@prefix vivo: . @prefix edm: . @prefix ns0: . @prefix dcterms: . @prefix dc: . @prefix skos: . vivo:departmentOrSchool "Education, Faculty of"@en, "Kinesiology, School of"@en ; edm:dataProvider "DSpace"@en ; ns0:degreeCampus "UBCV"@en ; dcterms:creator "Faktor, Marc Dylan"@en ; dcterms:issued "2009-11-27T21:54:28Z"@en, "2009"@en ; vivo:relatedDegree "Master of Science - MSc"@en ; ns0:degreeGrantor "University of British Columbia"@en ; dcterms:description """Research suggests that individuals who have increased fitness knowledge via health education are more likely to be physically active and fit. In addition, an individual’s health literacy is suggested to play a substantial role towards the acquisition of health knowledge. However, literature delineating the relationship between health knowledge, health literacy, and the components of health-related physical fitness is scarce and inconsistent. The Canadian Physical Activity, Fitness and Lifestyle Approach (CPAFLA) represents a series of standardized fitness testing procedures developed by the Canadian Society for Exercise Physiology. In addition, the CPAFLA provides important health-related information to individuals intended to promote healthy lifestyle activities. To-date, the influence of the CPAFLA on health-related physical fitness knowledge and the components of the Theory of Planned Behaviour (TPB) regarding physical activity has yet to be examined. One large study examining two distinct sub-questions was conducted. The first question examined objectively the relationship between health-related physical fitness knowledge, health literacy, and health-related physical fitness in 34 participants (18 F, 16 M; 19-49 years). Knowledge was examined using the FitSmart, while health literacy and physical fitness were assessed via the Newest Vital Sign and the CPAFLA, respectively. Results indicated that knowledge was a significant correlate (r=O.40, p 24.9)) statistically increase one’s risk of premature death (CSEP, 2003). Obesity is now a pandemic affecting many people worldwide, It is a condition of excess body fat that results from a chronic energy imbalance whereby intake exceeds expenditure. Too much body fat significantly increases a person’s risk of premature death from chronic diseases such as coronary artery disease, stroke, type 2 diabetes mellitus, gallbladder disease and some cancers (Katzmarzyk, 2002). Obesity in collaboration with physical inactivity places a significant 147 burden on the Canadian health care system by accrediting $9.6 billon towards their treatment and management (Katzmarzyk, 2004). There is increasing evidence that inferior musculoskeletal fitness is associated with a decline in overall health status and an increase in the risk of chronic disease and disability (Warburton, 2001). Longitudinal investigations have discovered that individuals with low levels of muscular strength have increased functional limitations and higher incidences of chronic diseases including diabetes, stroke, coronary artery disease, arthritis, and pulmonary disorders (Rantanen, 1998). Furthermore, deficient musculoskeletal fitness is positively associated with functional dependence, immobility, glucose intolerance, poor bone health, psychological disturbances and decreased quality of life, increased risk of falls, illness and premature death (Warburton et al., 2006a). Summary The health-related physical fitness components (physical activity participation, body composition, aerobic and musculoskeletal fitness) and their contributors are essential to one’s health status. There are many benefits associated with the assessment of health-related physical fitness. Moreover, the CPAFLA is a standardized and well recognized approach to the assessment of health-related physical fitness in the general population. Since the CPAFLA appraisal process is designed to increase one’s knowledge and awareness concerning health-related physical fitness we hypothesize that individuals who participate in the CPAFLA will increase components of their health related physical fitness knowledge base. Investigations that function to assess health- 148 related physical fitness are of much relevance to health care practitioners and agencies promoting health. Health Knowledge in Relation to Health-Related Physical Fitness Knowledge is considered one of the essential factors in establishing human behaviour (Andrade, 