Development of a Compendium of Energy Expenditures for Youth

Background  

This paper presents a Compendium of Energy Expenditures for use in scoring physical activity questionnaires and estimating energy expenditure levels in youth.     

An assessment of self-reported physical activity instruments in young people for population surveillance: Project ALPHA

Background  

The assessment of physical activity is an essential part of understanding patterns and influences of behaviour, designing interventions, and undertaking population surveillance and monitoring, but it is particularly problematic when using self-report instruments with young people. This study reviewed available self-report physical activity instruments developed for use with children and adolescents to assess their suitability and feasibility for use in population surveillance systems, particularly in Europe.     

Validation of the historical adulthood physical activity questionnaire (HAPAQ) against objective measurements of physical activity

Background  

Lifetime physical activity energy expenditure (PAEE) is an important determinant of risk for many chronic diseases but remains challenging to measure. Previously reported historical physical activity (PA) questionnaires appear to be reliable, but their validity is less well established.     

Brief scales to assess physical activity and sedentary equipment in the home

Background  

Sedentary behaviors such as TV viewing are associated with childhood obesity, while physical activity promotes healthy weight. The role of the home environment in shaping these behaviors among youth is poorly understood. The study purpose was to examine the reliability of brief parental proxy-report and adolescent self-report measures of electronic equipment and physical activity equipment in the home and to assess the construct validity of these scales by examining their relationship to physical activity, sedentary behavior, and weight status of children and adolescents.     

International Physical Activity Questionnaire (IPAQ) and New Zealand Physical Activity Questionnaire (NZPAQ): A doubly labelled water validation

Background  

Accurate measurement of physical activity is a pre-requisite for monitoring population health and for evaluating effective interventions. The International Physical Activity Questionnaire (IPAQ) is used as a comparable and standardised self-report measure of habitual physical activity of populations from different countries and socio-cultural contexts. The IPAQ has been modified to produce a New Zealand physical activity questionnaire (NZPAQ). The aim of this study was to validate the IPAQ and NZPAQ against doubly labelled water (DLW). Method: Total energy expenditure (TEE) was measured over a 15-day period using DLW. Activity-related energy expenditure (AEE) was estimated by subtracting the energy expenditure from resting metabolic rate and thermic effect of feeding from TEE. The IPAQ (long form) and NZPAQ (short form) were completed at the end of each 7-day period. Activity-related energy expenditure (IPAQ_AEE and NZPAQ_AEE) was calculated from each questionnaire and compared to DLW_AEE.     

Health-related quality of life of child and adolescent retinoblastoma survivors in the Netherlands

Background  

To assess health-related quality of life (HRQoL) in children (8–11 years) and adolescents (12–18 years) who survived retinoblastoma (RB), by means of the KIDSCREEN self-report questionnaire and the proxy-report version.     

Reliability and validity of the Norwegian child and parent versions of the DISABKIDS Chronic Generic Module (DCGM-37) and Diabetes-Specific Module (DSM-10)

Background  

International guidelines on type 1 diabetes advocate routine screening of health-related quality of life (HRQOL). DISABKIDS questionnaires are the first instruments developed across cultures and nations to provide age-appropriate measures of HRQOL in children with chronic diseases. DISABKIDS includes a Chronic Generic Module 37 (DCGM-37) and disease-specific modules. The purpose of this study was to examine reliability and validity of the Norwegian versions of the DISABKIDS questionnaires in children and adolescents with type 1 diabetes.     

Measurement properties of questionnaires assessing participation in children and adolescents with a disability: a systematic review

Purpose

To critically appraise the measurement properties of questionnaires measuring participation in children and adolescents (0–18 years) with a disability.

Methods

Bibliographic databases were searched for studies evaluating the measurement properties of self-report or parent-report questionnaires measuring participation in children and adolescents (0–18 years) with a disability. The methodological quality of the included studies and the results of the measurement properties were evaluated using a checklist developed on consensus-based standards.

Results

The search strategy identified 3,977 unique publications, of which 22 were selected; these articles evaluated the development and measurement properties of eight different questionnaires. The Child and Adolescent Scale of Participation was evaluated most extensively, generally showing moderate positive results on content validity, internal consistency, reliability and construct validity. The remaining questionnaires also demonstrated positive results. However, at least 50 % of the measurement properties per questionnaire were not (or only poorly) assessed.

Conclusions

Studies of high methodological quality, using modern statistical methods, are needed to accurately assess the measurement properties of currently available questionnaires. Moreover, consensus is required on the definition of the construct ‘participation’ to determine content validity and to enable meaningful interpretation of outcomes.     

Some psychometric properties of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales (PedsQL<Superscript>TM</Superscript>) in the general Serbian population

Purpose  

The aim of this study was to evaluate the general measurement properties of the Serbian version of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales (PedsQL^TM) self-report versions for children and adolescents (8–18 years).     

