Activity Monitors Flashcards
Purpose of portable electronic heart rate meters?
Used to infer metabolic activity in free-living (vs. laboratory) subjects
Fxn of pedometers
Count steps
Where are pedometers worn
At hip or ankle
Science behind pedometer
- low cost pedometers use simple mechanical switch
- when limb movement causes large enough perturbation of the monitor the switch closes momentarily and pedometer registers a step
What are accelerometers
- piezoelectric crystals that have property of producing tiny voltage proportional to amount of strain on crystal
3 things heart rate meters can measure?
- intensity of action
- metabolic rate
- caloric expenditure
Characteristics of heart rate meters
small, light, minimally intrusive
heart rate is a valid and reliable indicator for what in most cases?
exercise intensity
What is reliability
Similar value obtained on repeat measures under similar conditions
4 situations in which heart rate does not accurately reflect exercise intensity
- Arm work: HR overestimates intensity
- Prolonged exercise: HR drifts upward
- Medications: May limit HR increase
- Horizontal: HR lower for a given intensity compared w/upright posture
3 subjects written about activity monitor discussed in textbook
- accuracy of monitors (special consideration is the quantification of activity among children and youth)
- use of activity monitors to see if an “intervention” makes people more active
- does giving people a pedometer result in an increase in their activity level
When is inaccuracy of pedometers the greatest
at lower walking speeds or very fast walking/running
4 steps to ensure pedometer counts steps accurately
- attach device at waistline, directly above kneecap
- don’t attach pedometer to loose garments like dresses
- regularly check pedometer while ur walking to make sure doesnt shift out of position
- unless otherwise instructed, wear pedometer in 1upright position
Accuracy of pedometers varies with what factors
One’s walking speed, stride length, & force w/which one’s feet strikes the ground
What pre check can be done to check accuracy of pedometer?
clip to waist or belt & check accuracy by counting ur steps as u walk ur normal walk, then compare steps w/what pedometer indicates
Describe the sensitivity vs. specificity dilemma with pedometers
- how large a movement should be counted as a step?
- if sensitivity too low, some real steps overlooked
- if specificity too low, minor movements that aren’t “real” steps will be counted
Advantages of using pedometer to assess daily or weekly activity patterns as a whole
- cheap
- objective
- does not interfere w/daily activities & is thus appropriate to use in population studies
advantage of commercial accelerometer with time-sampling mechanism
could be used to provide a picture of the pattern of children’s activity
if wanting to use pedometers to motivate people to become more active, what aspect is more important and less important?
- accuracy doesn’t matter
- reliability matters
Example of indirect calorimetry
measurement of oxygen consumption
Main finding of Couter et al. (2003) for pedometer study?
pedometers most accurate for counting steps, less accurate for assessing distance, and even less accurate for assessing kcal
Main finding of Melanson et al. (2004) for pedometer study?
even at very slow speed of 1.0 mph, accuracy of piezoelectric pedometer while not good, was better than spring-levered pedometers
Main findings of Crouter, Schneider & Basset for pedometer study?
- in overweight and obese individuals, piezoelectric pedometer more accurate than spring-levered pedometer esp at slower walking speeds
- pedometer tilt (more than waist circumference and BMI) most important factor influencing accuracy of spring-levered pedometer
- piezoelectric pedometer not affected by pedometer tilt, waist circumference, or BMI
For Craig, Cameron, and Cragg study, avg # of steps reported was…
- less than that recommended to maintain healthy body mass
- Higher among males
- Higher in the West
- Higher among those said they participate in organized PA and sport
- Lower among those who said they prefer quiet activities
During Bruner et al. (2006) study involving youth, what did the results show
- inc in activity from oct to dec
- steady decline in each of the 3 subsequent periods
- greatest dec from feb to april
Why are children less likely to make accurate self-report assessment than adults
developmental differences, esp in ability to think abstractly and perform detailed recall
McMurray’s study on MVPA for adolescence showed what
3 day recall period too long for accurate recall of MVPA info
- for both genders survey overestimates activity lvls
Problems with using heart rate telemetry to give estimates of daily activity in children
- heart rate indirect estimate of PA and makes assumptions based on linear relationship btwn heart rate & oxygen uptake
- heart rate sensitive to emotional stress, body position, takes longer to reach resting lvls after physical exertion compared w/o2 uptake
- lags behind movement (bad cause children’s PA sporadic in nature)
What characteristics must instrument posses to accurate assess children’s activity patterns
- must be sensitive enough to detect, code, or record sporadic & intermittent activity
Out of heart rate monitoring, pedometry, triaxial accelerometry, and uniaxial accelerometry, which was the best measure for estimating oxygen consumption during typical Welsh children’s activities
triaxial accelerometry
Beets, Patton, & Edwards study accuracy of pedometers during self-paced walking and treadmill walking in children showed what
same pedometer inaccuracy at slower walking speeds as has been observed in adults
- time might be used in addition to steps to quantify the PA behaviour of children
Suggestions to improve assessments of PA in children with monitors?
