Update and Novel Validation of the Pregnancy Physical Activity Questionnaire (PPAQ)

项目摘要 怀孕期间缺乏运动是一个紧迫的公共卫生问题，并与过度运动有关 妊娠期体重增加、妊娠期糖尿病、先兆子痫和早产。自我报告的评估 体力活动(PA)仍然是最常见的监测、流行病学和 孕期佩戴活动监测仪依从性低的妊娠PA干预研究 适用于大样本量和显示器的高成本。因此，PA调查问卷既是关键，也是关键 有效可靠。妊娠体力活动问卷(PPAQ)是本课题组于2004年编制的 (R03HD039341)作为第一份有效的怀孕PA问卷，自那以来已成为 在该人群中广泛使用的评估PA的工具。然而，PPAQ是通过以下方式验证的 算法是从固定持续时间的模拟实验室活动中佩戴在臀部的加速计得出的， 已被证明在自由生活环境中表现不佳，特别是在检测久坐和 光强活动。从那时起，加速度计和直接加速度计都取得了进步 用于确定自我报告PA和PA的有效性的观察校准和验证方法 久坐的行为(某人)这一点很重要，因为某人最近出现了一个重要的新风险因素 不良妊娠结局独立于PA。因此，我们正处于创新的关键时间点 验证方法可用于评估自由生活环境中的PPAQ性能，并更新和 完善这一广泛使用的自我报告工具。我们高素质的研究团队将首先更新PPAQ以 包括当代SB选项(目标1)。然后，我们将招募一个种族多元化的50人的未来队列 怀孕早期的妇女。在每三个月中，参与者将完成更新的PPAQ，然后 在7天的自由生活活动中，佩戴手腕Actigraph GT3XP-BTLE和可穿戴相机。可穿戴式 摄像机图像是目前可用于分类加速度计背景的最好的客观方法- 定义了自由生活活动的情节。使用这些数据，我们将：1)创建新的缩写版本 PPAQ(PPAQ-SF)在测量其他生活方式因素的广泛研究中减轻参与者负担 (目标#2)；2)确定更新后的PPAQ和PPAQ-SF的准确性和精确度，以估计花费的时间 在类型(如家庭/照料、职业、运动/锻炼、交通、运动)和强度方面 对自由生活环境中的PA和SB进行分类(轻、中、强)(目标3)。因此，更新后的 根据这项工作开发的PPAQ和新的PPAQ-SF将是第一份在自由生活中得到验证的问卷 设置以提供对孕妇PA和SB的准确和精确的估计。这些工具将是 对于：1)监测研究评估PA指南的遵从性，2)PA的病因学研究和 母婴结局旨在确定预防这些疾病的最佳孕激素剂量 3)确定旨在增加怀孕期间PA的运动干预的有效性。

Project Summary Physical inactivity during pregnancy is an urgent public health concern and is implicated in excessive gestational weight gain, gestational diabetes, pre-eclampsia, and preterm birth. Self-reported assessments of physical activity (PA) continue to be the most common method for surveillance, epidemiological, and intervention studies of pregnancy PA given low compliance with activity monitor wear during pregnancy, need for large sample sizes, and the high cost of monitors. Therefore, it is critical that PA questionnaires be both valid and reliable. The Pregnancy Physical Activity Questionnaire (PPAQ) was developed by our group in 2004 (R03HD039341) as the first validated pregnancy PA questionnaire and has since become one of the most widely used instruments for assessing PA in this population. However, the PPAQ was validated using algorithms derived from accelerometers worn on the hip during fixed-duration simulated laboratory activities, which have been shown to perform poorly in free-living settings, particularly in the detection of sedentary and light intensity activity. Since that time, advances have been made in accelerometer and direct observation calibration and validation methods used to determine the validity of self-reported PA and sedentary behavior (SB). This is important as SB has recently emerged as an important new risk factor for adverse pregnancy outcomes independent of PA. Therefore, we are at a key point in time where innovative validation methods can be used to evaluate PPAQ performance in free-living settings and update and refine this widely used self-report tool. Our highly qualified research team will first update the PPAQ to include contemporary SB options (Aim #1). We will then recruit an ethnically diverse prospective cohort of 50 pregnant women in early pregnancy. In each trimester, participants will complete the updated PPAQ, then wear a wrist-worn Actigraph GT3XP-BTLE and a wearable camera over 7-d of free-living activity. Wearable camera images are the best objective method currently available to categorize the context of accelerometer- defined episodes of free-living activity. Using these data, we will: 1) Create a new short-form version of the PPAQ (PPAQ-SF) to reduce participant burden in studies which measure a wide range of other lifestyle factors (Aim #2); 2) Determine the accuracy and precision of the updated PPAQ and PPAQ-SF to estimate time spent in type (e.g., household/caregiving, occupational, sports/exercise, transportation, locomotion) and intensity classification (light, moderate, vigorous) of PA, and SB in a free-living setting (Aim #3). Thus, the updated PPAQ and new PPAQ-SF developed from this work will be the first questionnaires validated in free-living settings to provide accurate and precise estimates of PA and SB in pregnant women. These tools will be critical for: 1) surveillance studies assessing compliance with PA guidelines, 2) etiologic studies of PA and maternal-fetal outcomes designed to identify the optimal dose of pregnancy PA for the prevention of these disorders, and 3) to determine the efficacy of exercise interventions designed to increase PA in pregnancy.