Arguments at mealtime and child energy intake

Objective

To examine how arguments at mealtimes relate to children’s daily energy intake.

Design

A cross-sectional study using data obtained through the Québec Longitudinal Study of Child Development 1998-2010 (QLSCD), a representative sample of children born in 1998, in the province of Québec, Canada.

Setting

Face-to-face interviews, questionnaires, and 24-hour dietary recall interviews addressed to children’s parents.

Participants

One thousand five hundred forty-nine 4-year-old children who participated in a nutrition substudy.

Main Outcome Measure

Children’s energy intakes were measured through a 24-hour dietary recall interview administered to parents by trained nutritionists, in the children’s homes.

Analysis

The main associations were examined through chi-square tests of independence and through multivariate logistic regression analyses.

Results

The adjusted odds for consuming a high daily energy intake was 2.5 (95% confidence interval: 1.3-4.9) in children who were never exposed to arguments (between parents and children) at mealtimes, in comparison to children who were often or always exposed to arguments.

Conclusions and Implications

Mealtimes that are free of arguments, specifically between parents and children, appear to associate with high daily energy intakes in children, even after controlling for other factors, including a child’s level of physical activity, eating in front of the television, mother’s educational level, and number of overweight parents, among others.     

Measuring adolescents' HRQoL via self reports and parent proxy reports: an evaluation of the psychometric properties of both versions of the KINDL-R instrument

Background  

Several instruments are available to assess children's health-related quality of life (HRQoL) based on self reports as well as proxy reports from parents. Previous studies have found only low-to-moderate agreement between self and proxy reports, but few studies have explicitly compared the psychometric qualities of both. This study compares the reliability, factorial validity and convergent and known group validity of the self-report and parent-report versions of the HRQoL KINDL-R questionnaire for children and adolescents.     

Socioeconomic Status and Overweight: A Population-Based Cross-Sectional Study of Japanese Children and Adolescents

Background

Socioeconomic status (SES) as a determinant of obesity has received scant attention in Japan. This study examined the association between SES and overweight among Japanese children and adolescents.

Methods

Cross-sectional analyses of a representative sample of Japanese children (6–11 years: n = 397) and adolescents (12–18 years: n = 397) were performed, with measured heights and weights from the 2010 National Health and Nutrition Examination Survey and the 2010 Comprehensive Survey of Living Conditions. Overweight, including obesity, was defined by International Obesity Task Force cut-offs. SES indicators included household income, equivalent household expenditure, parental educational attainment, and parental occupational class.

Results

Overweight prevalence was 12.3% in children and 9.1% in adolescents. Adolescents living in middle-income households were more likely to be overweight than those living in high-income households (OR 2.26, 95% CI, 1.01–5.67) after adjustment for age, sex, and parental weight status. Similarly, adolescents living in households with low expenditure levels were more likely to be overweight than those living in households with high expenditure levels (OR 3.40, 95% CI, 1.20–9.60). In contrast, no significant association was observed among children.

Conclusions

Our results indicated that low household economic status was associated with being overweight, independent of parental weight status, among Japanese adolescents.Key words: socioeconomic status, overweight, children, adolescent, Japan     

Effect of time interval between food intake and exercise on substrate oxidation during exercise in obese and lean children

Background & aims

Exercise induces adaptations in fat metabolism favourable to the treatment of obesity. However, time interval between meal and exercise alters substrate bioavailability and oxidation during exercise. The aim of this study was therefore to investigate the effect of time interval between food intake and exercise on substrate oxidation rates in obese and lean children.

Methods

The metabolic responses to exercise of nine obese children (10.3 ± 1.8 years; %body fat: 36.1 ± 6.1) and seven lean children (9.2 ± 1.6 years; %body fat: 22.2 ± 4.1) were compared 1 h (time interval 1, TI1) and 3 h (TI3) after a standardized breakfast.

Results

Despite significantly lower plasma glucose and insulin concentrations and large effect size suggesting a higher plasma FFA availability (lean, 1.43, obese 0.98), fat oxidation was not significantly increased in TI3 compared to TI1 in both lean and obese children. Fat oxidation contributed marginally to energy expenditure during exercise (<20%) in both conditions and groups but was moderately increased during TI3 compared to TI1 in lean children (effect size: 0.54).

Conclusions

The low contribution of fat oxidation to energy expenditure during exercise in obese and lean children fed 3 h before exercise questions the efficacy of moderate intensity exercise to favourably affect fat balance.     

Psychometric properties of the CDC Symptom Inventory for assessment of Chronic Fatigue Syndrome

Objectives  

Validated or standardized self-report questionnaires used in research studies and clinical evaluation of chronic fatigue syndrome (CFS) generally focus on the assessment of fatigue. There are relatively few published questionnaires that evaluate case defining and other accompanying symptoms in CFS. This paper introduces the self-report CDC CFS Symptom Inventory and analyzes its psychometric properties.     