- focus assessments on key times or places that allow children to be active
- monitoring of entire groups for discrete periods of time useful to understand variability in activity patterns since children would all be exposed to same stimulus or opportunity to be active
- proxy measures useful (e.g. time spent outside strongly predictive of activity in children)
- employ multiple measures of PA to provide more complete description of children’s activity & permit a triangulation of outcomes
How many steps did people take in a typical day in Tudor-Locke et al. study?
~10,000 +/ 3000
According to Tudor-Locke et al. study, when is the best time during the year to sample if want to collect data that is representative of the whole year?
Spring or fall, not summer
Speck & Looney study on whether minimal intervention (daily records of physical activity) increases activity levels in a community sample of working women demonstrated what
Intervention group recorded significantly more steps than contorl group
Talbot et al showed what
Home-based pedometer-driven walking program w/arthritis self-management education inc PA, strength, fxn of group compared to arthritis self-management education group alone
Rooney et al. (2003) study on female employees showcased setting daily step goals, keeping a log of steps walked, and wearing the pedometer all the time were the indicators most likely to predict significant improvement in levels of ___?
awareness & amount of PA, self-efficacy, & other physical improvements
In Croteau (2004) study on college employees, who experienced the greatest increase in steps
participants who averaged fewer than 6,000 steps & obese participants
Roemmich, Gurgol and Epstein (2004) used what to motivate PA? Results?
- TV access when accumulated PA counts
- intervention group had increased PA activity
Chan, Ryan, and Turdor-Locke (2004) study of effects of pedometer-based activity intervention showed?
- on avg, participants experienced significant dec in BMI, waist girth, & resting heart rate
- reduction in waist girth & heart rate were significantly related to inc in steps per day
Stewart et al (2004) study showed what results
Take 10! program effective in providing moderate-to-vigorous intensity PA
Ball et al. (2004) study showed what
print-plus-telephone group maintained higher lvls of global reported activity & walking than those in print group
What does communication facilitate
understanding
What is communication
a way to share info, to establish rapport, to emphasize
how do humans communicate
- with sophisticated verbal and symbolic (e.g. mathematical, computer) languages
- give & receive subtle and rich non-verbal msgs
- person on receiving end gives verbal and non-verbal signals
What comprises active listening
- with sophisticated verbal and symbolic (e.g. mathematical, computer) languages
- give & receive subtle and rich non-verbal msgs
- person on receiving end gives verbal and non-verbal signals
3 reasons why beginnings are important
- They set the tone
- They are an opportunity to establish rapport, thru display of genuineness, empathy, & warmth
- They are a time to clarify expectations
4 open-ended questions counselors use that are effective
- Why do you think that is?
- What do you think might help?
- Has this ever happened before?
- What did you do about it then?
What are closed-ended questions
Those that can be answered briefly, usually with a single word like yes or no
- tend to stifle rather than encourage dialogue
why ask open ended questions instead of closed ended
to elicit lengthier answers
what to do when client wandered off topic or repeating herself
refocus session
- “ok im getting good picture of how u spend ur weekends, how do u spend ur weekdays?”
