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  2. Community Health Model Activities Program for Seniors Physical Activity Questionnaire

Community Health Model Activities Program for Seniors Physical Activity Questionnaire

Purpose

The Community Health Activities Model Program for Seniors physical activity self-report questionnaire (CHAMPS) was originally designed to assess the types and intensity levels of physical activity that are meaningful and appropriate for older adults, including lighter (e.g., leisurely walking, water exercises, stretching) as well as more vigorous activities. (Stewart et al, 2001)

Link to Instrument

Instrument Details

Acronym CHAMPS

Area of Assessment

Activities & Participation
Bodily Functions

Assessment Type

Patient Reported Outcomes

Cost

Free

Actual Cost

$0.00

Populations

Mixed Conditions

Key Descriptions

  • CHAMPS was developed to evaluate the effect of planned interventions on physical activity of community-dwelling older adults in the United States.
  • The questionnaire includes 41 items that explore the frequency and duration of light, moderate, and vigorous physical activities that have been performed weekly over the last 4 weeks.
  • Frequency is determined by having participants report if an activity was performed in the past 4 weeks (Y/N) and, if yes, how many times in one week. Participants also rate the hours per week spent doing the activity by selecting from a 6-point scale ranging from less than 1 hour to 9 or more hours.
  • Four different scores can be derived from the questionnaire: frequency of moderate or greater activity (MET > 3.0); frequency of all physical activity (light, moderate, and vigorous); caloric expenditure of moderate or greater activity; caloric expenditure of all physical activity. (Stewart et al, 2001).

Number of Items

41

Equipment Required

  • Writing Utensil
  • Printed Questionnaire

Time to Administer

15-20 minutes

Required Training

No Training

Instrument Reviewers

Adwaita Subhedar PT, MHS

ICF Domain

Activity
Participation

Measurement Domain

Participation & Activities

Considerations

Results suggested that several CHAMPS items may be susceptible to over-reporting. (Hekler, 2012)

The results from one study concluded that CHAMPS does not appear to be an appropriate tool to measure physical activity changes in shorter community-based physical activity programs for older adults that prescribe a single multi-component exercise routine. (Godrad, 2007)

Mixed Conditions

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Standard Error of Measurement (SEM)

Older adults following total knee arthroplasty: (Almeida, 2016; n= 28; mean age= 69; time post TKA- 3 to 6 months)

  • SEM = 12.8- 16.9 for min/day,
  • SEM = 46.7- 99.4 for kcal/day

Minimal Detectable Change (MDC)

Older adults following total knee arthroplasty: (Almeida, 2016)

Min/day:

  • MDC = 30.1 for light activities,
  • MDC = 28.4 for moderate exercise
  • MDC = 39.3 for light to moderate activities

 

Kcal/day

  • MDC = 109.0 for light activity
  • MDC = 236.0 for moderate activities
  • MDC = 231 for light to moderate activities. 

Test/Retest Reliability

Patients after total knee arthroplasty (Almeida et al, 2016)

  • Excellent test-retest reliability for all activities(ICC=0.86-0.92)
  • Excellent test-retest reliability for moderate-intensity physical activity(ICC=0.81-0.88)
  • Adequate test-retest reliability for vigorous-intensity physical activity (ICC=0.34-0.45)

Test/Retest Reliability

Patients with Fibromyalgia: (Kaleth et al, 2010; N=30; mean age 49.1 +/- 9.6 years; fibromyalgia)

  •  Adequate test-retest reliability (ICC= 0.58)

Mixed Conditions

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Test/Retest Reliability

adults aged 65+:

(Hekler et al, 2012; N = 870; mean age= 75.3 ± 6.8; older adults)

  • Adequate test-retest reliability (ICCs 0.56-0.70)

(Giles and Marshalls, 2009; N = 100; Australian community dwelling older adults; age > 65 years)

  • Adequate to excellent test-retest reliability (ICC=.70 to .89 for sessions/week and ICC=.65 to .75 for min/week).

