Developing content for national population health surveys: an example using a newly developed sedentary behaviour module

Stephanie A Prince,Andrew M Mackenzie,Wendy Thompson,Gregory P Butler,Travis J Saunders,Pam Lapointe,Maria Foley,Karen C Roberts,Rachel C Colley

doi:10.1186/s13690-019-0380-y

Abstract

BackgroundWhile physical (in) activity surveillance has grown and continues to grow globally, surveillance of sedentary behaviour is in its infancy. As surveillance evolves to meet the changing nature of these behaviours, there is a need for the development of national health survey questions to provide accurate and consistent measures over time. The development of national health survey content is a complex, detailed and often undocumented process. The objective of this paper is to outline the process that the Public Health Agency of Canada (PHAC) and Statistics Canada took in partnership with academic experts to develop a short, flexible, sedentary behaviour module for the Canadian Health Measures Survey (CHMS) and to provide an approach for the development of future survey content.MethodsDevelopment of the module followed a multi-step process. The results of this paper describe this process and present a framework for content development.ResultsInitially, PHAC and Statistics Canada analysts worked together to identify key content required for a potential survey module. Next, this work was formalized through a contract with academic experts, the scope included a: review of existing Canadian sedentary behaviour modules; literature review linking different sedentary behaviours to health outcomes; and, international scan of modules currently in use in large national health surveys and research. The key output from both review processes was recommendations for a short sedentary behaviour questionnaire module (International Sedentary Assessment Tool). These recommendations provided an evidence-informed basis for discussions about how to revise and update the CHMS sedentary behaviour questionnaire content. Qualitative testing was undertaken and a final module was developed using survey design best practices.ConclusionsContent volume in national surveys is limited due to demand to measure core content in addition to emerging health topics while keeping surveys as short as possible. Questions must therefore, be concise, valid/reliable, evidence-based, and developed using best practices. The paper describes the development process of a new survey module addressing the emerging area of sedentary behaviour for use in a national survey that may serve as a model for future population survey content development.

Highlights

While physical activity surveillance has grown and continues to grow globally, surveillance of sedentary behaviour is in its infancy
The objective of this paper is to outline the process that the Public Health Agency of Canada (PHAC) and Statistics Canada took in partnership with academic experts to develop a short, flexible, sedentary behaviour module for use on a national population survey in order to improve the accuracy and reporting of sedentary behaviour in Canada
A contract was established between the PHAC and a leading expert in the field of sedentary behaviour (TJS) to provide a formal report on: 1) the evidence around specific types of sedentary behaviour related to health outcomes in order to provide context for question development and prioritization; and, 2) suggestions for a short sedentary behaviour module focusing on the most reliable and valid questions available from both the published literature, as well as national health surveys from around the world

Summary

Introduction

While physical (in) activity surveillance has grown and continues to grow globally, surveillance of sedentary behaviour is in its infancy. While it is recognized that physical (in) activity surveillance has grown and continues to grow globally, surveillance of sedentary behaviour is in its infancy [1]. Sedentary behaviour is often confused with physical inactivity (i.e. not meeting physical activity guidelines), but they are not synonymous. Rather it refers to the time spent sitting, lying or reclining during waking time and includes activities such as watching television, passive transportation (e.g. riding in a bus, train or car) and using a computer at a traditional desk [3]. Sedentary behaviour is largely recognized as an independent risk factor for chronic disease and mortality [4]

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