, B., Kramer, M. K., Arena, V. C., Miller, R. G., Vanderwood, K. K., & Kriska, A. M. (2016) · Translational Journal of the American College of Sports Medicine · doi:10.1249/tjx.0000000000000004 · Cited by 12
“The MAQ is a reliable and valid instrument for use in adult populations (9,18,26,27,29) with strong correlations (ρ > 0.”
MethodSelf-citation
Advanced glycation end products and risk of hypertension in Iranian adults: Tehran lipid and glucose study
Mottaghi, A., Mirmiran, P., Yousefi, R., et al. (2018) · Journal of Research in Medical Sciences · doi:10.4103/jrms.jrms_982_17 · Cited by 10
“Physical activity level was assessed using the Persian‐translated Modifiable Activity Questionnaire (MAQ),[22] based on the frequency and time spent on light, moderate, high, and very high‐intensity activities according to the list of common activities of daily life over the past year.”
Fatiguing Trunk Flexor Exercise Decreases Pain Sensitivity in Postpartum Women
Deering, R. E., Pashibin, T., Cruz, M., Hunter, S. K., & Bement, M. H. (2019) · Frontiers in Physiology · doi:10.3389/fphys.2019.00315 · Cited by 12
Transportation physical activity earlier in life and areas of the brain related to dementia later in life
Torres, E. R., Bendlin, B. B., Kassahun‐Yimer, W., Magnotta, V. A., & Paradiso, S. (2020) · Journal of Transport & Health · doi:10.1016/j.jth.2020.100992 · Cited by 11
“Although there are alternative measures of lifetime physical activity (Chasan-Taber, Erickson, Nasca, Chasan-Taber, & Freedson, 2002; Kriska et al., 1990), only the LTPAQ assesses all four domains of physical activity (Sallis et al.”
Background
Associations of Dietary Patterns and Nutrients with Glycated Hemoglobin in Participants with and without Type 1 Diabetes
Basu, A., Alman, A. C., & Snell‐Bergeon, J. K. (2021) · Nutrients · doi:10.3390/nu13031035 · Cited by 11
“Participants also completed standardized questionnaires on medical history, current medication, insulin doses, physical activity (modifiable activity questionnaire) [19], alcohol and tobacco use and family medical history.”
Background
Plasma epoxyeicosatrienoic acids and dihydroxyeicosatrieonic acids, insulin, glucose and risk of diabetes: The strong heart study
Lemaître, R. N., Jensen, P. N., Zeigler, M. B., Denham, J., Fretts, A. M., Umans, J. G., Howard, B. V., Sitlani, C. M., McKnight, B., Gharib, S. A., et al. (2021) · EBioMedicine · doi:10.1016/j.ebiom.2021.103279 · Cited by 10
“Both the physical activity questionnaire and pedometers have been shown to be reliable and valid in free-living conditions [25,26].”
Background
The relationship between physical activity and lipoprotein subclasses in postmenopausal women
Gabriel, K. P., Kriska, A. M., Johnson, B. D., Conroy, M. B., Mackey, R. H., Orchard, T. J., & Kuller, L. H. (2006) · Menopause The Journal of The North American Menopause Society · doi:10.1097/01.gme.0000229573.29258.d5 · Cited by 10
Self-citation
Adolescent and Young Adult Exposure to Physical Activity and Breast Density
Gabriel, K. P., Klifa, C. S., Pérez, A., et al. (2013) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318289a7f8 · Cited by 10
“Physical Activity—The historical version of the Modifiable Activity Questionnaire (MAQ) (22), an interviewer-administered recall questionnaire, was used to assess leisuretime physical activity levels during: (a) high school (ages 14–17 years), (b) post high school (ages 18–21 years) and (c) the previous 12 months (pas…”
BackgroundMethodInfluentialSelf-citation
Socio-Behavioral Factors Associated with Overweight and Central Obesity in Tehranian Adults: a Structural Equation Model
Jalali‐Farahani, S., Amiri, P., Karimi, M., Gharibzadeh, S., Mirmiran, P., & Azizi, F. (2016) · International Journal of Behavioral Medicine · doi:10.1007/s12529-016-9574-7 · Cited by 10
“Levels of leisure time physical activity, assessed using the Modifiable Activity Questionnaire (MAQ) [25], were categorized into quartiles.”
