Psychometric evaluation of the Timeline Followback for Exercise among college students

doi:10.1016/j.psychsport.2012.06.002

Psychology of Sport and Exercise

Volume 13, Issue 6, November 2012, Pages 779-788

https://doi.org/10.1016/j.psychsport.2012.06.002 Get rights and content

Abstract

Objectives

Two separate studies assessed the psychometric properties of a retrospective behavioral measure adapted for exercise called the Timeline Followback for Exercise (TLFB-E). Study one examined criterion, convergent, and predictive validity. Study two examined test–retest reliability.

Design

Validity data was collected at three time points (baseline, 2 months, and 6 months) as part of a randomized clinical trial on exercise engagement. Test-retest reliability was assessed via two participant interviews scheduled one month apart.

Methods

Study one participants (N = 66) were college students 20.0 ± 1.4 yr. Validity of frequency, intensity, time, and type (FITT) of exercise as assessed on the TLFB-E was examined using Pearson r correlations with accelerometers, weekly exercise contracts between participants and researchers, question four of the College Alumni Questionnaire, and a health-related physical fitness battery. Study two participants were a different sample (N = 40) of college students 18.63 ± 1.0 yr. Pearson r correlations determined reliability of the TLFB-E for exercise frequency, intensity, and time. Kappa statistic determined reliability of the TLFB-E for type of exercise.

Results

The TLFB-E displayed evidence of criterion validity when compared to accelerometers (r = .35 to .39) and evidence of convergent validity when compared to weekly exercise contracts (r = .65 to .80) and question four of the College Alumni Questionnaire (r = .06 to .75). The TLFB-E displayed evidence of modest to adequate test-retest reliability (r = .79 to .97) for exercise frequency, intensity, and time and moderate Kappa (k = .49) for exercise type.

Conclusions

The TLFB-E produces evidence of reliable and valid scores among college students and improves upon other self-report, retrospective questionnaires by enabling daily collection of exercise FITT over a specified time period.

Highlights

► We examine psychometric properties of an exercise behavioral measure. ► Validity is shown through correlations with other measures of physical activity. ► Reliability is shown using a test–retest method. ► The exercise behavioral measure may improve upon current physical activity measures.

Section snippets

Method

Data for this study were derived from the National Institute of Health funded project entitled, Motivational Interventions for Exercise in Hazardous Drinking College Students (R21-AA017717). The study investigated the utility of exercise as an intervention for sedentary hazardous drinking college students.

Participants

Participants (N = 66, n = 37 women, n = 29 men) were English speaking, currently enrolled in college, 20.0 ± 1.4 yr, and normal weight [body mass index = 24.5 ± 3.3 kg/m²]. Participant

Participant characteristics

The overall sample was 20.0 ± 1.4 yr, normal weight, and had optimal BP. All physical fitness tests showed evidence of poor to below average physical fitness for individuals of their age except the push-up test in which participants scored good to very good (See Table 1; Thompson et al., 2009). Men had significantly higher systolic BP (p < .001), BMI (p = .004), and WC (p < .001), and scored significantly higher on the push-up (p = .029), and handgrip (p < .001) fitness tests than women. Men

Participants

A separate sample of participants was recruited from an undergraduate subject pool at the same state university and students received class research credit for completing the reliability study. Prior to participation, all participants signed an informed consent approved by the university Institutional Review Board. Participants (N = 40, n = 28 women, n = 12 men) were English speaking college students 18.6 ± 1.0 yr. Participant breakdown by ethnic category was 72.5% Caucasian, 20.0% Asian, 2.5%

Test–retest reliability, hypotheses five & six

At interview one, participants recorded an average of 22.0 total bouts (SD = 12.1, range = 6.0–50.0), 1379.9 min (SD = 1425.3, range = 140.0–8940.0) of exercise, RPE of 13.7 (SD = 1.9, range = 10.3–18.3), and expended an average of 1211.0 Kcal (SD = 1722.8, range = 192.9–11268.7). At the retest interview, participants recorded an average of 20.0 total bouts (SD = 12.4, range = 4.0–50.0), 1308.6 min (SD = 1445.8, range = 80.0–8880.0), RPE of 13.6 (SD = 1.8, range = 10.2–18.1), and expended an

Discussion

The primary purpose of this study was to test validity (study one) and reliability (study two) of the TLFB-E. We sought to test validity by correlating the FITT components of exercise collected on the TLFB-E with the FITT components of exercise collected using objective and subjective measures of exercise. We sought to test reliability by using a test–retest method between two interviews separated by one month. Results suggest that the TLFB-E produces valid test scores when assessing

