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. 2018 Jan 23:10:1.
doi: 10.1186/s13102-018-0090-8. eCollection 2018.

The effect of mere measurement from a cardiovascular examination program on physical activity and sedentary time in an adult population

Lisa Voigt  1   2 , Sophie Baumann  1   2 , Antje Ullrich  1   2 , Franziska Weymar  1   2   3 , Ulrich John  1   2 , Sabina Ulbricht  1   2
Affiliations

The effect of mere measurement from a cardiovascular examination program on physical activity and sedentary time in an adult population

Lisa Voigt et al. BMC Sports Sci Med Rehabil. .

Abstract

Background: Measuring physical activity (PA) and sedentary time (ST) by self-report or device as well as assessing related health factors may alter those behaviors. Thus, in intervention trials assessments may bias intervention effects. The aim of our study was to examine whether leisure-time PA, transport-related PA, and overall ST measured via self-report vary after assessments and whether a brief tailored letter intervention has an additional effect.

Methods: Among a sample of subjects with no history of myocardial infarction, stroke, or vascular intervention, a number of 175 individuals participated in a study comprising multiple repeated assessments. Of those, 153 were analyzed (mean age 54.5 years, standard deviation = 6.2; 64% women). At baseline, participants attended a cardiovascular examination (standardized measurement of blood pressure and waist circumference, blood sample taking) and wore an accelerometer for seven days. At baseline and after 1, 6, and 12 months, participants completed the International Physical Activity Questionnaire. A random subsample received a tailored counseling letter intervention at month 1, 3, and 4. Changes in PA and ST from baseline to 12-month follow-up were analyzed using random-effects modelling.

Results: From baseline to 1-month assessment, leisure-time PA did not change (Incidence rate ratio = 1.13, p = .432), transport-related PA increased (Incidence rate ratio = 1.45, p = .023), and overall ST tended to decrease (b = - 1.96, p = .060). Further, overall ST decreased from month 6 to month 12 (b = - 0.52, p = .037). Time trends of the intervention group did not differ significantly from those of the assessment-only group.

Conclusions: Results suggest an effect of measurements on PA and ST. Data of random-effects modelling results revealed an increase of transport-related PA after baseline to 1-month assessment. Decreases in overall ST may result from repeated assessments. A brief tailored letter intervention seemed to have no additional effect. Thus, measurement effects should be considered when planning intervention studies and interpreting intervention effects.

Trial registration: ClinicalTrials.gov NCT02990039. Registered 7 December 2016. Retrospectively registered.

Keywords: Brief intervention; Measurement reactivity; Question-behavior effect; Random-effects modelling; Research participation.

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Conflict of interest statement

The ethics committee of the University Medicine Greifswald approved the study (BB 002/15a). All participants provided informed written consent prior to participation.All participants provided written consent that was based on study information sheet which included the statement that all scientific publications will not include personal data (e.g., name, birth date, and address).The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow of participation and study design. AOG = Assessment-only group. IG = Intervention group. Assessments at baseline and at 12 months included: paper-pencil questionnaires on socio-demographics, physical activity, and sedentary time as well as physical examination (standardized measurement of blood pressure, body height, body weight, and waist- and hip-circumference, blood sample taking) and 7-day-accelerometry. Assessments at months 1, 3, 4, and 6 included: paper-pencil questionnaires on physical activity and sedentary time. a Eligibility criteria: age ≥ 40 and ≤ 65 years, no history of cardiovascular event (myocardial infarction or stroke) or vascular intervention, self-reported body mass index ≤ 35 kg/m2, resident in a pre-defined zip-code area. b had died, had a cardiovascular event or intervention, were too ill to participate, or moved away. c due to late response
Fig. 2
Fig. 2
Estimated average linear growth curves for log MET-hours per week of leisure-time physical activity (a), log MET-hours per week of transport-related physical activity (b), and hours per week of overall sedentary time (c) separately for assessment-only group and intervention group. MET = Metabolic equivalent of task. Results were adjusted for sex, age, and education. Slope variances fixed to zero as indicated by likelihood ratio tests. To raise intuitive understanding, the outcome of sedentary time was re-calculated into hours per week
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