The effect of question order on reporting physical activity and walking behavior.
BACKGROUND
Question order might affect self-reported regular physical activity (PA) measured with items from the Behavioral Risk Factor Surveillance System (BRFSS) PA module.


METHODS
A telephone survey was conducted using 2 forms (N = 1004, N = 212) with varying PA question order. The standard form presented moderate-PA, vigorous-PA, and walking questions, in that order, whereas the alternate form presented walking questions, followed by moderate-PA, and then vigorous-PA questions. Weighted, adjusted rates of vigorous PA, walking, meeting the Centers for Disease Control and Prevention (CDC) recommendation for moderate or vigorous PA, and moderate PA from each form were compared.


RESULTS
Vigorous PA and walking were similar regardless of question order. Meeting the CDC recommendation for moderate or vigorous PA was reported less often with the alternate form among 18- to 34-year-olds. Less moderate PA was reported with the alternate form overall and among 18- to 34-year-olds, women, whites, and those with a high school education or less.


CONCLUSIONS
Estimating PA and walking across sociodemographic strata with differing patterns of PA requires asking moderate-PA and vigorous-PA questions before walking questions. Asking walking questions first might lead to bias, especially for moderate PA. Walking, added to a survey with BRFSS moderate and vigorous PA items, should be placed after moderate and vigorous PA. Walking questions first may cause bias, especially for moderate PA.
Hutto
Brent
B
Prevention Research Center, University of South Carolina, Columbia, SC 29208, USA.
Sharpe
Patricia A
PA
Granner
Michelle L
ML
Addy
Cheryl L
CL
Hooker
Steven
S
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002487:Centers for Disease Control and Prevention, U.S. / Q000592:standards; D015444:Exercise / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D016138:Walking / Q000523:psychology*