what type of body language should you display when talking to client
- position urself close enough to client to be able to be converse in a normal voice (1-2 meters) while not invading personal space
- position urself so your eyes are at the same level of clients
- rest arms on legs or arm of chair, rest feet on floor
- make eye contact but don’t stare
- turn body so generally faces client
in a good counselling session, how much talking does counsellor do
20%
4 skills of active listening, example of each
- Bridging - use of little words like “yes, go on, I see”
- signal to speaker ur listening - Restating - repeating last word or few words of client
- “often i plan to run after work but i’m too tired. i’m usuall so organized idk whats wrong.” “counsellor: what’s wrong..?” - Paraphrasing - summarizing in own words what u heard
- ensure u understand what client thinking n feeling
- “it sounds as tho u r looking forward to brothers visit but concerned itll interfere w/ur workout sessions” - Asking for clarification - when ur not sure u’ve understood client
- “could you elaborate on that”
what is reactance
- counsellor wants to avoid causing client to “react”
- reactance presents in negative cognition like “I hate you”
- the reacting person perceives a threat to their freedom & respond by becoming defensive and stubborn
- reactance causes person to do more of the behaviour u r trying to get them to stop
- more likely in response to explicit, threatening language, or dogmatic, authoritarian, or domineering tone
- subject w/high reactance scores more prone to rxn than others
1st step when working w/new person or group is to? next steps?
- establish rapport
- explore issues
- mobilize his/their resources
- develop self-efficacy
how does a group leader change over time in a group that starts to mature
- initially directive, as group develops confidence & self-efficacy and matures, an effective leader will back off and give inc responsibiity n autonomy to group
Characteristics of teaching
- plan but be flexible
- have a standard format, but use variety
- plan the session in 20-min ‘chunks’. learning falls off dramatically as attention span wanes
- keep it simple
- more is not better
- first demonstrate, & then explain
- if the msg is complex, give it in writing
goal of counsellor?
support change
what should a counsellor do
- help client frame the problem “Why are u here? What would u like to happen?”
- help client explore the issue “what have u tried in the past”
- try to build self-efficacy
Process of active listening with client and counsellor
- Develop rapport w/client
- Create a comfortable environment
- Establish a helping relationship
- Structure ur sessions
- Help client develop alternatives in pursuit of active living
- Gather data about: clients lifestyle, activity preferences, activity levels, goals/aspirations, physical conditions
- Engage in mutual problem solving
- Determine realistic goals
- Make appropriate changes
- Recognize limits to ur expertise, & refer as indicated to qualified specialists for issues such as: mental health, substance abuse, eating disorders, family/martial issues, medical conditions
What is empathy
the capacity for participation in another’s feelings or ideas
What is sympathy
the act or capacity of entering into or sharing the feelings or interests of another OR affinity, association, or relationship btwn persons or things wherein whatever affects one similarly affects the other
Should counsellors empathize or sympathize
empathize
why is sympathy not appropriate for a counsellor
counsellor and client relationship is a working one not a personal one
6 communication errors?
- Let ur mind wander
- Give advice w/out listening
- Be insincere or condescending
- Use inappropriate behaviour
- Appear inattentive; be conscious of the signals u r sending w/ur body language
- Be insensitive to clients concerns or judge their behaviour
6 ways to deal with difficult situations
- Intervene early
- Choose the right time & place
- Explain what the problem is & why it is a problem
- Invite suggestion re how it can be solved
- Agree on a solution
- Follow up
How has human interaction occurrence
- used to occur in physical space to virtual space
what is physical space
some place which has a certain size, shape, colour, temp, lighting lvl, furnishing etc.
what is virtual space
over the internet
why is it inappropriate for counsellor to wear sunglasses if not coaching on sunny field
client cant see ur eyes & nonverbal info they convey
What is the “zone” people have
1 meter diameter around them that they perceive as “my space”
The Canadian Society for Exercise Physiology lists what 4 diff counselling styles
- Preacher
- Director
- Educator
- Consultant
Who is a preacher
- urges client adopt healthy lifestyle
- tells client what to do, but not much about how to do it
- motivates people (maybe thru guilt) but imposes value judgments & prevents dialogue
Who is a director
- tells client what to do
- provides guidance & structure
- most appropriate at action stage
- most clients resent being told what to do
- under-uses client herself as a resource
Who is an educator
- delivers info in an objective, nonjudgmental & nondirective way
- efficient at covering lot of material in given time period
- reassuring for people familiar w/this style (students)
- intimidates other clients
- prevents dialogue
- info alone has disappointingly small effect on altering behaviour
Who is a counsellor
- works w/client & involves them actively
- helps clients to have insight, consider alternatives, & make choices
- promotes dialogue
- accesses client’s resources
- supports self-efficacy
- this style takes time & skill
- some people want info or direction best facilitated by other counselling styles
Which counselling approach(es) is most useful
- combined approach
- use diff styles in diff situations, depending for example on particular setting, client, stage of change & goals for that counselling session
Why is “measurement” better than “test”
test implies a judgement
When reading results of a test, what should u start off with first
start w/items scored well on and conclude w/weakest area
Traditional health education is strong on what “three M’s”
- Market ; identifying a target market or audience
- Message ; tailoring messages to suit the values, attitudes, & language of that market
- Media ; using media (t.v., radio etc.) to deliver msg to target market
Lawrence W. Green asserts the traditional approach to health education isn’t wrong but ____ and ___
- too narrow and limited
Lawrence Green’s health education definition
- health education is a process which bridges the gap btwn health info and health practices. health education motivates the person to take the info & do smtg w/it – to keep himself healthier by avoiding actions that are harmful & forming habits that are beneficial
What is Green’s health education definition similar to
health motivation
Green’s health educational planning process called?
