title: Awareness of physical activity in healthy middle-aged adults: a cross-sectional study of associations with sociodemographic, biological, behavioural, and psychological factors.
abstract: BACKGROUND
  Interventions to promote physical activity have had limited success. One reason may be that inactive adults are unaware that their level of physical activity is inadequate and do not perceive a need to change their behaviour. We aimed to assess awareness of physical activity, defined as the agreement between self-rated and objective physical activity, and to investigate associations with sociodemographic, biological, behavioural, and psychological factors.
  
  
  METHODS
  We conducted an exploratory, cross-sectional analysis of awareness of physical activity using baseline data collected from 453 participants of the Feedback, Awareness and Behaviour study (Cambridgeshire, UK). Self-rated physical activity was measured dichotomously by asking participants if they believed they were achieving the recommended level of physical activity. Responses were compared to objective physical activity, measured using a combined accelerometer and heart rate monitor (Actiheart®). Four awareness groups were created: overestimators, realistic inactives, underestimators, and realistic actives. Logistic regression was used to assess associations between awareness group and potential correlates.
  
  
  RESULTS
  The mean (standard deviation) age of participants was 47.0 (6.9) years, 44.4% were male, and 65.1% were overweight (body mass index ≥ 25). Of the 258 (57.0%) who were objectively classified as inactive, 130 (50.4%) misperceived their physical activity by incorrectly stating that they were meeting the guidelines (overestimators). In a multivariable logistic regression model adjusted for age and sex, those with a lower body mass index (Odds Ratio (OR) = 0.95, 95% Confidence Interval (CI) = 0.90 to 1.00), higher physical activity energy expenditure (OR = 1.03, 95% CI = 1.00 to 1.06) and self-reported physical activity (OR = 1.13, 95% CI = 1.07 to 1.19), and lower intention to increase physical activity (OR = 0.69, 95% CI = 0.48 to 0.99) and response efficacy (OR = 0.53, 95% CI = 0.31 to 0.91) were more likely to overestimate their physical activity.
  
  
  CONCLUSIONS
  Overestimators have more favourable health characteristics than those who are realistic about their inactivity, and their psychological characteristics suggest that they are less likely to change their behaviour. Personalised feedback about physical activity may be an important first step to behaviour change.
authors.forename: Job G
authors.initials: JG
authors.lastname: Godino
authors.forename: Clare
authors.initials: C
authors.lastname: Watkinson
authors.forename: Kirsten
authors.initials: K
authors.lastname: Corder
authors.forename: Stephen
authors.initials: S
authors.lastname: Sutton
authors.affiliation: MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Addenbrooke's Hospital, Box 285, Hills Road, Cambridge CB2 0QQ, United Kingdom. simon.griffin@mrc-epid.cam.ac.uk.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Griffin
authors.forename: Esther M F
authors.initials: EM
authors.lastname: van Sluijs
mesh_terms: D061725:Accelerometry / Q000379:methods / Q000706:statistics & numerical data; D001294:Attitude to Health; D001364:Awareness; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D015444:Exercise / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000523:psychology; D057566:Self Report; D012959:Socioeconomic Factors; D006113:United Kingdom