1999). People who understand the concepts of physical fitness are also more likely to incorporate physical activity and exercise into their everyday life (Zhu et al., 1999). Thus, an important step in becoming physically fit and endorsing constructive attitudes in relation to fitness is learning the concepts and principles of health-related physical fitness (Miller & Housner, 1998). Evidence supporting a positive relationship between health-related physical fitness knowledge and health-related physical fitness has been suggested in adolescents (Keating, 2007), limitedly shown in adulthood (Avis, McKinlay, & Smith, 1990; Liang et al., 1993), and within elderly populations (Fitgerald, Singleton, Neale, Prasad, & Hess, 1994). However, literature delineating the relationship between health knowledge base and health-related physical fitness is inconsistent. For example, investigations have shown no significant relationship between fitness knowledge and components of physical fitness (i.e., physical activity) (Morrow et al., 2004). This section will outline the pertinent investigations that highlight the relationship between health-related physical fitness knowledge base and health-related physical fitness. Health Knowledge and Physical Fitness in Adults Avis et al. (1990) examined the level of cardiovascular risk factor knowledge and its relationship to behaviour in females. On average, the participants were more educated and had higher incomes in comparison to the general population. In addition, 149 only a small portion was not Caucasian. Cardiovascular risk factor knowledge was assessed by asking participants to outline the specific steps an individual could take to decrease the risk of a stroke or heart attack. Interviewers lobbied respondents to mention all actions of which they were aware. The risk factors and health behaviours measured included smoking (self report # cigarettes per day), weight status (BMI), cholesterol (venous blood sample), physical activity (kilocalories expended via Harvard alumni scale (Paffenbarger, Wing, & Hyde, 1978)), blood pressure (standard sphygmomanometer), and stress (self report). Health knowledge was positively related to education (p < .01), being female (P < .01), and amount of exercise (p <.05). The authors suggested that the positive relationship between the health-related physical fitness components and health knowledge may have been mediated by the sampling of a higher socioeconomic bracket. Further investigation incorporating well established and standardized assessment measures is needed to quantify this relationship in representative samples of the general population. In addition, the results of this investigation suggest that education and knowledge are necessary to prevent negative health behaviours, but not sufficient to influence behavioural change once health damaging behaviours (e.g., smoking) have been established. Thus, evidence based health promotion programs focusing on prevention are needed to educate and increase knowledge regarding the positive relationship between health behaviours and health outcomes. Liang et al. (1993) examined whether or not first year medical student’s knowledge and attitudes concerning health and exercise affected physical fitness. The fitness assessment took into account body fat (hydrostatic weighing) and cardiovascular fitness (maximal aerobic fitness test (VO2max)). A questionnaire was utilized to assess 150 knowledge and attitudes regarding health promotion, disease prevention, and exercise. Results showed that health knowledge influenced medical student’s fitness levels; however, attitudes concerning health promotion and disease prevention were stronger predictors of fitness levels Morrow et al. (2004) studied the influence of exercise knowledge on the physical activity behaviours of American adults. All data was generated via random digit dialling phone interviews. A 20 item verbal questionnaire incorporating exercise prescription, traditional physical activities, and lifestyle activities was used to determine levels of health-related exercise knowledge. Physical activity behaviour was assessed by asking participants to select one of eight responses that functioned to best describe their current behaviour (Martin, Morrow, Jackson, & Dunn, 2000). Results indicated that knowledge of exercise recommendations had no effect on exercise