(Gennuso et al, 2015; n=58; older adults over 65)

  • Adequate test-retest reliability (ICC=0.64)

(Stewert et al, 2001)

  • Adequate test-retest reliability for moderate activity ICC = 0.67 All activities ICC= 0.66

(Cyarto et al, 2006; n=167; mean age 79.1(6.3) years; older adults)

  • Excellent test-retest reliability for moderate intensity PA(ICC=0.81-0.88)
  • Adequate test-retest reliability for vigorous intensity PA (ICC=0.34-0.45)

(Harada et al, 2001; n=87; mean age 75 (6); older adults in retirement homes, and community center)

  • Adequate test-retest reliability in Kcals/week for “All” Activities (ICC= 0.62)
  • Excellent test-retest reliability in Kcals/week for “Moderate” Activities (ICC= 0.76)

Criterion Validity (Predictive/Concurrent)

Concurrent validity:

Older adults 65+:

(Giles and Marshalls, 2009)

  • Adequate correlations with walking step counts (r = 0.40).

(Harada et al, 2001)

  • Adequate correlations with EE(Q) – ankle counts(ML) (r = 0.36) 

(Pruitt et al, 2008; n =91; two group of participates physical activity group mean age 77.6(4), and participants of successful aging group 77.3 (4.5))

  • Adequate (CHAMPS for all activities) compared actigraph accelerometry (r = 0.42)
  • Adequate (CHAMPS for all activities) correlation with actigraph accelerometry (r = 0.31)
  • Adequate for frequency of all activities in CHAMPS correlation with actigraph accelerometry (r = 0.33)
  • Poor for frequency of moderate activities in CHAMPS correlation with actigraph accelerometry (r = 0.27)

(Hekler et al, 2012)

  • Poor correlation with accelerometer between frequency of moderate activities (ρ= 0.12-0.06)
  • Adequate correlation with accelerometer moderate-to-vigorous variables (ρ= .27 to .42)

Construct Validity

Convergent validity:

(Stewert et al, 2001)

(Correlations between CHAMPS baseline physical activity measures and physical functioning/health-related quality of life (N = 249)

Measures:

Body Mass Index (r)

Lower body functioning

(r)

6-Min walk test (r)

Self-reporting physical function (r)

Caloric expenditure/ week (MET  > or equal 3.0) in CHAMP

 

-0.06

 

0.28

 

0.27

 

0.30

Frequency/week in (MET > or equal 3.0) in CHAMPS

-0.17

0.20

0.20

0.30

Caloric expenditure/ week in all PA

In CHAMPS

 

0.04

 

0.27

 

0.22

 

0.27

Frequency/ week in all listed PA in CHAMPS

 

-0.21

 

0.15

 

0.10

 

0.23

Measures

Self-reported energy/fatigue

Self-reported pain

Self-reported psychological being

Caloric expenditure/ week (MET  > or equal 3.0) in CHAMPS

 

0.20

 

0.11

 

 

0.09

Frequency/week in (MET > or equal 3.0) in CHAMPS

 

0.23

 

0.17

 

0.14

Caloric expenditure/ week in all PA in CHAMPS

 

0.17

 

0.08

 

0.05

Frequency/ week in all listed PA in CHAMPS

 

0.14

 

0.07

 

0.02

*Poor correlation between all the self-reporting scales and CHAMPS

 (Cyarto et al, 2006)

  • Poor correlation with physical performance measure (ρ=0.14-0.32)
  • Poor correlation with physical health scale of the SF-12 (ρ=0.12-0.24)

(Feldman et al, 2009; n= 50; Age (years) 51 ± 17, measured at baseline, 1 week, and 1 month post laparoscopic cholecystectomy)

Correlation with CHAMPS:

 

Baseline (r)

1 week (r)

1 month (r)

6 Min walk test

Adequate 0.32

 Adequate 0.50

Adequate 0.47

SF 36 physical function

Adequate 0.38

Poor 0.30

Adequate 0.43

Physical role performance

Poor 0.29

Poor 0.18

Poor 0.19

Bodily pain

Poor 0.28

Poor 0.24

Poor 0.30

General health perceptions

Poor 0.26

Poor 0.06

Poor 0.19

Vitality

Adequate 0.40

Poor 0.30

Adequate 0.40

Social functioning

Poor 0.28

Poor 0.15

Adequate 0.36

Emotional role performance

Poor 0.18

Poor 0.02

Poor 0.26

Mental Health

Poor 0.20

Poor 0.05

Poor 0.30

Physical component summary

Poor 0.30

Adequate 0.33

Poor 0.26

Mental component summary

Poor 0.19

Poor 0.07

Adequate 0.32

Pain with movement (VAS)

Adequate 0.38

Adequate 0.43

Adequate 0.38

Fatigue (VAS)

Poor 0.30

Adequate 0.55

Adequate 0.43

Self-assessed recovery (diary)

 

Adequate 0.55

 

 

(Colbert et al, 2011; n = 56; mean age = 74.7(6.5); older adults)

  • Poor correlation with doubly labeled water–measured physical activity energy expenditure (r = 0.28)

(Stahl, and Insana, 2014; n = 10; mean age = 63.8 (3.17); older adults)

  • Excellent correlation with accelerometry device (fitbit) (r = 0.61)

Floor/Ceiling Effects

(Feldman et al, 2009)

  • Poor 24% of subjects reported caloric expenditure of 0 at baseline, suggesting a possible floor effect when analyzing moderate or greater intensity activities separately.

