Predictors of Reactivity to Physical Activity Measurement among Women in Midlife with Elevated CVD Risk: Examination Across 7 Studies

摘要 患心血管疾病(CVD)的风险在中年(40-60岁)和 女性和男性的轨迹不同。增加体力活动(PA)可以降低这些风险， 迫切需要能够减少参与这一人群的障碍的研究。帕 测量反应性，或PA参与度因PA引入而发生的变化 衡量，可能会偏离对PA的客观评估，这对于评估PA推广是必不可少的 努力。然而，目前支持PA测量反应性是PA中的一个关键因素的证据令人困惑 研究结果喜忧参半，包括来自调查团队的初步证据。我们资助的R03是 旨在解决现有工作的主要局限性--包括强调儿童或健康、年轻的人 心血管疾病风险较低的成年人，以及对参与者之间的个体差异缺乏关注-在 心血管疾病风险升高的中年妇女(如肥胖、高血压；N=800)。建议数 补充条款旨在进一步解决低功率对性别进行关键测试的限制 PA测量反应性反应的差异，包括男性和进行第一次完全测试 这是对这一领域性别差异的有力检验。我们将使用来自美国国立卫生研究院资助的临床的6个现有数据集 用于检查PA测量反应性的性别差异的试验和公开数据库 在心血管疾病风险升高的中年成年人中(N=1940)。使用协调分析方法，我们将 使用多水平建模技术来实现以下目标：(1)描述中年成年人的特征 PA测量4个PA结果的反应性(全样本和性别内)：步骤、分钟 轻度活动，中等到剧烈强度的活动分钟，以及久坐的行为分钟，(2) 为了确定测量反应性的存在或程度是否基于人口统计而不同， 医学或心理特征(重点是性别)，以及(3)确定 测量反应性的存在或程度因研究等研究特征而异 设计(即，干预开始前仅进行观察与PA观察)和PA监测 程序(即研究级加速度计与商用可穿戴设备的对比)。我们还将 检查性别是否缓和了研究设计、BMI或 抑郁症状。这项工作将确定与PA的问题水平相关的情况 测量中年成年人的反应性，以及降低中年成年人反应性的潜在性别目标 高危人群。因此，本R03补编是对已资助工作的重要延伸， 利用现有数据源提高PA领域研究的科学严谨性 测量和干预，并提供高质量的证据，说明潜在的性别 PA测量反应性反应的差异。

ABSTRACT Risk for cardiovascular disease (CVD) substantially increases during midlife (ages 40-60) and risk trajectories differ for women and men. Increasing physical activity (PA) can mitigate these risks and there is a critical need for research that can reduce barriers to engagement in this population. PA measurement reactivity, or a change in PA engagement in response to the introduction of PA measurement, may bias the objective assessment of PA that is essential to evaluating PA promotion efforts. At present, however, evidence supporting PA measurement reactivity as a key confound in PA research is mixed, including preliminary evidence from the investigative team. Our funded R03 is designed to address key limitations of existing work – including emphasis on children or healthy, young adults with low risk for CVD and lack of attention to individual differences between participants – among women in midlife with elevated CVD risk (e.g., obesity, hypertension; N = 800). The proposed supplement is designed to further address limitations of low power for conducting critical tests of gender differences in PA measurement reactivity responses, by including men and conducting the first fully powered test of gender differences in this area. We will use 6 existing datasets from NIH-funded clinical trials and publicly available databases to examine gender differences in PA measurement reactivity among midlife adults with elevated CVD risk (N = 1940). Using a coordinated analysis approach, we will employ multilevel modeling techniques to achieve the following aims: (1) To characterize midlife adults’ PA measurement reactivity across 4 PA outcomes (full sample and within genders): steps, minutes of light activity, minutes of moderate-to-vigorous intensity activity, and minutes of sedentary behavior, (2) To determine whether the presence or extent of measurement reactivity differ based on demographic, medical, or psychological characteristics (with emphasis on gender), and (3) To determine whether the presence or extent of measurement reactivity differ based on study characteristics such as research design (i.e., observation only vs. PA observation prior to the start of an intervention) and PA monitoring procedures (i.e., research-grade accelerometers vs. commercially available wearables). We will also examine whether gender moderates the influence of characteristics such as study design, BMI, or depressive symptoms. This work will identify circumstances associated with problematic levels of PA measurement reactivity among adults in midlife and potential gender-specific targets for reducing it in an at-risk group. This R03 supplement thus represents an important extension of funded work that leverages existing data sources to increase the scientific rigor of research in the fields of PA measurement and intervention, and to provide high-quality evidence that speaks to potential gender differences in PA measurement reactivity responses.