behaviours; however, ethnicity, education level, and age were significantly correlated to health knowledge. The authors suggest that the results could support the concept of knowledge being required yet not sufficient for behaviour change. Other factors (e.g., self motivation, attitudes or perceived benefits) could be interacting with knowledge to influence behaviour change (Morrow et al., 2004). Nevertheless, it is recommended for health promotion programs to emphasize aspects of knowledge that are directly related to the behaviour change of interest. Rutledge et al. (2001) showed that greater knowledge concerning breast cancer and its detection methods was significantly correlated to breast self examination behaviours. Thus, individuals that possess specific knowledge regarding health-related physical fitness should be better predisposed to engage in these fitness behaviours. Unfortunately, even though many adults are aware 151 of the benefits related to physical activity, many lack specific knowledge of how to be physically active for a health benefit (Morrow, Jackson, Bazzarre, Milne, & Blair, 1999). Health Knowledcie and Physical Fitness in the Elderly Fitzgerald et al. (1994) examined physical activity (self report), measured fitness status, exercise knowledge, and exercise beliefs of African American and Caucasian females (ages 50-80) in good health. One question addressed in this investigation asked, “What are the exercise knowledge and beliefs of this group and how do exercise knowledge and beliefs relate to measured fitness status and exercise behaviour?”. The degree to which exercise knowledge and beliefs are related to physical activity in the elderly is of much relevance to geriatric practitioners as preventative measures are essential to halt the aging process and increase longevity (Fitgerald et al., 1994). Fitness status was determined via a sub-maximal treadmill test (up to 70% predicted maximum heart rate). A 7-day physical activity recall estimating frequency and duration of significant aerobic exercise was utilized to assess physical activity. The exercise knowledge assessment consisted of three questions derived from the American College of Sport Medicine guidelines for cardiovascular fitness. Results indicated that exercise beliefs and knowledge do influence exercise habits. Fitzgerald et al. suggested that the regression model implemented for the statistical analysis was a poor fit of the data, meaning that the independent variables did not significantly explain fitness status (Fitgerald et al., 1994). This was most likely due to the variability in the measures used. A more rigorous fitness assessment along with knowledge assessment is recommended to examine the relationship of interest. 152 Summary Knowledge is considered one of the critical factors in establishing human behavior (Andrade, 1999.) Furthermore, people who understand the concepts of physical fitness are also more likely to incorporate physical activity and exercise into their everyday life (Zhu et al., 1999). Thus, since regular physical activity participation is often assumed as a significant predictor of health-related physical fitness (Katzmarzyk, 1998), we postulate that individuals who possess superior levels of health-related physical fitness knowledge will demonstrate higher levels of health-related physical fitness. To-date, literature demonstrating a positive relationship between fitness knowledge and health-related physical fitness in adulthood is limited. When analyzing why these previous investigations provide inconsistent evidence supporting this relationship, methodology seems to be the issue. Each investigation utilized different health knowledge assessments, measures of physical fitness, as well as sampling methods. Given the deviations in methodology between investigations the limited and inconsistent evidence is not surprising. A study or set of investigations that implement similar established, valid, and reliable protocols which function to evaluate this relationship within a cross-sectional design (e.g., young adulthood vs. middle adulthood) would make an important contribution to the current body of literature. 