1. The AE120XL Pedometer A simple objective device to measure physical activity in the Strong Heart Family Study Kristi L. Storti, MS, MPH University of Pittsburgh Graduate School of Public Health Division of Physical Activity Epidemiology

2. Why Use A Pedometer to Assess Physical Activity? ò Correlate moderately with different estimates of energy expenditure (median r=0.49) (Bassett 2000) ò Correlate strongly with different accelerometers which are considered the “gold standard” of objective activity monitoring (median r=0.84-0.93) (Leenders 2000)

3. StrengthsStrengths ò Objective Assessment of Physical Activity Not subject to participant’s inability to accurately recall activity ò Ability to measure lower intensity physical activity which is often harder to recall ò Can be used across different populations (i.e. adults, children)

4. WeaknessesWeaknesses ò Cannot get wet ò Does not accurately measure some activities Bicycling Arm Movement ò Becomes less accurate in obese and slow gait speeds ò Can’t provide information on activity type Activities that move away from walking/running

5. Wearing the Pedometer Should be fastened to a belt or waistband, in the midline of the thigh. Worn on the hip in an upright position and held firmly against the body..When correctly positioned, it does not matter what side of the body the pedometer is worn on, unless the person has a gait abnormality.

6. General Pedometer Instructions The pedometer should be worn during all waking hours of the day. 1. Every morning, the pedometer should be zeroed “0” out before putting it on. 2. The time that the pedometer was put on should be recorded in seven-day pedometer record.

7. 3. The pedometer should be worn all-day from the time the participant gets up to the time that they go to bed except when bathing or participating in water activities. 4. The monitor should be removed at night just before bedtime and the number of steps/day on the pedometer along with the time it was removed should be recorded in the seven-day pedometer record. General Pedometer Instructions

8. Pedometer “Step Test” for Accuracy ò Have the participant put on the pedometer and find a space where they can walk at their typical walking pace. ò Have the participant put on the pedometer and Reset the pedometer to “0”and close the cover. ò Have the participant walk 20 steps. ò Carefully open the cover and determine the number of steps on the pedometer. Determining Accuracy ò Perfect = 20 steps ò Good = 19 or 21steps (± 5% error) ò Acceptable = 18 or 22 steps (± 10% error) ò Unacceptable = ≤ 17 or ≥ 23 steps

9. What if? What if? ò The monitor is not working properly A.Check positioning 1.If necessary have the participant move the pedometer to the small of the back 2.Make sure the pedometer is upright 3.Repeat 20 step test B.Change clothes 1.Make sure that the participant is wearing snug fitting clothing 2.If possible, have participant wear a belt 3.Repeat 20 step test C.Go through the instructions

10. What if? ò Participant is sick during the week they are to wear the pedometer Ask the participant to wear the pedometer after they have gotten over their illness If participant is having surgery or has an injury, try to delay the assessment period until cleared by physician or has completed their recovery period

11. What if? ò Participant only wears the pedometer 3 days If possible, have the participant finish the week out Try to have the participant complete 7 full days

12. Front ViewSide View THE STRONG HEART – FAMILY STUDY GENETICS OF CARDIOVASCULAR DISEASE IN AMERICAN INDIANS DIRECTIONS TO PARTICPANTS FOR USING THE PEDOMETER SPECIFIC INSTRUCTIONS 1.Every morning, just before you put the pedometer on, push the YELLOW reset button so that the pedometer resets to “0”. 2.Record the time that you attached the pedometer in your pedometer record. Make sure to indicate am or pm. 3.Wear the pedometer on your hip (please see pictures above), make sure to keep it upright, and make sure that it remains firmly in place against your body. 4.Wear the pedometer ALL DAY except when bathing, swimming, or in the rain (unless the pedometer is protected by clothing and will not get wet). If you take off the pedometer for longer than 30 minutes, record the length of time it was off (minutes or hours) in your pedometer record. 5.At bedtime, take off the pedometer. Record in your pedometer record (a) the number of steps taken on the pedometer, and (b) the time you removed your pedometer. Make sure to indicate am or pm. 6.Please do not touch the YELLOW reset button during the day or you will erase your activity numbers. 7.Keep the cover closed or the pedometer will not record your activity. 8.Do not wear the pedometer in a pants, coat, or shirt pocket. The pedometer will not work correctly. 9.Please bring back or mail to us, in the self-addressed stamped envelope, the pedometer record after you have completed your week. 10.Please keep the pedometer as a token of our appreciation for your participation in the Strong Heart Family Study. The ACCUSPLIT Pedometer measures movement. You are being asked to wear this pedometer EVERY DAY for a seven-day period from ______________ to ______________. The pedometer is worn on the hip and should be clipped to the waistband of your pants/skirt, underwear, or belt. Most importantly, the pedometer must be worn in an upright position. Please keep the pedometer firmly against your body so it does not move around freely. DO NOT LET THE PEDOMETER GET WET by wearing it in the rain or while bathing or swimming. Please remember to reset the pedometer to “0” (zero) when you put it on in the morning and to record the number of steps from the pedometer in your activity record when you take it off at night. If you have any questions, please contact _________________ at ______________________.

13. REMINDER: RESET THE PEDOMETER TO “0” EVERY MORNING Day 1Day 2Day 3Day 4Day 5Day 6Day 7 Date Day of week Time attached (am/pm) Please circle either am or pm am pm am pm am pm am pm am pm am pm am pm Pedometer steps at bedtime Time removed (am/pm) Please circle either am or pm am pm am pm am pm am pm am pm am pm am pm Did you take off the pedometer for any reason for longer than 30 minutes? Please circle “Y” for yes or “N” for no. Y N If yes, for how long (indicate minutes or hours)? Complete this question after completing the pedometer record. Have your physical activity levels in the past seven (7) days been typical for you compared to your regular activity level? Yes____ No____ Name: ____________________________________ SHS Family I.D.: |___|___|___|___|___|___|___| SHS I.D.: |___|___|___|___|___|___| THE STRONG HEART – FAMILY STUDY GENETICS OF CARDIOVASCULAR DISEASE IN AMERICAN INDIANS SEVEN-DAY PEDOMETER RECORD

14. Contact Information: Kristi L. Storti, MS, MPH University of Pittsburgh Graduate School of Public Health Department of Epidemiology 515 Parran Hall 130 DeSoto Street Pittsburgh, PA 15261 USA Phone: 412-624-0188 Email: klsst75@pitt.eduklsst75@pitt.edu