PRECEDE-PROCEED
What are Green’s 5 fallacies
- Empty vessel (container)
- Some methods inherently better
- More is better
- Technology is the solution
- Teacher motivates the student
What is and why is the empty vessel false
- this fallacy states that students know nothing, they wait eagerly to have their minds filled w/knowledge. ‘expert’ casts ‘his pearls of wisdom’ for students to gobble up
- by young adulthood, students know a lot and start semester w/lots of related knowledge and lifetime experience, attitudes, beliefs, & values. not starting from “ground zero”
Why are ‘some methods are inherently better’ false
- nothing inherently superior about any one method
- method should be viewed as a tool, and should be appropriately applied. most effective teacher will be those w/biggest tool kit, the sensitivity to understand their audience, & the wisdom to use the best tool for the job at hand
Why is more is better false
- the amt of learning not related to amt of material presented, but to the degree of active involvement of the listener. passive participation is less effective
Why is technology is the sln false
- new things tend to arouse curiosity and interest, but high-tech can be useless too e.g. clickers if q’s posed too hard for group. low-tech like blackboards can also work very well
- use appropriate tech and a process that engages the learner
Why is the teacher motivates the student false
- u cannot motivate someone, motivation isn’t smtg u can give to someone
- u can only help his or her own motivational processes to influence behaviour
Lebanese poet Kahil Gibran views the teacher is a ___ rather than as expert
guide
Markets can be populations of what three things
- Individuals
- Groups
- Organizations
What is market segmentation
The division of the total market into relatively homogeneous but distinct segments
Purpose of market segmentation
used to identify target audiences & strengthen a campaign’s effectiveness in reaching selected segments. segments usually respond to campaigns elements differently & diff techniques required to reach & motivate various segments
3 ways to segment a population are
- Geographically: by location
- Demographically: by socio-economic group, characterized by age, income, sex etc.
- Psychographically: by such things such as attitudes, values, lifestyles, & opinions
Ling et at. grouped vietnamese-american youth into what four psychographic segments
- Risk seekers
- Stressed pessimists
- Optimistic achievers
- Sedentary well-behaved
Ling et at. study results
- attitudes towards tobacco use, secondhand smoke, smoke-free policies different btwn 4 groups. Implication was that tobacco control msgs should address these diff attitudes
Commonly used tool in segmenting a market for social marketing is what model
Stages of Change Model
Stages of Change Model explains what
- explains the psychological process individuals experience as their behaviour changes
- this model tends to divide population into segments w/common knowledge, attitudes, beliefs, & behaviours relative to issue at hand
What are the 6 stages in Stages of Change Model and a bit of each
- Pre-contemplation; no intention to change behaviour. in denial or uninformed of the need to change
- Contemplation; acknowledge problem & beginning to think about changes
- Preparation; plan to take action w/in next month & make adjustments b4 behaviour change
- Action; modify behaviour & surrondings to facilitate change
- Maintenance; work to consolidate the gains attained during action phase, struggle to prevent lapses and relapse
- Termination; new behaviour is fully adopted
In 2005 health canada conducted survey on ___ and ___ related to healthy eating, physical activity, and sport participation in preparation for a campaign on Healthy Living
- attitudes & behaviours
Health canada’s research was a psychographic analysis which segmented market based on what 4 things
- Current behaviour
- Perceptions of the benefits of healthy eating & PA
- Need for info on healthy living subjects
- Current actions/intentions to improve their families health
Health canada’s research study gave four diff segments, w/diff lvls of commitment to healthy living & w/diff info needs
- Gold medalists, low info needs, highest commitment to healthy living
- Status Quo - moderate info needs, high commitment to healthy living
- Info seekers - higher info needs, high commitment to healthy living
- Skeptics - moderate info needs, lowest commitment to healthy living
Which 2 groups did Health Canada select as target audiences ? Why
Status Quo and Info Seekers
- they were in position to make improvements & were responsive to change
Really Me! psychographic analysis segmented groups based on their views regarding…
- Work ethic
- Family value
- Current drug use behaviour
- Tendency to follow others
- Their futures
What 7 lifestyle groups did Really Me! use