153 Table A.1. Components of the Canadian Physical Activity, Fitness and Lifestyle Approach (CPAFLA): A Standardized Health-Related Physical Fitness Assessment Tool (Adapted from CSEP, 2003). Pre-Appraisal Screening • The Physical Activity Readiness Questionnaire (PAR-Q) • A pre-activity screening tool designed to identify people for whom certain physical activities may be inappropriate and those who should seek medical advice (e.g., individuals with documented cardiovascular disease). • Measurement of resting heart rate and blood pressure • The Healthy Physical Activity Participation Questionnaire o Used to assess current levels of physical activity Composite Body Composition Assessment • Body mass index • Waist circumference • Skinfold thickness (a measure of subcutaneous body fat) Assessment of Aerobic Fitness • Modified Canadian Aerobic Fitness Test (mCAFT) o A valid and reliable, predictive, submaximal, and progressive step exercise test designed specifically for the general population Assessment of Musculoskeletal Fitness • Grip strength • Push-ups • Sit-and-reach test • Partial curl-ups • Vertical jump • Back extension endurance Assessment of back health • Weighted scores for physical activity participation, waist circumference, sit and reach, partial curl-ups, and back extension, are combined to provide an indication of composite back fitness. Results and Counselling Session • Individual results generated based on Canadian normative data • Evidence based guidance provided to stress the health benefits of regular physical activity participation • Fitness goals are set based on individual data Background factors indMdual Personality Mood, emotion Intelligence Values, stereotyper General attitudes Experience Social Education Age, gender Income Religion Race, ethnicity Culture Th/rmation Knowledge Media intervention Figure A.1. Schematic of the Theory of Reasoned Action/Planned Behaviour (From Ajzen & Fishbein, 2005). 154 F / \\ 155 References Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association (1999). Health literacy: Report of the council on scientific affairs. The Journal of the American MedicalAssociation, 281(6), 552-557. Ajzen, I. (1988). Attitudes, personality and behavior. Chicago: Dorsey Press. Ajzen, I. (1991). The theory of planned behavior. 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NASPA Journal, 41(4), 588-630. 165 APPENDIX B UBC Clinical Research Ethics Board Certificate of Approval iJC The University ofBritish Columbia - Office ofResearch Services Clinical Research Ethics Board — Room 210, 828 West 10th Avenue, Vancouver, BC V5Z 1L8 ETHICS CERTIFICATE OF FULL BOARD APPROVAL ‘RINCIPAL INVESTIGATOR: LNSTITUTION / DEPARTMENT: UBC CREB NUMBER: shannon S.D. Bredin IUBC/Educationllluman Kinetics 1H08-00468 LNSTITUTION(S) WHERE RESEARCH WILL BE CARRIED OUT: Institution I Site UBC Vancouver (excludes UBC Hospital) Other locations where the research will be conducted: N/A DO-INVESTIGATOR(S): 4arc D. Faktor )arren Warburton yan Rhodes SPONSORING AGENCIES: ‘ROJECT TITLE: E-IEALTH-RELATED PHYSICAL FITNESS KNOWLEDGE: THE INFLUENCE OF PHYSICAL FITNESS AND DMINISTRATION OF THE CANADIAN PHYSICAL ACTIVITY FITNESS & LIFESTYLE APPROACH. [‘HE CURRENT UBC CREB APPROVAL FOR THIS STUDY EXPIRES: April 8, 2009 The full UBC Clinical Research Ethics Board has reviewed the above described research project, including ssociated documentation noted below, and finds the research project acceptable on ethical grounds for research [nvolving human subjects and hereby grants approval. REB FULL BOARD MEETING I EVIEW DATE: I pril 8, 2008 I )OCUMENTS INCLUDED IN THIS APPROVAL: )ATE DOCUMENTS APPROVED: Document Name I Version I Date Protocol: Condensed Research Proposal 1 February 21, Fune 20, 20082008 Consent Forms: Informed Consent Form Advertisements: Recruitment Notice Questionnaire, Questionnaire Cover Letter, Tests: FitSmart: Health-Related Physical Fitness Knowledge Examination Forms 1 and 2 Health Literacy Assessment (Newest Vital Sign Score Sheet) Health Literacy Assessment (Newest Vital Sign Nutrition Label) PAR-Q PARmed-X Physical Activity Beliefs and Attitudes Survey Health Literacy Assessment (PAR-Q) Letter of Initial Contact: Letter of Initial Contact Other Documents: External Peer Review Report DERTIFICATION: In respect of clinical trials: 1. The membership of this Research Ethics Board complies with the membership requirementsfor Research Ethics 9oards defined in Division 5 ofthe Food and Drug Regulations. ?. The Research Ethics Board carries out itsfunctions in a manner consistent with Good Clinical Practices. 