Responsiveness

(Stewert et al, 2001; Change examined the extent to which 1-yr changes in physical activity differed between the intervention and the control group)

  • Moderate effect sizes (0.38–0.64)

(Feldman et al, 2009)

  • Moderate SRM baseline to 1 week postoperatively was (-0.73)
  • Moderate SRM Recovery from 1 week to 1 month was (+0.60)

Bibliography

Almeida, G. J., Irrgang, J. J., Fitzgerald, G. K., Jakicic, J. M., & Piva, S. R. (2016). Reliability of Physical Activity Measures During Free-Living Activities in People After Total Knee Arthroplasty. Physical therapy, 96(6), 898. Link on PubMed

Colbert, L. H., Matthews, C. E., Havighurst, T. C., Kim, K., & Schoeller, D. A. (2011). Comparative validity of physical activity measures in older adults. Medicine and science in sports and exercise, 43(5), 867.

Cyarto, E. V., Marshall, A. L., Dickinson, R. K., & Brown, W. J. (2006). Measurement properties of the CHAMPS physical activity questionnaire in a sample of older Australians. Journal of Science and Medicine in Sport, 9(4), 319-326.

Feldman, L. S., Kaneva, P., Demyttenaere, S., Carli, F., Fried, G. M., & Mayo, N. E. (2009). Validation of a physical activity questionnaire (CHAMPS) as an indicator of postoperative recovery after laparoscopic cholecystectomy. Surgery, 146(1), 31-39.

Gennuso, K. P., Matthews, C. E., & Colbert, L. H. (2015). Reliability and validity of 2 self-report measures to assess sedentary behavior in older adults. Journal of Physical Activity and Health, 12(5), 727-732. Find on PubMed

Giles, K., & Marshall, A. L. (2009). Repeatability and accuracy of CHAMPS as a measure of physical activity in a community sample of older Australian adults. Journal of Physical Activity and Health, 6(2), 221-229. Find on PubMed

Godard, M. P., & Standley, C. M. (2007). Relationship between CHAMPS physical activity questionnaire and functional fitness outcomes in older adults. Activities, Adaptation & Aging, 31(1), 19-40.

Harada, N. D., Chiu, V., King, A. C., & Stewart, A. L. (2001). An evaluation of three self-report physical activity instruments for older adults. Medicine and science in sports and exercise, 33(6), 962-970.

Hekler, E. B., Buman, M. P., Haskell, W. L., Conway, T. L., Cain, K. L., Sallis, J. F., ... & King, A. C. (2012). Reliability and validity of CHAMPS self-reported sedentary-to-vigorous intensity physical activity in older adults. Journal of Physical Activity and Health, 9(2), 225-236. Find on PubMed

Kaleth, A. S., Ang, D. C., Chakr, R., & Tong, Y. (2010). Validity and reliability of community health activities model program for seniors and short-form international physical activity questionnaire as physical activity assessment tools in patients with fibromyalgia. Disability and rehabilitation, 32(5), 353-359. Find on PubMed

Pruitt, L. A., Glynn, N. W., King, A. C., Guralnik, J. M., Aiken, E. K., Miller, G., & Haskell, W. L. (2008). Use of accelerometry to measure physical activity in older adults at risk for mobility disability. Journal of aging and physical activity, 16(4), 416-434.

Stahl, S. T., & Insana, S. P. (2014). Caloric expenditure assessment among older adults: Criterion validity of a novel accelerometry device. Journal of health psychology, 19(11), 1382-1387.

Stewart, A. L., Mills, K. M., King, A. C., Haskell, W. L., Gillis, D. A. W. N., & Ritter, P. L. (2001). CHAMPS physical activity questionnaire for older adults: outcomes for interventions. Medicine and science in sports and exercise, 33(7), 1126-1141

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