- TGIF; less ambitious & disciplined. substance use/abuse tends to be part of TGIF lifestyle
- Tomorrow’s Leaders; ambitious, leaders not followers. optimistic about future. tend to be against smoking
- Quiet conformers. strong work ethic and social conscious. follow rather than lead. against smoking and other substance abuse
- Concerned Moralists; very traditional attitudes towards family, sexuality etc. follow rather than lead. need the support and approval of others
- Passive Luddites; more tolerant of, if not involved in, substance use/abuse. some degree of independence, but concerned about how one seen by others
- Small Town; traditionalists. traditional attitudes and beliefs. ambitious, self-confident, anti-substance use/abuse
- Big City Independents; independent. not easily influenced. “loners” more than team player. Wide range of substance-use behaviours
Analysis of youth identified what 3 psychographic groups based on drug use attitudes n behaviour, particularly use of marijuana
- Active - larger percentage of older youth. willing to experiment w/drugs. highest proportion of friends that use drugs
- Contemplators - equally split btwn younger n older teens. some use marijuana, but infrequently. least likely to be leaders
- Inactive - least likely to have tried marijuana. believe drug use is dangerous. majority prefer not to be w/those that use drugs.
What is target marketing
the selection n concentration of marketing resources on one or more market segments (often more than 1 target audiences selected, audiences then divided into primary n secondary target audiences)
what is TARPARE
A model that can help to analyze market segments w/a view to choosing target audiences where the greatest impact is likely to occur
Define all letters of TARPARE
T (total # of people in segment) - segments encompassing larger groups of individuals more attractive
AR (At Risk) - segments at higher lvls of risk should be given priority
P (Persuadability) - a segment that is easily persuaded to change should be given a higher priority, as it will take fewer resources to establish a behaviour change
A (Accessibility) target audiences that are easier to reach w/messages are more attractive as less work n fewer resources needed to make an impact
R (Resources required) - the fewer the resources required, to meet the needs of the target market, teh greater expected return on investment
E (Equity) - the need to target specific disadvantaged segments
Why were women aged 25-39 chosen as primary target audience for Eat Well. Have Fun. You can prevent type 2 diabetes campaign
- they were accessible n often made decisions that contributed to the health of their children, spouses (men, at higher risk) n parents (elderly, at higher risk) thus disseminating msgs to all intended targets
Who were the secondary target audience for Eat Well. Have Fun. You can prevent type 2 diabetes campaign
men aged 23-39
Why were men secondary target compared to women even tho they have lower awareness lvls of diabetes n worse eating habits than women
least accessible target audience
How did ParticipAction levered support
personally visited media outlets to explain their cause (won over media people w/cute, clever, n original advertising material)
Analysis of target audience helps social marketers understand what 4 things
- Current behaviour, knowledge, attitudes n values of target audience
- Barriers that discourage target audiences from adopting the desire behaviour
- Knowledge gaps T
- The appeal of competing behaviours
Health Canada Vitality campaign chose their target audience adults aged 25-44 with 9-13 years of education why
they were at increased risk of developing cancer, heart disease n diabetes, yet existing public awareness n prevention programs had not been successful in changing their behaviour
Health Canada Vitality campaign chose their target audience adults aged 25-44. Why were they not responsive to msgs on weight loss
these programs had rarely been successful in creating long term change n often left individuals feeling discouraged
Health Canada Vitality campaign chose their target audience adults aged 25-44. What was their major obstacle to eating nutritiously n engaging in regular physical activity
lack of time
Health Canada Vitality campaign chose their target audience adults aged 25-44. Based on research, the program integrated what aspects
healthy eating, PA, n pos body image. a pos msg used to motivate individuals to act on knowledge they already have
- campaign worked to incorporate values of target audience n showed moments of daily life when adults forgot about their concerns, n spent time in company of their children n friends
What is social marketing
adaption of commercial marketing techniques to achieve social goals
5 common social marketing techinqiues
- Market segmentation
- Target marketing
- Consumer research
- Mass media
- Tracking of results, i.e. ‘outcome measures’