Factor structure of the Singapore English version of the KINDL? children quality of life questionnaire

Background  

Quality of life (QoL) outcomes are useful in the assessment of physical, mental and social well-being and for informed healthcare decision making. However, few studies have evaluated QoL issues among Asian children due largely to the lack of culturally valid and reliable QoL questionnaires. Hence, we aimed to report the psychometric properties, in particular factor structure, of KINDL (Singapore) questionnaires among school-going children.     

Self-report and parent-report of physical and psychosocial well-being in Dutch adolescents with type 1 diabetes in relation to glycemic control

Background  

To determine physical and psychosocial well-being of adolescents with type 1 diabetes by self-report and parent report and to explore associations with glycemic control and other clinical and socio-demographic characteristics.     

Are community-living and institutionalized dementia patients cared for differently? Evidence on service utilization and costs of care from German insurance claims data

Background

The validity of survey-based health care utilization estimates in the older population has been poorly researched. Owing to data protection legislation and a great number of different health care insurance providers, the assessment of recall and non-response bias is challenging to impossible in many countries. The objective of our study was to compare estimates from a population-based study in older German adults with external secondary data.

Methods

We used data from the German KORA-Age study, which included 4,127 people aged 65–94 years. Self-report questions covered the utilization of long-term care services, inpatient services, outpatient services, and pharmaceuticals. We calculated age- and sex-standardized mean utilization rates in each domain and compared them with the corresponding estimates derived from official statistics and independent statutory health insurance data.

Results

The KORA-Age study underestimated the use of long-term care services (?52%), in-hospital days (?21%) and physician visits (?70%). In contrast, the assessment of drug consumption by postal self-report questionnaires yielded similar estimates to the analysis of insurance claims data (?9%).

Conclusion

Survey estimates based on self-report tend to underestimate true health care utilization in the older population. Direct validation studies are needed to disentangle the impact of recall and non-response bias.     

Adaptation and cognitive testing of physical activity measures for use with young, school-aged children and their parents

Background

Increasing physical activity is one way to address the public health concern of childhood obesity. Physical activity measures for use with young, school-aged children are limited.

Methods

This study adapted two existing activity measures for young children, specifically self-efficacy and 7-day recall of physical activity.

Results

Through expert review and cognitive testing, the scales were adapted for use with young, school-aged children (ages 7?C9). This article describes how the measures were adapted to insure comprehension of the child self-report measures. Reliability analyses provide support for their use in this population [Cronbach??s alpha?=?0.76 for the self-efficacy scale; moderate correlation between parent report and child report of child physical activity over the past week (rho?=?0.52, P?<?0.01].

Conclusions

Suggestions are offered for researchers interested in using similar methods when designing and adapting physical activity measures for new populations.     

Activities Contributing to Total Energy Expenditure in the United States: Results from the NHAPS Study

Background  

Physical activity is increasingly recognized as an important factor influencing health and disease status. Total energy expenditure, both low-intensity and high-intensity, contributes to maintenance of healthy body weight. This paper presents the results of a quantitative approach to determining the activities that contribute to total energy expenditure in the United States.     

Validity of the Modified Baecke Questionnaire: comparison with energy expenditure according to the doubly labeled water method

Background

In epidemiological research, physical activity is usually assessed by questionnaires. Questionnaires are suitable for large study populations since they are relatively inexpensive and not very time consuming. However, questionnaire information is by definition subjective and prone to recall bias, especially among elderly subjects. The Modified Baecke Questionnaire, developed by Voorrips and coworkers, measures habitual physical activity in the elderly. The questionnaire includes questions on household activities, sports, and leisure time activities, over a time period of one year. The Modified Baecke Questionnaire results in a score to classify people as high, moderate, or low in daily physical activity, based on tertiles.

Methods

The validity of the Modified Baecke Questionnaire score was assessed among 21 elderly men and women using the doubly labeled water method as the reference criterion. This method is considered to be the gold standard for measuring energy expenditure in free-living individuals. Energy expenditure on physical activity is estimated by the ratio of total energy expenditure measured by the doubly labeled water method and resting metabolic rate measured by indirect calorimetry. This ratio is called the physical activity ratio.

Results

The Spearman correlation coefficient between the questionnaire score and the physical activity ratio (PAR) was 0.54 (95% CI 0.22–0.66). Correct classification by the questionnaire occurred in 71% of participants who were in the lowest tertile of PAR, in 14% of participants in the middle tertile, and in 43% of participants in the highest tertile. Subjects were not wrongly classified in an opposite tertile.

Conclusion

The validity of the Modified Baecke Questionnaire is fair-to-moderate. This study shows that the questionnaire can correctly classify individuals as low or high active, but does a poor job for moderately active individuals.