Clusters of fatty acids in the serum triacylglyceride fraction associate with the disorders of type 2 diabetes
Johnston, L., Liu, Z., Retnakaran, R. R., Zinman, B., Giacca, A., Harris, S. B., Bazinet, R. P., & Hanley, A. J. (2018) · Journal of Lipid Research · doi:10.1194/jlr.p084970 · Cited by 11
“Each reported activity from the MAQ was weighted by its metabolic intensity allowing for the estimation of metabolic equivalents of tasks (MET) hours per week (19).”
BackgroundMethodInfluential
Association of obesity severity and duration with incidence of chronic kidney disease
Ghazy, F., Ebrahimi, N., Ebadinejad, A., Barzin, M., Mahdavi, M., Valizadeh, M., Azizi, F., & Hosseinpanah, F. (2024) · BMC Nephrology · doi:10.1186/s12882-024-03757-x · Cited by 11
“Since LRC is not accurate, the Modifiable Activity Questionnaire (MAQ) was used for the rest of the follow-up examinations to cover all kinds of activity (i.e., leisure, occupation, and in-house) [19].”
Method
Men and women show partly distinct effects of physical activity on brain integrity
Gonneaud, J., Moreau, I., Felisatti, F., Arenaza‐Urquijo, E. M., Ourry, V., Touron, E., Sayette, V. D. L., Vivien, D., & Chételat, G. (2022) · Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring · doi:10.1002/dad2.12302 · Cited by 12
Vascular determinants of hippocampal viscoelastic properties in healthy adults across the lifespan
Sanjana, F., Delgorio, P. L., DeConne, T. M., Hiscox, L. V., Pohlig, R. T., Johnson, C. L., & Martens, C. R. (2023) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1177/0271678x231186571 · Cited by 9
“47 Serum lipids (triglycerides, total cholesterol, high-and low-density lipoproteins) and serum glucose was measured using standard lipid and metabolic panels (Quest Diagnostics, USA), respectively during the time of initial screening following a 12 h overnight fast.”
Method
Predicting parental social influences: The role of physical activity variability
WILSON, K. S., & Spink, K. S. (2011) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2011.08.005 · Cited by 9
The dose-response effects of aerobic exercise on musculoskeletal injury: a post hoc analysis of a randomized trial
Brown, J. C., & Schmitz, K. H. (2017) · Research in Sports Medicine · doi:10.1080/15438627.2017.1314295 · Cited by 9
“Physical activity was assessed using the Modifiable Physical Activity Questionnaire (Kriska et al., 1990).”
Method
Aspartame Intake Relates to Coronary Plaque Burden and Inflammatory Indices in Human Immunodeficiency Virus
Hall, L. N., Sanchez, L. R., Hubbard, J. L., Lee, H., Looby, S. E. D., Srinivasa, S., Zanni, M. V., Stanley, T. L., Lo, J., Grinspoon, S. K., et al. (2017) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofx083 · Cited by 9
“Physical activity was assessed using the Modifiable Activity Questionnaire to assess hours of leisure activity during the past year [18].”
Method
The First Cigarette Smoking Experience and Future Smoking Behaviors Among Adolescents with Different Parental Risk: a Longitudinal Analysis in an Urban Iranian Population
Amiri, P., Masihay‐Akbar, H., Jalali‐Farahani, S., et al. (2020) · International Journal of Behavioral Medicine · doi:10.1007/s12529-020-09910-8 · Cited by 9
“Physical Activity Parental physical activity was assessed using the Modifiable Activity Questionnaire (MAQ) [28]; the Persian translation of which has been assessed with acceptable validity and high reliability [29].”
