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theses

Physical activity is a core educational focus for the Expanded Food and Nutrition Education Program (EFNEP), a federally funded nutrition education program that works with low-income families. However, there have been no previously validated tools to assess adults’ physical activity behavior changes resulting from EFNEP participation. This research’s primary purpose was to develop a brief physical activity assessment tool (BPAAT) that is reliable, valid, and sensitive for measuring changes in physical activity behaviors among EFNEP adult participants. Notably, this research was part of a multi-state, multi-year Agricultural Experiment Station research project, NC2169/3169: EFNEP-Related Research, Program Evaluation and Outreach.

The BPAAT includes 3 questions written in accordance with the Physical Activity Guidelines for Americans and the contents taught in EFNEP. A mixed method approach, with samples from various States, was used to accomplish the following: establish
content validity, face validity, test-retest reliability, concurrent validity, and sensitivity to change for the BPAAT.

In summary:
• Physical activity experts and State EFNEP Coordinators reviewed the BPAAT and response options to confirm content validity. Questions and response options were revised as necessary.
• One-on-one, semi-structured cognitive interviews (N=57) were conducted with adults who were eligible for EFNEP to test the BPAAT’s ease of understanding and appropriateness. Questions and response options were revised as needed.
• Test-retest reliability was established with low-income adults (N=75). Testing results showed all questions had at least moderate correlations using Spearman’s rank order correlation coefficients and Cohen’s weighted kappa (> 0.40) and “good” agreement (intraclass correlation coefficients > 0.70).
• Concurrent validity testing was done with EFNEP participants (N=106) who, for 5 days: wore an accelerometer-based PA monitors for at least 10 hours per day; and, completed a self-reported physical activity log. The Spearman rank order correlation coefficient ranged from -0.18 to 0.87 comparing the BPAAT responses to the accelerometer data and the self-report logs.
• A secondary data analysis, using EFNEP’s national dataset from federal fiscal year 2018, was performed to assess sensitivity to change. Participants’ responses (N=53,393) to all questions demonstrated significant increase from pre to post-EFNEP (p<0.0001).

This newly developed BPAAT is the first to have been validated in a national representative sample of low-income adults. It is reproducible, sensitivity to intervention change, and rigorously tested for validity. The BPAAT provides a practical method to assess PA for programs with limited time and resources.

ETD_10500

Ph.D.

Includes bibliographical references

doi:10.7282/t3-ptd5-8k90

ETD doctoral

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