The Sedentary Time and Activity Reporting Questionnaire (STAR-Q): Reliability and Validity Against Doubly Labeled Water and 7-Day Activity Diaries

• Published in: American journal of epidemiology Vol. 180; no. 4; pp. 424 - 435
• Main Authors: CSIZMADI, Ilona, NEILSON, Heather K, ROBSON, Paula J, KOPCIUK, Karen A, KHANDWALA, Farah, LIU, Andrew, FRIEDENREICH, Christine M, YASUI, Yutaka, RABASA-LHORET, Rémi, BRYANT, Heather E, LAU, David C. W
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 15.08.2014; Oxford Publishing Limited (England)
• Series: Editor's choice
• Subjects: Adult; Alberta - epidemiology; Basal Metabolism; Bioenergetics; Biological and medical sciences; Body Mass Index; Correlation analysis; Deuterium; Diet - statistics & numerical data; Energy Metabolism; Epidemiology; Female; General aspects; Humans; Male; Medical Records; Medical sciences; Middle Aged; Miscellaneous; Motor Activity; Oxygen Isotopes; Physical fitness; Practice of Epidemiology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Questionnaires; Reliability; Reproducibility of Results; Sedentary Lifestyle; Surveys and Questionnaires - standards; Validation studies; Water - metabolism; Alberta; Alberta Canada; Water; Physical exercise; Questionnaire; Label; Activity; Test reliability; sedentary lifestyle; Epidemiology; Result; motor activity; physical activity; Test validation; questionnaires; reproducibility of results; Reproducibility; validation studies; Sedentary; Public health; Life style
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwu150

We determined measurement properties of the Sedentary Time and Activity Reporting Questionnaire (STAR-Q), which was designed to estimate past-month activity energy expenditure (AEE). STAR-Q validity and reliability were assessed in 102 adults in Alberta, Canada (2009-2011), who completed 14-day doubly labeled water (DLW) protocols, 7-day activity diaries on day 15, and the STAR-Q on day 14 and again at 3 and 6 months. Three-month reliability was substantial for total energy expenditure (TEE) and AEE (intraclass correlation coefficients of 0.84 and 0.73, respectively), while 6-month reliability was moderate. STAR-Q-derived TEE and AEE were moderately correlated with DLW estimates (Spearman's ρs of 0.53 and 0.40, respectively; P < 0.001), and on average, the STAR-Q overestimated TEE and AEE (median differences were 367 kcal/day and 293 kcal/day, respectively). Body mass index-, age-, sex-, and season-adjusted concordance correlation coefficients (CCCs) were 0.24 (95% confidence interval (CI): 0.07, 0.36) and 0.21 (95% CI: 0.11, 0.32) for STAR-Q-derived versus DLW-derived TEE and AEE, respectively. Agreement between the diaries and STAR-Q (metabolic equivalent-hours/day) was strongest for occupational sedentary time (adjusted CCC = 0.76, 95% CI: 0.64, 0.85) and overall strenuous activity (adjusted CCC = 0.64, 95% CI: 0.49, 0.76). The STAR-Q demonstrated substantial validity for estimating occupational sedentary time and strenuous activity and fair validity for ranking individuals by AEE.