Smith Ben J, Marshall Alison L, Huang Nancy
School of Public Health, University of Sydney, New South Wales, Australia.
Am J Prev Med. 2005 Nov;29(4):256-64. doi: 10.1016/j.amepre.2005.07.005.
Physical activity (PA) is relevant to the prevention and management of many health conditions in family practice. There is a need for an efficient, reliable, and valid assessment tool to identify patients in need of PA interventions.
Twenty-eight family physicians in three Australian cities assessed the PA of their adult patients during 2004 using either a two- (2Q) or three-question (3Q) assessment. This was administered again approximately 3 days later to evaluate test-retest reliability. Concurrent validity was evaluated by measuring agreement with the Active Australia Questionnaire, and criterion validity by comparison with 7-day Computer Science Applications, Inc. (CSA) accelerometer counts.
A total of 509 patients participated, with 428 (84%) completing a repeat assessment, and 415 (82%) accelerometer monitoring. The brief assessments had moderate test-retest reliability (2Q k=58.0%, 95% confidence interval [CI]=47.2-68.8%; 3Q k=55.6%, 95% CI=43.8-67.4%); fair to moderate concurrent validity (2Q k=46.7%, 95% CI=35.6-57.9%; 3Q k=38.7%, 95% CI=26.4-51.1%); and poor to fair criterion validity (2Q k=18.2%, 95% CI=3.9-32.6%; 3Q k=24.3%, 95% CI=11.6-36.9%) for identifying patients as sufficiently active. A four-level scale of PA derived from the PA assessments was significantly correlated with accelerometer minutes (2Q rho=0.39, 95% CI=0.28-0.49; 3Q rho=0.31, 95% CI=0.18-0.43). Physicians reported that the assessments took 1 to 2 minutes to complete.
Both PA assessments were feasible to use in family practice, and were suitable for identifying the least active patients. The 2Q assessment was preferred by clinicians and may be most appropriate for dissemination.
身体活动（PA）与家庭医疗中多种健康状况的预防和管理相关。需要一种高效、可靠且有效的评估工具来识别需要PA干预的患者。
2004年，澳大利亚三个城市的28名家庭医生使用两问题（2Q）或三问题（3Q）评估法对成年患者的PA进行评估。约3天后再次进行评估以评估重测信度。通过测量与《活跃澳大利亚问卷》的一致性来评估同时效度，并通过与7天的计算机科学应用公司（CSA）加速度计计数进行比较来评估标准效度。
共有509名患者参与，其中428名（84%）完成了重复评估，415名（82%）进行了加速度计监测。简短评估的重测信度中等（2Q k = 58.0%，95%置信区间[CI] = 47.2 - 68. | 8%；3Q k = 55.6%，95% CI = 43.8 - 67.4%）；同时效度为一般到中等（2Q k = 46.7%，95% CI = 35.6 - 57.9%；3Q k = 38.7%，95% CI = 26.4 - 51.1%）；对于识别活动充分的患者，标准效度较差到一般（2Q k = 18.2%，95% CI = 3.9 - 32.6%；3Q k = 24.3%，95% CI = 11.6 - 36.9%）。从PA评估得出的PA四级量表与加速度计记录的分钟数显著相关（2Q ρ = 0.39，95% CI = 0.28 - 0.49；3Q ρ = 0.31，95% CI = 0.18 - 0.43）。医生报告称评估完成时间为1至2分钟。
两种PA评估在家庭医疗中使用都是可行的，且适用于识别活动最少的患者。临床医生更倾向于2Q评估，它可能最适合推广。