rather than trying to sell product or service, social marketing tries to ____
achieve certain social goals
Health canada’s view of social marketing
“social marketing combines the best elements of the traditional approaches to social change in an integrated planning n action framework, n utilizes advances in communication tech n marketing skills. it uses marketing techniques to generate discussion n promote info, attitudes, values, n behaviours. by doing so, it helps to create a climate conducive to social n behavioural change”
Wagnam stated social marketing can only be used effectively when (4)…
- We r aware of beliefs n values of target audience
- new behaviour is accessible to target audience
- msg promoted repeated using variety of formats
- appropriate method of evaluation used to measure behavioural change
Boslaugh said goal of audienc segmentation is…
to identify population subgroups that are homogeneous w/respect to certain variables associated w/a given outcome or behaviour. when such groups identified and understood TARGETED INTERVENTION STRATEGIES can be developed to address their unique characteristics n needs
When Boslaugh applied diff segmentation approaches he conlcuded that
simple segmentation strategies such as those replying on demographic variables alone provide little improvement over no segmentation at all. audience segmentation appears to yield more homogeneous subgroups when psychosocial n health status factors r combined w/demographic variables
5 key elements of tobacco control
- clinical intervention n management
- educational strategies
- regulatory efforts
- economic approaches
- combo of all these into comprehensive programs that address multiple facets of the environment simultaneously
Mercer et al. implies lessons learned from tobacco control can be applied to current ____ epidemic
global obesity epidemic
Target of Condomania
heterosexual women aged 19-30 who were based w/in popular culture of Vancouver
main msg of condomania
condoms were fun/make condoms more acceptable
Program evaluation of Condomania was?
Pre n post-test telephone surveys of target group, plus series of in-depth interviews held w/bar patrons
How is HIV spread in the Lao PDR
related to the proliferation of road networks n construction site thruout Laos
Where does Vietnam distribute condoms
Traditional (pharmacy) and nontraditional (coffee shop) stores
Social marketing programs can act as a bridge between _____
public n private sectors
What did How Do You Know What You Know challenge
provocatively challenged common assumptions some men make about their risk of transmitting or contracting HIV when engaging in anal intercourse without condoms with men whose HIV status they dont know for certain
How Do You Know What You Know campaign depicted what kind of messages
- ‘inner voice’ assumptions men might make in casual sexual encounter
Condomania and How Do You Know What You Know campaign are examples of upstream or downstream marketing
Downstream
What is downstream marketing
msg intended to flow down from health promotion agency to target of behavioural change
what is upstream marketing
health promotion organization directs msg up to industry or gov
- intent is to get these decision makers to change the political, social, legal, physical, or public policy environment around behaviour in question
When is upstream marketing useful
when significant environmental barriers exist that make it difficult to change at individual lvl
example of upstream marketing
Mothers Against Drunk Driving, Heather
What is a strategy
- big-picture plan for how u will achieve the objective
- means “a global plan to reach a long-term goal”
- comes from Greek word that means army leadership
What are tactics
the specific steps taken to implement the strategy
- means “a short-term plan or behaviour”
- comes from Greek word that means science of arrangement
both strategy n tactics come from where
military planning
Peter Drucker quote on strategy n tactics
strategy is doing the right things, tactics is doing things right
What is validity
How well it measures what is it supposed to measure
What is accuracy
How close the measured value is to the true value
What is reliability
How repeatable is the measurement
What is sensitivity
How a small change can be detected
Why is pedometers good for weight loss
Can set a behavioural goal (rather than a weight goal, which changes more slowly)
Main msg in Activity Monitor Chapter
In a lot of these interventions, behaviour relapses after the fact
Strategies to estimate child activity levels
- Reports by ‘key informants’, e.g. parents, teachers (self-reports in children less accurate than in adults)
- Focus assessments on key times & places that allow children to be active, e.g., after school
- Use proxy measures: time spent outdoors, involvement in community sports programs, etc…
- Employ multiple measures of activity (e.g., self-reports, HR, pedometry) and triangulate
