Canadian-French adaptation and test-retest reliability of the leisure time physical activity questionnaire for people with disabilities.

OBJECTIVES: The Leisure Time Physical Activity Questionnaire (LTPAQ) measures the duration of physical activities performed during the past 7 days, and results are expressed in minutes. This study aimed to translate this questionnaire into Canadian-French and to evaluate the content validity and its test-retest reliability in people with physical disabilities. METHODS: The LTPAQ was translated from English to French by forward and backward translation. To assess content validity, 9 adults with physical disabilities read and provided comments regarding the relevance, wording and understanding of the items of the preliminary Canadian-French version of the questionnaire. For test-retest reliability, 37 adults with physical disabilities completed the questionnaire 2 or 3 times at T1 (baseline), T2 (2 days from baseline) and T3 (7 days from baseline). The test-retest reliability was investigated by intra-class correlation coefficients (ICCs), paired t test and Bland and Altman tests. RESULTS: The translation and the content validation process resulted in a Canadian-French version of the LTPAQ (LTPAQ-CF). Total LTPAQ-CF scores between T1-T2 and T1-T3 featured strong ICCs, 0.90 and 0.75 (P≤0.01). Paired t tests and Bland and Altman analyses confirmed the good reproducibility of results. CONCLUSION: The LTPAQ-CF has good test-retest reliability when self-administered or administered by interview to people with physical disabilities.

Levels of circulating cortisol and cytokines in members of the Canadian Armed Forces: associations with age, sex, and anthropometry.

This study assessed blood levels of cortisol and cytokines (inflammatory and non-inflammatory) in members of the regular Canadian Armed Forces (CAF), and examined the associations between sex, age, and adiposity and circulating levels of cortisol as well as pro- and anti-inflammatory cytokines. As part of a larger ranging project, 331 blood samples were collected from a representative population of the total CAF, which included officers and noncommissioned women and men from the Air Force, Navy, and Army. The blood samples were analyzed for levels of cortisol, C-reactive protein (CRP), adiponectin, and 20 cytokines (which included interleukins, interferons, and tumor necrosis factors). Higher levels of adiponectin were found in women compared with men (median and interquartile range; 16.71 (7.68-25.32) vs 5.81 (3.52-13.19) µg/mL), and higher levels of interleukin (IL)-18 in men compared with women (89.25 (84.03-94.48) vs 75.91 (69.70-82.13) pg/mL). An association between age and levels of stress and inflammatory cytokines was observed, with CRP, IL-18, IL-2 and adiponectin all increasing with increasing age. However, contrary to trends seen in the general population, cortisol levels decreased with increasing age. Levels of CRP and IL-18 increased with an increase in adiposity, while adiponectin levels decreased. Most importantly, at the entire cohort level, a low detection rate for most of the cytokines was observed with 17 out of 22 cytokines having a detection below 10%. IN CONCLUSION: In this CAF population, although an association between age and inflammatory cytokines was observed, both sex and adiposity had a small impact on levels of cortisol and cytokines.

The FORCE Fitness Profile--Adding a Measure of Health-Related Fitness to the Canadian Armed Forces Operational Fitness Evaluation.

In 2013, the Canadian Armed Forces (CAF) implemented the Fitness for Operational Requirements of Canadian Armed Forces Employment (FORCE), a field expedient fitness test designed to predict the physical requirements of completing common military tasks. Given that attaining this minimal physical fitness standard may not represent a challenge to some personnel, a fitness incentive program was requested by the chain of command to recognize and reward fitness over and above the minimal standard. At the same time, it was determined that the CAF would benefit from a measure of general health-related fitness, in addition to this measure of operational fitness. The resulting incentive program structure is based on gender and 8 age categories. The results on the 4 elements of the FORCE evaluation were converted to a point scale from which normative scores were derived, where the median score corresponds to the bronze level, and silver, gold, and platinum correspond to a score which is 1, 2, and 3 SDs above this median, respectively. A suite of rewards including merit board point toward promotions and recognition on the uniform and material rewards was developed. A separate group rewards program was also tabled, to recognize achievements in fitness at the unit level. For general fitness, oxygen capacity was derived from FORCE evaluation results and combined with a measure of abdominal circumference. Fitness categories were determined based on relative risks of mortality and morbidity for each age and gender group. Pilot testing of this entire program was performed with 624 participants to assess participants' reactions to the enhanced test, and also to verify logistical aspects of the electronic data capture, calculation, and transfer system. The newly dubbed fitness profile program was subsequently approved by the senior leadership of the CAF and is scheduled to begin a phased implementation in June 2015.

Promoting active living among people with physical disabilities evidence for neighborhood-level buoys.

