4727.0.55.002 - Australian Aboriginal and Torres Strait Islander Health Survey: Users' Guide, 2012-13
ARCHIVED ISSUE Released at 11:30 AM (CANBERRA TIME) 05/12/2014 First Issue
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ADULT PHYSICAL ACTIVITY (NON-REMOTE AREAS)
Walking was defined as requiring a 10 minute minimum threshold per session, and aimed to include continuous walking, excluding activities such as walking around a shopping centre as people tend to frequently pause while shopping. Walking for transport and walking for fitness, recreation or sport were collected separately.
Moderate intensity physical activity/exercise was defined as activities that caused a moderate increase in the heart rate or breathing of the respondent. Vigorous intensity physical activity/exercise was defined as activities that caused a large increase in the respondent's heart rate or breathing. Moderate and vigorous physical activity/exercise excluded previously identified walking as well as household chores, gardening or yard work.
Information was collected for persons aged 18 years and over in non-remote areas in the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) and the National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS).
Respondents were asked a series of questions about the physical activity/exercise they undertook in the last week. Physical activity (adults) was collected in both the NATSIHS and the NATSINPAS surveys with similar questions.
Information on adult exercise level data was first published in First Results using NATSIHS data and referred to a sample of approximately 3,400 people aged 18 years and over. More detailed information on adult physical activity data was published in Physical Activity, using NATSINPAS data and referred to the sample of approximately 1,200 people aged 18 years and over. Some data from the combined samples in the Australian Aboriginal and Torres Strait Islander Health Survey is also available and comprises of people aged 18 years and over for a sample of approximately 4,550 people.
For comparison of adult physical activity with NATSIHS only items or for time-series, the NATSIHS file should be used. For comparison with NATSINPAS only items, the NATSINPAS file should be used. Due to comparability issues identified below, the combined Core data file contains minimal adult physical activity data items. When other items collected in the Core are used, the physical activity items available can be used for comparison. For more information on the structure of the AATSIHS, see the Structure of the Australian Aboriginal and Torres Strait Islander Health Survey page of this Users' Guide.
Whether met guidelines
Data on physical activity were collected in order to report against the National Physical Activity Guidelines for Australian adults (18 years and over). The Guidelines at the time of the survey recommended at least 30 minutes of moderate-intensity physical activity on most, preferably all, days. This has been represented by the following three measures:
The NATSINPAS collected data that could produce results for the first two measures. The NATSIHS collected data for all three.
To measure against the Guidelines, the data collected was for leisure-time physical activity, in line with Active Australia. NATSIHS collected these questions using the concept of ‘exercise’. NATSINPAS collected these questions using the concept of ‘physical activity’.
The questions used were generally the same in NATSIHS and NATSINPAS and included:
Moderate and vigorous activity excluded household chores, walking, gardening and yard work.
For each of these domains of physical activity, respondents were asked:
From this information the following items were derived for persons 18 years and over:
2 The ‘Level of (exercise/physical activity)’ items were created with the aim of producing a descriptor of relative overall physical activity level, and to indicate the quality of the activities undertaken in terms of maintaining heart, lung and muscle fitness. Intensity, or Metabolic Equivalent of Task (MET), is a measure of the energy expenditure required to carry out the exercise, expressed as a multiple of the resting metabolic rate (RMR). This item has historically been used in NATSIHS output. As a result, this item was produced as two versions, to allow time-series to be produced which excludes walking for transport in the calculation.
3 Available on NATSIHS file only.
4 As the NATSIHS does not collect details of the types of activities undertaken, an intensity value was estimated for each of the three domains of exercise identified in the survey, as shown in the above formula. For comparability purposes, NATSINPAS has also utilised the allocated intensity value for this type of variable.
While NATSIHS and NATSINPAS data is generally comparable, care should be used when interpreting the data. Differences in collection including terminology, questions used and ordering are outlined in the Interpretation section.
Days exercised for at least 30 minutes
In the NATSIHS, following on from the walking, moderate and vigorous physical activity questions, respondents were asked on how many days they exercised, and, of those days, how many they did exercise for at least 30 minutes. These questions were asked in order to measure against the 5 days and 30 minutes recommendation that is used in physical activity campaigns.
Typical work day
Employed respondents in NATSIHS were then asked which of the following best described what they do on a typical work day:
As part of the collection of walking, moderate and vigorous physical activity, the NATSINPAS also collected data on duration and number of sessions of vigorous gardening. This was keeping consistent with the Active Australia questions, where it is utilised to ensure that this data is not included in the vigorous data, due to a view that the intensity of gardening is over-reported.
Type of activity/whether organised/MET
After the set of physical activity questions in NATSINPAS, respondents were asked to specify the types (up to 10) of moderate/vigorous activities in which they had participated in the last week, and indicate for each activity whether some, all or none of it was organised by a club, association or other such organisation. The activities have had a classification applied, based on that used in the ABS Participation in Sport and Physical Recreation Survey and is the same as that used in the 2011-12 National Nutrition and Physical Activity Survey (NNPAS). This data is presented on the Adult Physical activity level, so that each activity can be identified as having been organised/not organised or both.
In processing this type of activity data, MET scores were applied to each physical activity reported using the 2011 Compendium of Physical Activities. In the compendium some activities have multiple MET scores (depending on intensity, or specific type, for example). Where this was the case, the lowest score on or above the moderate activity threshold was assigned, even if the respondent identified that they had only undertaken vigorous activity in the preceding questions. The MET scores associated with each reported activity have been provided as a data item for reference purposes and are consistent with those allocated in the 2011-12 NNPAS. For the purposes of calculating against physical activity recommendations in this survey, the MET scores have not been used. This was for consistency with the NATSIHS and other surveys that use the Active Australia questions, and also as some activities are identified as having the MET of less than 3 but the respondent had identified that for them it was considered moderate or vigorous intensity. As the MET scores have been generically applied to the activities, they should be used with caution. The MET scores assigned are outlined in Appendix 8 with the Adult physical activity classification.