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Non-fatal overdoses are underreported and there is no accepted and feasible self-report research measure of non-fatal opioid overdose. Timeline follow-back (TLFB) calendar-based questionnaires assess self-reported risk behaviors. We assessed feasibility and acceptability of a new TLFB research measure for opioid use, non-fatal opioid overdose, and substance use disorder treatment among opioid overdose survivors.
For the Repeated-dose Behavioral Intervention to Reduce Opioid Overdose Trial (REBOOT) study among opioid overdose survivors, we developed a TLFB questionnaire to assess daily non-prescribed opioid use, opioid overdose, facility stays, medications/behavioral treatment for opioid use disorder, and COVID-19 history during the previous 120 days. Staff assessors administered TLFB at four-monthly visits over the 16-month study participation period. To measure feasibility, we estimated TLFB completion time using an electronic timestamp tool. To measure acceptability, we administered a satisfaction survey to 103 participants who completed REBOOT.
Among 525 TLFB assessments conducted in 174 participants from January 2021-January 2023, opioid use was reported in 510 assessments, medication for opioid use disorder (MOUD) in 331 assessments, and ≥ 1 overdose in 107 assessments. Median TLFB completion time was 11 (IQR: 6–17) minutes for sections administered to all participants; detailed overdose questions administered to those reporting overdose took an additional 3 (IQR: 2–6) minutes. Report of ≥ 1 overdose and MOUD use were significantly associated with increased TLFB completion time. 88 % of participants reported that TLFB was very/somewhat acceptable.
Among opioid overdose survivors, REBOOT TLFB was a feasible and acceptable research measure, with similar completion time as other TLFB assessments of substance use.
The effects of substance use and physical activity on cognition: The impact of incongruent health behaviors
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Cognitive functioning refers to storage and manipulation of information and includes executive functioning (EF) and attention (ATT). While physical activity (PA) improves cognitive functioning, decrements are associated with frequent substance use. This study examined PA on cognitive functioning within the context of past-year substance use.
Using NESARC–III data (N = 36,309), cross-sectional analysis examined interactions between self-reported past-year PA and substance use in relation to cognitive functioning.
As hypothesized, light-to-moderate, vigorous, and total PA conditional main effects were positively associated with both facets of cognition, while frequent substance use conditional main effects were negatively associated with ATT and EF. The positive association between PA and cognition was diminished by substance use. Frequent binge drinking, marijuana, cocaine, and opioid use weakened the impact of light-to-moderate PA on EF, and only frequent cocaine use lessened the relationship between vigorous PA on EF. When PA intensities were combined, frequent binge drinking and cocaine use weakened the PA and EF association. Infrequent stimulant use reduced the association between all levels of PA and ATT, while infrequent marijuana use unexpectedly enhanced the relation between vigorous PA and ATT.
Overall, PA enhanced two facets of cognitive functioning across six substances. However, these benefits are reduced in the context of frequency of substance use. The positive association between light-to-moderate PA and EF appears to be more sensitive in the context of frequent substance use than vigorous PA. Implications for public health messaging and PA as cognitive remediation treatment for substance use disorders are discussed.
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Eating disorder (ED) symptoms are negatively associated with quality of life (QOL), while exercise is typically positively associated with QOL. Past studies have not examined the relative contribution of depression to this outcome. This study examined the influence of ED symptoms, exercise frequency, and exercise motivation on global QOL in undergraduates while accounting for the shared relationship between ED symptoms and depression.
Students (N = 851) completed the EDE-Q, Reasons for Exercise Inventory, BDI-II, Quality of Life Inventory, and a 1-month exercise timeline followback calendar. Hierarchical regression analyses were conducted to examine the relative contributions of ED symptoms, depression, and exercise variables to QOL.
Shape concern and BDI-II scores accounted for significant variance in QOL scores. Depressive symptoms, however, accounted for 9.55% of the unique variance in QOL, while shape concern accounted for only 0.77%. Exercise frequency did not explain significant variance in QOL. The motivations of exercising for mood improvement and for enjoyment explained significant variance in QOL. No interactions between exercise frequency and exercise motivations were significant. In the final model, identifying as a woman was associated with decreased QOL.
Results suggest that studies examining the impact of disordered eating and exercise on QOL should account for depression due to depression's high comorbidity with EDs and its influence on exercise behavior and motivation. Additionally, results support findings that factors such as exercise motivation may better account for differences in QOL than exercise frequency.
Changes in coping, autonomous motivation, and beliefs about exercise among women in early recovery from alcohol participating in a lifestyle physical activity intervention
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Physical Activity Duration and Using Physical Activity to Cope. For the purposes of this study, we utilized the Timeline Followback for Exercise (TLFB; Panza, Weinstock, Ash, & Pescatello, 2012) as a self-reported measure of participants' physical activity. This procedure asks participants to indicate the days, of the previous 90, that they engaged in physical activity lasting 10 min or more in duration.
Women are particularly likely to drink alcohol for the purpose of coping with or alleviating negative affect. Engaging in physical activity has been posited as a potentially effective alternate coping strategy during early recovery for managing mood and cravings. Utilizing exercise to cope may be associated with more adaptive coping strategies in general. Additionally, an intrinsic (autonomous) motivational style and positive beliefs about exercise are associated with long-term adherence to physical activity. The current study evaluates changes in coping strategies, autonomous motivation, and beliefs about exercise among women engaged in a physical activity intervention during early recovery (N = 20; mean age = 39.53). General coping strategies, motivational style, and beliefs about exercise were examined before and after engaging in the 12-week intervention which aimed to help women utilize physical activity as a means to cope with negative affect and alcohol craving. We found that, by the end of the intervention, participants significantly increased utilization of adaptive coping strategies such as the use of emotional support from others. Additionally, participants increased autonomous motivation over time. There were no significant changes in beliefs about exercise. Changes in beliefs about benefits of exercise, autonomous motivation, and adaptive coping were related to use of exercise to cope. However, even though these changes were associated with how women in the intervention used exercise, they were not associated with exercising more. Results from this open pilot suggest that women in early recovery from alcohol who increase physical activity – specifically as a means to cope with negative affect and craving – also demonstrate other wider coping strategies, more positive beliefs, and autonomous motivation.
Developing a Fitbit-supported lifestyle physical activity intervention for depressed alcohol dependent women
2017, Journal of Substance Abuse Treatment
Citation Excerpt :
Physical activity was measured in several ways: step counts, minutes of physical activity, and episodes of using physical activity to cope. We measured self-reported physical activity using the Timeline Followback for Exercise (Panza, Weinstock, Ash, & Pescatello, 2012). The psychometric properties of the TLFB-E include: criterion validity (r = 0.35 to r = 0.39), convergent validity (r = 0.65 to r = 0.80), and test-retest reliability (r = 0.79 to r = 0.97).
Women in alcohol treatment are more likely to relapse when in unpleasant, negative emotional states. Given the demonstrated benefits of exercise for decreasing depression, negative affect, and urges to drink, helping women engage in a lifestyle physical activity (LPA) intervention in early recovery may provide them a tool they can utilize “in the moment” in order to cope with negative emotional states and alcohol craving when relapse risk is highest. New digital fitness technologies (e.g., Fitbit activity monitor with web and mobile applications) may facilitate increases in physical activity (PA) through goal setting and self-monitoring.
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Citation Excerpt :
Second, the lack of objective measure of exercise behavior between sessions is an important limitation. In addition, the reliability and validity of the TLFB for assessing levels of daily exercise over extended periods of time, as utilized in this study, has only recently been examined (Panza et al., 2012). Future studies should consider supplementing TLFB assessments using objective monitoring devices, such as pedometers or accelerometers.
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Psychometric evaluation of the Timeline Followback for Exercise among college students