BACKGROUND: People with physical disabilities are more likely to be sedentary than the general population, possibly because they have an accrued sensitivity to environmental features. OBJECTIVES: This paper describes the relationship between neighborhood-level active living buoys and the active living practices of adults with physical disabilities living in a large urban area. METHODS: A sample of 205 people with physical disabilities was recruited via a local rehabilitation center and its adapted fitness center. Telephone interviews were administered by senior occupational therapy students. The interview included a modified version of the Physical Activity and Disability Survey, a validated instrument that includes questions on physical activity, active transportation, and other activities of daily living. Individuals were geocoded within their census tract of residence (n=114) using their postal codes. Data on neighborhood active living potential were gleaned from systematic social observation. RESULTS: Multilevel logistic regression analyses showed that the association between the presence of environmental buoys and leisure activity was significant (OR=4.0, 95% CI=1.1-13.8) despite adjustments for individual difference variables while the association with active transportation became nonsignificant (OR=2.9, 95% CI=0.7-7.7) following adjustment for these variables. CONCLUSIONS: People with physical disabilities who live in neighborhoods with more environmental buoys are more likely to report involvement in leisure-time physical activity.

Association between neighborhood active living potential and walking.

This paper examines the association between neighborhood active living potential and walking among middle-aged and older adults. A sample of 2,614 (61.1% women) persons aged 45 years or older and living in one of 112 census tracts in Montreal, Canada, were recruited between February and May of 2005 to participate in a 20-minute telephone survey. Data were linked to observational data on neighborhood active living potential in the 112 census tracts and analyzed through multilevel modeling. Greater density of destinations in the census tract was associated with greater likelihoods of walking for any reason at least 5 days per week for at least 30 minutes (odds ratio = 1.53, 95% confidence interval: 1.21, 1.94). Associations were attenuated but remained statistically significant after controlling for socioeconomic, health, lifestyle, and other physical activity characteristics. Sensitivity analyses showed that associations were robust across smaller and larger volumes of walking. No associations were found between dimensions of neighborhood active living potential and walking for recreational reasons. The authors conclude that a larger number and variety of neighborhood destinations in one's residential environment are associated with more walking and possibly more utilitarian walking among middle-aged or older adults.

Neighborhood-level active living buoys for individuals with physical disabilities.

BACKGROUND: In an effort to advance the research agenda on residential determinants of active living among people with physical disabilities, the purposes of this paper are (1) to describe the extent to which environmental supports (buoys) promoting active living among individuals with disabilities are present in neighborhoods located in a large urban area, and (2) to examine the association between the presence of these buoys and neighborhood-level indicators of affluence, proportions of individuals with disabilities living in the neighborhood, and other neighborhood active living indicators. METHODS: In the context of a larger project, pairs of evaluators assessed potential determinants of active living in 112 neighborhoods (census tracts) on the island of Montreal, Canada, in the summer of 2003. The assessment grid included 18 items related to active living for the general population and three specifically for people with physical disabilities. RESULTS: Analyses performed in 2006 show that few neighborhoods in this large urban area are equipped with environmental buoys that might support active living among people with physical disabilities. Lower levels of environmental buoys to promote active living among those with disabilities were most strongly associated with lower levels of neighborhood activity-friendliness. Less consistent associations were observed between lower environmental buoys and lower density of destinations, greater safety, lower proportions of people with disabilities, and higher proportions of those of low income. CONCLUSIONS: More research is needed to better understand the distribution of environmental buoys in residential areas and their influences on active living among people with physical disabilities.

From walkability to active living potential: an "ecometric" validation study.

BACKGROUND: The purpose of this paper is to establish the reliability and validity of a neighborhood-level measure of active living potential by applying principles of ecometrics. METHODS: Following a 3-day training session, observers (n =8) were provided with a map of a predetermined walking route constructed through the joining of ten randomly selected street blocks. Then, using an 18-item observation grid, pairs of observers performed ratings of 112 neighborhoods. Resulting observations produced a hierarchically structured data set including 4032 observations nested within observers, which in turn were nested within neighborhoods. Data from the 2001 Canadian census were linked to the neighborhood data. RESULTS: Application of ecometric multilevel modeling analyses showed that once interitem and interobserver variability were statistically controlled, about one third of the variability in observations were at the between-neighborhood level. Reliability estimates were 0.78 for items measuring activity-friendliness, 0.76 for safety, and 0.83 for density of destinations. Assessment of the convergent validity of the instrument identified that safety of the environment was positively associated with neighborhood affluence. Density of destinations was negatively associated with affluence and positively associated with higher proportions of persons in the neighborhood walking to work. CONCLUSIONS: The three dimensions of the neighborhood active-living potential measure have good reliability and convergent validity and are able to capture between neighborhood differences. Measurement characteristics would have been difficult to ascertain without the ecometrics methodology.