Method
Association of cumulative excess weight and waist circumference exposure with transition from metabolically healthy obesity to metabolically unhealthy
Jahromi, M. K., Ebadinejad, A., Barzin, M., et al. (2022) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2022.07.014 · Cited by 9
Relation of dietary insulin index and dietary insulin load to metabolic syndrome depending on the lifestyle factors: Tehran lipid and glucose study
Khoshnoudi-Rad, B., Hosseinpour‐Niazi, S., Javadi, M., Mirmiran, P., & Azizi, F. (2022) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-022-00968-w · Cited by 10
Effect of Medical Advice for Diet on Diabetes Self-Management and Glycemic Control for Haitian and African Americans with Type 2 Diabetes
Huffman, F. G., Exebio, J. C., Vaccaro, J. A., et al. (2013) · Food and Nutrition Sciences · doi:10.4236/fns.2013.411142 · Cited by 9
“Physical activity was estimated from the Modifiable Activity Questionnaire (MAQ) [18].”
Method
HPLC-Fluorescence Determination of Individual Free and Conjugated Bile Acids in Human Serum
Gatti, R., Roda, A., Cerré, C., Bonazzi, D., & Cavrini, V. (1997) · Biomedical Chromatography · doi:10.1002/(sici)1099-0801(199701)11:1 · Cited by 37
Méthodes d'évaluation de l'activité physique habituelle et obésité
Oppert, J. (2006) · Science & Sports · doi:10.1016/j.scispo.2006.03.008 · Cited by 9
Antecedents and consequences of family social control use following an adolescent physical activity lapse
WILSON, K. S., & Spink, K. S. (2011) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2011.06.003 · Cited by 9
Cognitive Testing of the STAR-Q: Insights in Activity and Sedentary Time Reporting
Neilson, H. K., Ullman, R., Robson, P. J., Friedenreich, C. M., & Csizmadi, I. (2013) · Journal of Physical Activity and Health · doi:10.1123/jpah.10.3.379 · Cited by 8
Strong Men, Strong Communities: Design of a Randomized Controlled Trial of a Diabetes Prevention Intervention for American Indian and Alaska Native Men
Sinclair, K., Carty, C. L., Gonzales, K. L., Nikolaus, C. J., Gillespie, L., & Buchwald, D. (2020) · American Journal of Men s Health · doi:10.1177/1557988320945457 · Cited by 9
“Physical activity is assessed with the Modifiable Activity Questionnaire (Pereira et al., 1997), which has previously been used in AI/AN communities (Kriska et al., 1990).”
Method
Cardio‐Metabolic Risk Profile of Women With Endometriosis: A Population‐Based Study
Naz, M. S. G., Noroozzadeh, M., Ardebili, S. N., Mousavi, M. A., Azizi, F., & Tehrani, F. R. (2024) · Endocrinology Diabetes & Metabolism · doi:10.1002/edm2.70008 · Cited by 13
“Physical activity was measured using a modifiable activity questionnaire (MAQ) and its levels were expressed as metabolic equivalent hours per week (METs h/week) [18, 19].”
Method
Social Provisions and Young Women’s Health-Related Physical Activity
Ulvick, J. D., & Spink, K. S. (2015) · Women & Health · doi:10.1080/03630242.2015.1061093 · Cited by 8
“We operationalized participants’ activity involvement as energy expenditure, and assessed it using the Modifiable Activity Questionnaire (MAQ; Kriska et al. 1990), which is a self-report measure of leisure-time physical activity that has been used previously with a young-adult sample (Spink,…”
MethodInfluential
Changes in Body Composition and Activity Levels of a Division-1 Football Team During COVID-19
Cholewinski, M. C., Buzzard, J., Gordon, Q., Ross, R., Funderburk, L., & Gallucci, A. R. (2021) · Journal of Exercise and Nutrition · doi:10.53520/jen2021.10385 · Cited by 8
“To measure the athletes’ activity during the suspended activity period (March – June) the validated Modifiable Activity Questionnaire (MAQ) 13 was given to the athletes to confidentially complete.”
Method
Coronary Artery Calcium and Cognitive Decline in the Diabetes Prevention Program Outcomes Study
Gadde, K. M., Yin, X., Goldberg, R. B., Orchard, T. J., Schlögl, M., Dabelea, D., Ibebuogu, U. N., Watson, K. E., Pi-Sunyer, X., Crandall, J. P., et al. (2023) · Journal of the American Heart Association · doi:10.1161/jaha.123.029671 · Cited by 9

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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