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Toddler physical activity study: laboratory and community studies to evaluate accelerometer validity and correlates
Erin R Hager1,2, Candice E Gormley3,4, Laura W Latta3,5
1Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA. ehager@peds.umaryland.edu.
Insights
Ankle accelerometry accurately measures physical activity in toddlers. Younger, female, Black toddlers, and those in urban areas with less active mothers are at higher risk for inactivity.
Area of Science:
- Pediatric Health
- Exercise Science
- Public Health
Background:
- Toddlerhood is crucial for establishing physical activity (PA) habits to prevent obesity.
- Accurate PA assessment is vital for understanding trends, sedentary behavior, and program effectiveness.
- Identifying at-risk subgroups for inactivity requires validated, feasible objective measures.
Purpose of the Study:
- Develop valid thresholds for ankle accelerometry in toddlers.
- Examine the feasibility of using ankle accelerometers in community settings.
- Investigate demographic and anthropometric correlates of moderate-to-vigorous physical activity (MVPA) in low-income toddlers.
Main Methods:
- Two studies were conducted: a laboratory validation study (n=24) and a community-based study (n=277).
- Actical accelerometers were worn on the ankle, with PA assessed using the Child Activity Rating Scale (CARS) in the lab.
- Community study involved >7 days of wear, with data analyzed for feasibility and correlates of MVPA using stepwise multiple linear regression (sMLR).
Main Results:
- Actical accelerometers demonstrated good reliability (r=0.980) and validity (r=0.75) with high sensitivity (86%) and specificity (88%) for PA thresholds.
- Feasibility in the community study was 86% wear rate, with 69% valid data; primary issues were refusal and insufficient wear time.
- MVPA was associated with older age, male gender, higher maternal MVPA, suburban location, and non-Black race; no association with toddler weight status.
Conclusions:
- Ankle accelerometry is a reliable, valid, and feasible tool for assessing toddler PA in community studies, particularly for low-income families.
- Specific subgroups, including younger, female, Black toddlers, those with less active mothers, and urban dwellers, are at higher risk for inactivity.
- Findings highlight the need for targeted PA interventions for at-risk toddler populations.
Background:
Toddlerhood is an important age for physical activity (PA) promotion to prevent obesity and support a physically active lifestyle throughout childhood. Accurate assessment of PA is needed to determine trends/correlates of PA, time spent in sedentary, light, or moderate-vigorous PA (MVPA), and the effectiveness of PA promotion programs. Due to the limited availability of objective measures that have been validated and evaluated for feasibility in community studies, it is unclear which subgroups of toddlers are at the highest risk for inactivity. Using Actical ankle accelerometry, the objectives of this study are to develop valid thresholds, examine feasibility, and examine demographic/ anthropometric PA correlates of MVPA among toddlers from low-income families.
Methods:
Two studies were conducted with toddlers (12-36 months). Laboratory Study (n = 24)- Two Actical accelerometers were placed on the ankle. PA was observed using the Child Activity Rating Scale (CARS, prescribed activities). Analyses included device equivalence reliability (correlation: activity counts of two Acticals), criterion-related validity (correlation: activity counts and CARS ratings), and sensitivity/specificity for thresholds. Community Study (n = 277, low-income mother-toddler dyads recruited)- An Actical was worn on the ankle for > 7 days (goal >5, 24-h days). Height/weight was measured. Mothers reported demographics. Analyses included frequencies (feasibility) and stepwise multiple linear regression (sMLR).
Results:
Laboratory Study- Acticals demonstrated reliability (r = 0.980) and validity (r = 0.75). Thresholds demonstrated sensitivity (86 %) and specificity (88 %). Community Study- 86 % wore accelerometer, 69 % had valid data (mean = 5.2 days). Primary reasons for missing/invalid data: refusal (14 %) and wear-time ≤2 days (11 %). The MVPA threshold (>2200 cpm) yielded 54 min/day. In sMLR, MVPA was associated with age (older > younger, β = 32.8, p < 0.001), gender (boys > girls, β = -11.21, p = 0.032), maternal MVPA (β = 0.44, p = 0.002) and recruitment location (suburban > urban, β = 19.6, p < 0.001), or race (non-Black > Black, β = 18.5, p = 0.001). No association with toddler weight status.
Conclusions:
Ankle accelerometry is a valid, reliable, and feasible method of assessing PA in community studies of toddlers from low-income families. Sub-populations of toddlers may be at increased risk for inactivity, including toddlers that are younger, female, Black, those with less active mothers, and those living in an urban location.