3. This Research Ethics Board has reviewed and approved the clinical trial protocol and informed consentform for the trial which is to be conducted by the quafl/led investigator named above at the specfled clinical trial site. This pproval and the views ofthis Research Ethics Board have been documented in writing. fhe documentation included for the above-named project has been reviewed by the UBC CREB, and the research study, as presented in the documentation, was found to be acceptable on ethical grounds for research involving mman subjects and was approved by the UBC CREB. Approval ofthe Clinical Research Ethics Board by one of Dr. Gail Beliward, Chair 166 2 June 4, 2008 2 June 6, 2008 N/A March 7,2008 1 June 6, 2008 1 June 6, 2008 2 June 4, 2008 1 January 9,2008 2 April21, 2008 I June 13, 2008 2 June 6, 2008 February 19, 2008 167 APPENDIX C Sample FitSmart Health Knowledge Examination Questions 1. The most accurate indicator of cardiorespiratory fitness is A. percent body fat. B. maximum oxygen uptake. C. resting heart rate. D. vital capacity. 2. Which of the following principles about physical fitness is most accurate? A. It is reversible and needs continuous exercise through moderate to vigorous activity. B. It is a permanent quality which carries over from youth into adulthood. C. It is maintained through heavy exercise. D. it is maintained through a person’s normal lifetime activities 3. What is the relationship between physical fitness and health? A. People who are highly fit are always healthier; people who have poor fitness are always unhealthier. B. People who are moderately fit typically enjoy good health. C. The relationship is more important for children than adults. D. There is no relationship between physical fitness and health. 4. An individual’s heart rate immediately after exercise indicates A. the recovery rate of the heart. B. the strength of the heart. C. the intensity of the exercise. D. all of the above. 5. Which of the following occurs to muscle fibers with regular weight training? A. Increase in number B. Increase in size C. Increase in length D. Increase in fat 6. Threshold of training refers to the effort needed to increase fitness. It applies to which of the following? A. Minimum effort required B. Maximum effort required C. Level of effort when fitness begins to decline D. Level of effort associated with decreasing intensity of exercise 168 APPENDIX D Theory of Planned Behaviour Component Assessment Identification #__________ Regular Physical Activity Beliefs and Attitudes Survey Instructions In this survey, we are going to ask you a series of questions about your beliefs and attitudes towards regular physical activity. There are no right or wrong answers and all we ask is that you provide responses that are as honest and accurate as possible. The questionnaire should take about 15 minutes for you to complete. All responses are completely confidential and will never be used in any way that could link them to you. It is important to answer all questions so that we can include your responses in our analyses. If you have any questions please ask the research assistant. When your questionnaire is completed, please raise your hand and the research assistant will collect your questionnaire. Definition of Regular Physical Activity All the questions in this survey ask you about regular physical activity. Here, we define regular physical activity as: A) leisure-time activity performed at least 3 times per week, for at least 20-30 minutes in duration (can include multiple daily sessions of 10 minutes), at a vigorous intensity (i.e., hard breathing, heart beats rapidly, heavy sweating). Some examples of vigorous physical activities are running, jogging, aerobics, circuit weight training, and vigorous sports such as hockey or soccer. Or, B) leisure-time activity performed at least 3 times per week, for at least 3 0-60 minutes in duration (can include multiple daily sessions of 10 minutes) at a moderate intensity (i.e., slightly increased breathing, faster then normal but not rapid heart beat, light sweating, can keep a conversation going). Some examples of moderate intensity physical activities are brisk walking, yoga, house work, bicycling 5 to 9 mph, water aerobics and sports such as baseball, golf while carrying clubs, and archery. 