title: Impact of activity outcome and measurement instrument on estimates of youth compliance with physical activity guidelines: a cross-sectional study.
abstract: BACKGROUND
  The national physical activity guidelines (PAG) in many countries recommend that youth accumulate 60 min or more of moderate-to-vigorous physical activity (MVPA) daily (PAG-MVPA). A daily target of ≥ 11,500 steps/day has been proposed as a step count alternative to this guideline (PAG-Steps). Contemporary activity monitors are capable of estimating both MVPA and steps, but it is not clear how these units compare when used to evaluate compliance with the national PAG. The purpose of this study was to compare prevalence estimates of meeting the PAG-MVPA and PAG-Steps using two commonly used monitors, the ActiGraph (AG) and SenseWear Armband (SWA).
  
  
  METHODS
  A sample of 69 children (25 girls and 44 boys) aged 9-16 years each wore a wrist-mounted AG and a SWA over a one-week period. Days with ≥10 h of wear time for both monitors were included in the analysis. Estimates of time spent in MVPA were obtained using the Crouter equation for the AG and from proprietary algorithms for the SWA. Step counts for the AG and SWA were directly obtained from the respective software. The prevalence of meeting the PAG-MVPA and PAG-Steps was compared within each monitor, using Cohen's kappa (κ) statistic. Agreement was similarly assessed between monitors using each guideline individually.
  
  
  RESULTS
  When assessed with the AG, the prevalence of meeting PAG was substantially higher for the PAG-MVPA (87.2 %) than for the PAG-Steps (54.2 %), with fair classification agreement (κ = 0.30) between the two guidelines. Higher prevalence rates were also observed for the PAG-MVPA (83.6 %) than for the PAG-Steps (33.8 %) when assessed using the SWA, but the prevalence rates and classification agreement (κ = 0.18) were lower than the values from the AG. Classification agreement between AG and SWA was lower for the PAG-MVPA (κ = 0.42) than for the PAG-Steps (κ = 0.55).
  
  
  CONCLUSIONS
  The results show differential patterns of compliance with the PAG-MVPA and PAG-Steps, as assessed by the AG and SWA. Additional research is needed to directly evaluate and compare findings from public health research based on different guidelines and measurement methods.
authors.affiliation: Iowa State University, 237 Forker Building, Ames, IA, 50011, USA. hibbing@iastate.edu.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Hibbing
authors.affiliation: Iowa State University, 237 Forker Building, Ames, IA, 50011, USA. youngwon.kim@mrc-epid.cam.ac.uk.|MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK. youngwon.kim@mrc-epid.cam.ac.uk.
authors.forename: Youngwon
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Iowa State University, 237 Forker Building, Ames, IA, 50011, USA. pedrosm@iastate.edu.|University of Minho, Braga, Portugal. pedrosm@iastate.edu.
authors.forename: Pedro F
authors.initials: PF
authors.lastname: Saint-Maurice
authors.affiliation: Iowa State University, 237 Forker Building, Ames, IA, 50011, USA. gwelk@iastate.edu.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Welk
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D015203:Reproducibility of Results