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Sedentary behaviour and physical inactivity assessment in primary care: the Rapid Assessment Disuse Index (RADI) study
  1. Kerem Shuval1,2,3,
  2. Harold W Kohl III1,4,
  3. Ira Bernstein5,
  4. Dunlei Cheng6,
  5. Kelley Pettee Gabriel1,
  6. Carolyn E Barlow1,7,
  7. Liu Yinghui8,
  8. Loretta DiPietro9
  1. 1Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas, School of Public Health, Dallas and Austin, Texas, USA
  2. 2Harold C Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
  3. 3American Cancer Society, Atlanta, Georgia, USA
  4. 4Department of Kinesiology and Health Education, University of Texas, Austin, Texas USA
  5. 5Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
  6. 6Division of Biostatistics, School of Public Health, University of Texas, Dallas, Texas, USA
  7. 7Cooper Institute, Cooper Institute, USA
  8. 8Division of General Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
  9. 9Department of Exercise Science, George Washington University, School of Public Health and Health Services, Washington, DC, USA
  1. Correspondence to Dr Kerem Shuval, American Cancer Society, Atlanta, GA 30303, USA; kerem.shuval{at}


Background The emerging evidence of the effects of sedentary time on health outcomes suggests a need to better measure this exposure. Healthcare settings, however, are not equipped with a tool that can quickly assess the sedentary habits of their patient population. The purpose of this study was to validate a tool for rapidly quantifying and tracking the sedentary time and low levels of daily lifestyle physical activity among primary care patients.

Methods The study examined the test–retest reliability and validity of the rapid assessment disuse index (RADI) among adult patients from a large primary care clinic. Patients completed RADI (comprised of 3 items: sitting, moving and stair climbing) twice, followed by accelerometer monitoring. Test–retest reliability was computed, and the correlation between survey responses and accelerometry was determined. A receiver operating characteristic curve was constructed and the area under the curve (AUC) was calculated.

Results RADI was temporally stable (intraclass correlation coefficients 0.79), and a higher score was significantly correlated with greater sedentary time (ρ=0.40; p<0.01), fewer sedentary to active transitions (ρ=−0.42; p<0.01), and less light-intensity physical activity (ρ=−0.40; p<0.01). The ability of RADI to detect patients with high levels of sedentary time was fair (AUC=0.72).

Conclusions This brief assessment tool, designed to quickly identify patients with high levels of sitting and low daily physical activity, exhibits good reliability and moderate validity. RADI can assist in providing recommendations at the point of care pertaining to modifying sedentary behaviour.

  • Physical activity measurement
  • Physical activity promotion in primary care

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