169 The following question asks you to rate how you feel about participating in regular physical activity on 6 different scales. Pay careful attention to the words and descriptors at the end of each scale and place an “X” over the line that best represents how you feel about participating in regular physical activity. Please answer all items from a) to f). 1. For me, participating in regular physical activity over the next month would be: a) ______ ______ ______ ______ ______ ______ ______ extremely quite slightly neutral slightly quite extremely harmful harmful harmful beneficial beneficial beneficial b) _ __ _ __ __ _ ___ _____ _____ extremely quite slightly neutral slightly quite extremely useless useless useless useful useful useful c) extremely quite slightly neutral slightly quite extremely unimportant unimportant unimportant important important important d) extremely quite slightly neutral slightly quite extremely unenjoyable unenjoyable unenjoyable enjoyable enjoyable enjoyable e) _____ ___ _ __ __ __ _ extremely quite slightly neutral slightly quite extremely boring boring boring fun fun fun f) extremely quite slightly neutral slightly quite extremely painful painful painful pleasurable pleasurable pleasurable This next set of questions ask you to rate how other people in your life may feel about you participating in regular physical activity over the next month. Pay careful attention to the words and descriptors at the end of each scale and place an “X” over the line that best represents what you think about their feelings. Please answer all items from a) to c). 2. I thinic that if I were to participate in regular physical activity over the next month, most people who are important to me would be: a) 170 extremely quite slightly neutral slightly quite extremely disapproving disapproving disapproving approving approving approving b) _____ _____ _____ _____ _____ _____ extremely quite slightly neutral slightly quite extremely unsupportive unsupportive unsupportive supportive supportive supportive c) __ _ __ _ __ __ __ __ ___ __ ___ _ extremely quite slightly neutral slightly quite extremely discouraging discouraging discouraging encouraging encouraging encouraging 171 This next set of questions ask you to rate how active you think other people in your life are likely to be over the next month. Pay careful attention to the words and descriptors at the end of each scale and place an “X” over the line that best represents their physical activity levels. 3. I think that over the next month, most people who are important to me will be: extremely quite slightly neutral slightly quite extremely inactive inactive inactive active active active 4. I think that over the next month, most people who are important to me will participate in regular physical activity. extremely quite slightly neutral slightly quite extremely disagree disagree disagree agree agree agree 5. I think that over the next month, the regular physical activity participation levels of most people who are important to me will be: extremely quite slightly neutral slightly quite extremely low low low high high high This next set of questions ask you to rate how likely you feel it is that you will be able to participate in regular physical activity over the next month if you were really motivated. Pay careful attention to the words and descriptors at the end of each scale and place an “X” over the line that best represents your feelings. 6. If you were really motivated, how controllable would it be for you to participate in regular physical activity over the next month? extremely quite slightly neutral slightly quite extremely uncontrollable uncontrollable uncontrollable controllable controllable controllable 7. If you were really motivated, how easy or difficult would it be for you to participate in regular physical activity over the next month? extremely quite slightly neutral slightly quite extremely difficult difficult difficult easy easy easy 8. If you were really motivated, do you feel that whether or not you participate in regular physical activity over the next month would be completely up to you? extremely quite slightly neutral slightly quite extremely disagree disagree disagree agree agree agree 9. If you were really motivated, how confident are you that you could participate in regular physical activity over the next month? extremely quite slightly neutral slightly quite extremely 172 unconfident unconfident unconfident confident confident confident 10. If you were really motivated, do you feel you would