title: Application of the American Heart Association/American College of Sports Medicine Adult Preparticipation Screening Checklist to a nationally representative sample of US adults aged >=40 years from the National Health and Nutrition Examination Survey 2001 to 2004.
abstract: BACKGROUND
  Although the American Heart Association/American College of Sports Medicine's Preparticipation Questionnaire (AAPQ) is a recommended preexercise cardiovascular screening tool, it has never been systematically evaluated. The purpose of this research is to provide preliminary evidence of its effectiveness among adults aged ≥40 years.
  
  
  RESULTS
  Under the assumption that participants would respond to AAPQ items as they responded to a general health survey, we calculated the sex- and age-specific proportions of adult participants in the National Health and Nutrition Examination Survey 2001 to 2004 who would receive a recommendation for physician consultation based on AAPQ referral criteria. Additionally, we compared recommended AAPQ referrals to a similar assessment using the Physical Activity Readiness Questionnaire in the study sample. AAPQ referral proportions were higher with older age. Across all age groups ≥40 years, 95.5% (94.3% to 96.8%) of women and 93.5% (92.2% to 94.7%) of men in the United States would be advised to consult a physician before exercise. Prescription medication use and age were the most commonly selected items. When referral based on AAPQ was compared with that of the Physical Activity Readiness Questionnaire, the 2 screening tools produced similar results for 72.4% of respondents.
  
  
  CONCLUSIONS
  These results suggest that >90% of US adults aged ≥40 years would receive a recommendation for physician consultation by the AAPQ. Excessive referral may present an unnecessary barrier to exercise adoption and stress the healthcare infrastructure.
authors.affiliation: Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Austin, TX (G.P.W., K.K.P.G., M.H.R., H.W.K.); Center for Clinical and Translational Sciences, University of Texas Health Science Center, Houston, TX (M.H.R.); and the Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX (H.W.K.).
authors.forename: Geoffrey P
authors.initials: GP
authors.lastname: Whitfield
authors.forename: Kelley K
authors.initials: KK
authors.lastname: Pettee Gabriel
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Rahbar
authors.forename: Harold W
authors.initials: HW
authors.lastname: Kohl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000572:American Heart Association; D057189:Checklist / Q000639:trends*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009749:Nutrition Surveys; D012017:Referral and Consultation / Q000639:trends; D012189:Retrospective Studies; D013178:Sports Medicine; D011795:Surveys and Questionnaires; D014481:United States
keywords: epidemiology; exercise; health surveys; mass screening