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

摘要 心血管疾病（CVD）的风险在中年（40-60岁）期间大幅增加， 妇女和男子的发展轨迹不同。增加体力活动（PA）可以减轻这些风险， 迫切需要开展研究，以减少参与这一群体的障碍。PA 测量反应性，或响应于PA引入的PA接合的变化 测量，可能会偏见的客观评估PA是必不可少的评估PA的推广 努力然而，目前，证据支持PA测量反应性作为PA中的关键混淆因素， 研究结果好坏参半，包括调查小组提供的初步证据。我们的R 03基金是 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 患有心血管疾病的低风险成年人，缺乏对参与者之间个体差异的关注- 中年女性CVD风险升高（例如，肥胖、高血压; N = 800）。拟议 补充材料旨在进一步解决进行性别关键测试的低功率限制 PA测量反应性反应的差异，包括男性和进行第一次全面 这一领域的性别差异的有力测试。我们将使用来自NIH资助的临床研究的6个现有数据集， 试验和公开可用的数据库，以检查PA测量反应性的性别差异 在CVD风险升高的中年成人中（N = 1940）。使用协调分析方法，我们将 采用多层次模型技术，以实现以下目标：（1）表征中年人的 4种PA结局的PA测量反应性（全样本和性别内）：步骤、分钟 轻度活动，中等至剧烈强度活动分钟数，久坐行为分钟数，（2） 为了确定测量反应性的存在或程度是否基于人口统计学而不同， 医学或心理特征（重点是性别），以及（3）确定是否 测量反应性的存在或程度因研究特征而异， 设计（即，仅观察vs.开始干预前PA观察）和PA监测 程序（即，研究级加速度计与市售可穿戴设备）。我们还将 检查性别是否会调节研究设计、BMI或 抑郁症状这项工作将确定与有问题的PA水平相关的情况 测量反应在中年成年人和潜在的性别特异性目标，以减少它在一个 高危人群因此，该R 03补充说明是受资助工作的重要延伸， 利用现有的数据源，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测量反应性响应的差异。

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.