have complete control over whether or not you were physically active over the next month? extremely quite slightly neutral slightly quite extremely untrue untrue untrue true true true 11. If you were really motivated, how certain or uncertain would you be that you could participate in regular physical activity over the next month? extremely quite slightly neutral slightly quite extremely uncertain uncertain uncertain certain certain certain This next set of questions ask you to rate how motivated you are to participate in regular physical activity over the next month. Pay careful attention to the words and descriptors at the end of each scale and place an “X” over the line that best represents your motivation. 12. How motivated are you to participate in regular physical activity over the next month? extremely quite slightly neutral slightly quite extremely unmotivated unmotivated unmotivated motivated motivated motivated 13. I strongly intend to do everything I can to participate in regular physical activity over the next month. extremely quite slightly neutral slightly quite extremely untrue untrue untrue true true true 14. How committed are you to participating in regular physical activity over the next month? extremely quite slightly neutral slightly quite extremely uncommitted uncommitted uncommitted committed committed committed 15. I intend to participate in vigorous physical activity _____ times per week over the next month for minutes each time. (please place a number between 0 and 7) (please place a number between 0 and 60) 16. I intend to participate in light-moderate physical activity _____ times per week over the next month for ______ minutes each time. (please place a number between 0 and 7) (please place a number between 0 and 60) 173 For this next question, we would like you to recall your average weekly physical activity participation yç the past month. How many times per week on average did you do the following kinds of physical activity over the past month? When answering these questions please: H consider your average over the past month. H only count physical activity sessions that lasted 10 minutes or longer in duration. H note that the main difference between the three categories is the intensity of the exercise. H please write the average frequency on the first line and the average duration on the second line. Times Per Week Average Duration Per Session a. STRENUOUS (HEART BEATS RAPIDLY, SWEATING) (e.g., running, jogging, hockey, soccer, squash, cross country skiing, judo, roller skating, vigorous swimming, vigorous long distance bicycling, vigorous aerobic dance classes, heavy weight training) b. MODERATE EXERCISE (NOT EXHAUSTING, LIGHT PERSPIRATION) (e.g., fast walking, baseball, tennis, easy bicycling, volleyball, badminton, easy swimming, alpine skiing, popular and folk dancing) c. MILD EXERCISE (MINIMAL EFFORT, NO PERSPIRATION) (e.g., easy walking, yoga, archery, fishing, bowling, lawn bowling, shuffleboard, horseshoes, golf, snowmobiling) 174 This last part of the questionnaire is needed to help understand the characteristics of the people participating in the study. For this reason it is very important information. All information is held in strict confidence and its presentation to the public will be group data only. 1. Age: _____ 2. Sex: Male_____ Female 3. With which ethnic group do you identif,’? _______________ 4. Education Level (Highest formal education diploma/certificate received or in-progress) ________ 5. Annual Income (If supported by parents please select their annual income): < $20,000 $20-39,000 _____ $40-59,000 __ $60-79,000 ___ $80-99,000 > $100,000 175 APPENDIX E The Newest Vital Sign (NVS) health literacy assessment Nutrition Label Nu1tIon Facts SeMiga per ntahier 4 ArnJnt per IeMng Cak1ee 250 FitC 120 %DV Tot.IF.t 13 20% 8tF1$n 40% Choleaterol 2&nç 12% Sodium 55mg 2% TotI Carbatwdrte 30g 12% Dietary Fiber 2g SugerB 23g Prolaki 4g Peirnia Dhjea (DV ‘e bed cni 2000 c.rh dial. )rd.Iyu may b. ghercr vn ur caJo needi. hiedIiflh crrr. Jm MI Lhid Si.r. Yii EIIka Dwi IHt PwiutOiSuer. Bufler. Sat. Vib E*tracL 176 The Newest Vital Sign (NVS) health literacy assessment Score Sheet Score Sheet for the Newest Vital Sign Questions and Answers READ TO SUBJECT: This information is on the back ANSWER CORRECT? of a container of a pint of ke cream. yes no 1. If you eat the entire container, how many calories