ARRA: An Intergenerational CBPR Intervention to Reduce Appalachian Health Disparities

This supplementary proposal seeks to assess and likely improve the measurement of physical activity (PA), a key primary outcome of the parent grant, within our community-based sample of rural residents. Currently, the protocol for our energy balance intervention uses self-report for PA assessment. Although self-reported PA is an easily obtained method that is culturally acceptable, existing literature demonstrates that there are limitations in the accuracy of such reports. Our aim for the proposed supplement is to evaluate the validity of sell-reported PA among Appalachian children, adolescents, and adults, as compared to the objective measurement provided by accelerometers and pedometers. In addition, we will evaluate the acceptability and feasibility of using accelerometers and pedometers in this population. We propose to evaluate three of the most commonly used PA measurement tools-self-report, pedonieters, and accelerometers-across several key several dimensions with a rural Appalachian sample. These dimensions include: (1) reliability and validity of outcome data (i.e., frequency, intensity, and duration of PA); (2) cultural acceptability; and (3) feasibility, focusing on participant and researcher burden, including cost. We propose to purchase accelerometers and pedometers; hire and train local personnel in their use; and provide part time support to a graduate student who will assist with data collection, management, analysis, and development of scholarly products. We will compare assessment outcomes among a sub-sample of our participants and, on the basis of those results, determine whether the protocol (a) should continue using self- reported PA; (b) would be improved by using pedometers or accelerometers; or (c) should use a combination of the assessment methods. In addition to improving the quality of measurement for a key outcome variable in our parent grant, the results of this sub-study will be presented at national conferences, published in a peer reviewed Iournals~ and offer extensive opportunity for economic stimulus.