Measuring older adults' sedentary time: Reliability, validity, and responsiveness

Abstract

Purpose: With evidence that prolonged sitting has deleterious health consequences, decreasing sedentary time is a potentially important preventive health target. High-quality measures, particularly for use with older adults, who are the most sedentary population group, are needed to evaluate the effect of sedentary behavior interventions. We examined the reliability, validity, and responsiveness to change of a self-report sedentary behavior questionnaire that assessed time spent in behaviors common among older adults: watching television, computer use, reading, socializing, transport and hobbies, and a summary measure (total sedentary time). Methods: In the context of a sedentary behavior intervention, nonworking older adults (n = 48, age = 73 ± 8 yr (mean ± SD)) completed the questionnaire on three occasions during a 2-wk period (7 d between administrations) and wore an accelerometer (ActiGraph model GT1M) for two periods of 6 d. Test-retest reliability (for the individual items and the summary measure) and validity (self-reported total sedentary time compared with accelerometer-derived sedentary time) were assessed during the 1-wk preintervention period, using Spearman (ρ) correlations and 95% confidence intervals (CI). Responsiveness to change after the intervention was assessed using the responsiveness statistic (RS).Results: Test-retest reliability was excellent for television viewing time (ρ (95% CI) = 0.78 (0.63-0.89)), computer use (ρ (95% CI) = 0.90 (0.83-0.94)), and reading (ρ (95% CI) = 0.77 (0.62-0.86)); acceptable for hobbies (ρ (95% CI) = 0.61 (0.39-0.76)); and poor for socializing and transport (ρ < 0.45). Total sedentary time had acceptable test-retest reliability (ρ (95% CI) = 0.52 (0.27-0.70)) and validity (ρ (95% CI) = 0.30 (0.02-0.54)). Self-report total sedentary time was similarly responsive to change (RS = 0.47) as accelerometer-derived sedentary time (RS = 0.39). Conclusions: The summary measure of total sedentary time has good repeatability and modest validity and is sufficiently responsive to change suggesting that it is suitable for use in interventions with older adults.