will you eat? Answer: 11000 is the only correct answer 2. If you are allowed to eat 60 grams of carbohydrates as a snack. how much ice cream could you have? Answer: Any ofthe following is correct: 1 cup (or any amount upto 1 cup). Half the container Nate: Ifpatient answers “two servings,Uask “How much ice cream would that be ifyou were to measure it into a bowL 3. Your doctor advises you to reduce the amount of saturated fat in your diet, You usually have 42 g of saturated fat each day, which includes one serving of ice cream. If you stop eating ice cream, how many grams of saturated fat would you be consuming each day? Answer: 33 is the only correct answer 4. If you usually eat 2500 calories in a day, what percentage of your daily value of calories will you be eating if you eat one serving? Answer: 10% is the only correct answer READ TO SUBJECT: Pretend that you are allergic to the following substances: Penicillin, peanuts, latex gloves, and bee stings. 5. Is it safe for you to eat this ice cream? Answer: No 6. (Ask only if the patient responds question 5):Why not? Answer: Because it has peanut oiL Interpretation Number of correct answers: Score of 0-i suggests high likelihood (50% or more) of limited literacy Score of 23 indicates the possibility of limited literacy. Score of 4-6 almost always indicates adequate literacy. 177 APPENDIX F CFAFLA Preliminary Instructions for Participants Name of Participant__________________________________ Age______________ Appraisal Date___________________ Time____________ Location________________ Name of Appraiser Please adhere to thefollowing conditionsfor the appraisal: Dress Requirements: Shorts and short-sleeved or sleeveless shirt/blouse should be worn. Running shoes are the recommended footwear. Food and Beverages: Do not eat for at least two hours prior to your appraisal. Also refrain from drinking caffeine beverages for two hours and alcoholic drinks for six hours prior to the appraisal. Smoking: Do not smoke during the two hours prior to the appraisal Physical Activity: Strenuous physical activity should be avoided for six hours prior to the appraisal. Note: Failing to adhere to the above conditions may affect your results negatively. Source: (CSEP, 2003). The Canadian Physical Activity, Fitness & Lifestyle Approach APPENDIX G Physical Activity Readiness Questionnaire (PAR-Q) 178 PAR-Q & YOU (A Que tionnaiee foi ro,Ie *qed IS to 69) Regic phpk sc2r z d hesIfl w me pecçle sie bscmt mo scuo tery da Beq nns‘ eiy !50 fr pee Mane opncle thnck Ith do bdxc wtbecce nn *Øanne f J1I1fl9 h !T JDQEy I1O CiJ Je rou rt by s qiodi thj o 13 nd 6, the A-Q .1 Id yw f uAi theck ath,docbe yo o 6ê1 sec od uu n rdtD bár* wry theck )O4i Conn me it .our butt gtie her u uoerthesu quent Thmoe resdth, qnesboe csrut od eech iie% deck 5 or 2 Pbooie cai buiaweny nesyoi g tbereuthoepbyikwtht *I’ ed bfl gth4 1thl tt aid eeetuui pat sbioo awra _______________________________________ cai pai th eet**ryo b h3 Uto N.EA5E WWL hdithaigi,r e thr yo butan b odWunitLed. kowr144,Iwöx Uf,oo ecMun rhicst hei bekreynslu1 bucorg esch Øc edie. cdiuigyai *9 itbe I(do Cfl,dbere&iei.tuedi Ifbhi ppU* II b lo h.aqca purii*ted You ii. eacouraged to phetecapy he P*iLQ but ouly if yea use the e.4ire be Qa bIqub nehabu I. jatou ie Lit4er q ‘aid hiudg 1 ,reed, uidoaid ad qiwiad Aiqettaie kid isode mydlsii ole Tbk pbyskdl adhtty clearance o walld Too a marimian .1 11 eaaI bern tbe doTe It Is co.Ipte*ed and becernet beafli 11 yo caeUeehes so tur ea wcedd ar Y€t to any at tbe saran quesdcos •o. Heeffl aItóV W •I Canacia or 1 90 Q [] t. atas your doctor suer said Teat you havit heart coadMian atbat you Ituuld on’y do pbyclcst attIuUy by o dodd? 2. Do you tool pain Ia ynec chest lhan you do ybysicol ectbety? [] Q 3. In the past rnontb, hair yea bed best pale when yen sane net ie4n pbpkal odhety? Q Q 4. Do you hoe yner halmece because of azzffiess or do ye. ever ide caa,ctaernesa? D Q 3. Do yen bo a bane or J.Tet pesbie. tier esampie, bach, bane or tip) tuat coal to .11. ow,. by e cbaaqe hi yow peydral ocdoy? Q Q Is yourS dacbar rweeuNy presceiblag drags (fur ueto $Iu io. your 040.4 preane or heart c.o [] [] 7, Do yea .1 an, .thoo yen shoal net do physlcas acthlty? If you answered YES to one or more questions ?áaih yos for bykoe wn ptrtor B tatZgrnnhiemd fEiw hairs hea rãd. N clsrLcul thc l%4 aid d*i tsc aeoood e do ur,ohki yoleot arloigai eu daàdi4ipaà4I