Abstract

Objectives

Design

Methods

Results

Conclusions

Highlights

Section snippets

Method

Participants

Participant characteristics

Participants

Test–retest reliability, hypotheses five & six

Discussion

Journal of Clinical Epidemiology

The Australian and New Zealand Journal of Public Health

Journal of Science & Medicine in Sport

Preventive Medicine

Annals of Epidemiology

Physical activity monitoring system—instruction manual software version 2.0

Compendium of physical activities: an update of activity codes and MET intensities

Medicine & Science in Sports & Exercise

Psychometric and laboratory measures to assist in the treatment of alcoholism

Clinical Psychology Review

American college health association-national college health assessment II, reference group executive summary, fall 2010

A preliminary investigation of college students' physical activity patterns

American Journal of Health Studies

Borg's perceived exertion and pain scales

Reliability and validity of a smoking timeline follow-back interview

Psychology of Addictive Behaviors

Early release of selected estimates based on data from the 2010 national health interview survey

Criterion-related validity of sit-and-reach tests in university men in Hong Kong

Perceptual and Motor Skills

International physical activity questionnaire: 12-country reliability and validity

Medicine & Science in Sports & Exercise

Cross-validation of the alcohol and cannabis use measures in the Global Appraisal of Individual Needs (GAIN) and Timeline Followback (TLFB; Form 90) among adolescents in substance abuse treatment

Addiction

Validity and reliability of the International Physical Activity Questionnaire in college students

American Journal of Health Education

Reliability and concurrent validity for a 7-d recall of physical activity in college students

Medicine & Science in Sports & Exercise

Primary outcome indices in illicit drug dependence treatment research: systematic approach to selection and measurement of drug use end-points in clinical trials

Addiction

Reliability and validity of 6-month timeline reports of cocaine and heroin use in a methadone population

Journal of Consulting and Clinical Psychology

The timeline followback spousal violence interview to assess physical aggression between intimate partners: reliability and validity

Journal of Family Violence

Agreement between two dietary methods in the measurement of alcohol consumption

Journal of Addiction

Statistical methods for rates and proportions

Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise

Medicine & Science in Sports & Exercise

The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity

Public Health Nutrition

Measurement of grip strength: validity and reliability of the sphygmomanometer and jamar grip dynamometer

The Journal of Orthopedic and Sports Physical Therapy

Physical activity and public health. Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association

Medicine & Science in Sports & Exercise

Introducing the 2008 physical activity guidelines for Americans