Strength and toning
Following the moderate/vigorous questions, NATSINPAS respondents were asked to report on the duration and number of sessions of strength and toning activities they had done in the last week. Muscle strength and toning activity can help maintain bone strength and reduce the risk of osteopenia or osteoporosis.
These activities were defined as being designed to increase muscle strength or tone, such as lifting weights, pull-ups, push-ups, or sit-ups. These sessions were meant to be undertaken with the specific intention of strength and toning, and not include incidental activity, such as carrying or lifting wood for a wood fire or heavy grocery bags. Responses to these questions could include activities for which they had already reported, such as part of training sessions that were considered to meet moderate/vigorous intensity.
NATSINPAS respondents were then asked to identify the ways they got from place to place in the last week. Categories for this question were worded with the aim of being able to produce active versus inactive transport data.
Active transport categories were:
The data items and related output categories for this topic are available in Excel spreadsheet format from the Downloads page of this product.
Points to be considered when interpreting data relating to physical activity (walking, moderate, vigorous activity):
In addition to the above points, the following collection differences between the NATSIHS and NATSINPAS should be considered.
NATSINPAS uses the term 'physical activity' where NATSIHS uses 'exercise’. The WHO definition of physical activity states:
So in essence NATSINPAS collects a broader concept of activity than NATSIHS.
The order of the NATSINPAS walking questions and moderate and vigorous questions was reversed from those asked in NATSIHS.
Ordering of the walking questions has identified some differences. While both surveys reported an average time spent walking for transport higher than average time spent walking for fitness, NATSINPAS (which asks the transport question first) has a significantly larger difference between the two walking questions than NATSIHS. Data items produced using total walking times (e.g. Level of (exercise/physical activity) (undertaken) for fitness, recreation, sport or walking for transport in last week) are not affected by the different collection methods for walking. Where only walking for fitness (e.g. Level of exercise undertaken for fitness, recreation or sport in last week (time series)) is used in an item, there is likely to be some impact from the ordering effect when comparing between surveys and therefore has not been produced for NATSINPAS.
For moderate and vigorous activity, NATSIHS asks about moderate activity first and NATSINPAS asks about vigorous activity first. In both surveys, there is a higher number of sessions and duration reported in response to questions about the first intensity threshold asked. NATSINPAS data for vigorous is approximately 3 times higher when compared to moderate, compared with NATSIHS data for moderate being approximately 1.6 times higher when compared to vigorous.
As factors of 7.5 and 5 are applied to vigorous and moderate activity times respectively for the ‘Level of (exercise/physical activity) (undertaken) for fitness, recreation, sport or walking for transport in last week’ item and vigorous is multiplied by two for the ‘Whether participated in sufficient activity in last week (duration and session)’ and ‘Whether participated in sufficient activity in last week (duration)’ data items, the ordering effect of these two questions is amplified for these items if looked at by each individual survey. Caution should therefore be used if comparing this data from the two survey datasets.
No significant difference was found between the two surveys for combined moderate and vigorous data and combined walking for fitness and transport data. Therefore data which do not have a multiplier such as ‘Whether (exercise/physical activity) last week met 150 minutes recommended guidelines’ and ‘Whether (exercise/physical activity) last week met 150 minutes and 5 sessions recommended guidelines’ which don’t contain a multiplier are considered to be comparable and are available on the Core data files.
Vigorous gardening and other issues
The NATSINPAS calculation of physical activity excludes vigorous gardening data, though there are separate questions to collect information on vigorous gardening activity. NATSIHS did not collect this separately, and although the question collecting exercise excluded gardening, it is possible that some gardening was included in NATSIHS responses. It is expected that the separation of the question in NATSINPAS has increased the likelihood of reporting and as a result the extent to which NATSIHS respondents may have included it in their responses is not comparable to the levels identified by the NATSINPAS questions. This difference in collection should be considered if making comparisons of total activity between the two surveys.
As mentioned in the methodology section, responses for type of moderate/vigorous activity in NATSINPAS have generally been left as reported even if the MET intensity did not meet a moderate intensity level. However, where walking was identified, this data was moved to the walking for fitness question where possible.
Comparability with 2004-05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS)
The majority of the 2012-13 NATSIHS data on exercise were collected with the same methodology and similar questions to those used in the 2004-05 survey. However, the following differences should be noted:
Comparisons between 2012-13 NATSINPAS physical activity data and historical NATSIHS data should be made with caution and are not recommended, as per the differences outlined between the 2012-13 NATSIHS and NATSINPAS outlined in the interpretation section.
Comparability with 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS)
The 2008 NATSISS collected data on attendance at sporting events in the last 12 months or attendance/participation in sporting activities in the last 3 months and the frequency of attendance. Given the difference in question reference periods, and the questions are conceptually different to those collected in the 2012-13 AATSIHS, no comparisons are considered appropriate.
Comparability with 2011-12 Australian Health Survey (AHS)
The 2011-12 AHS surveys have the same ordering differences between National Health Survey (NHS) and National Nutrition and Physical Activity Survey (NNPAS) as those found in the NATSIHS and NATSINPAS. As such, it is not recommended to compare NNPAS data with NATSIHS data or NHS data with NATSINPAS data.
In addition, the 2011-12 NHS collected data from selected persons aged 15 years and over, rather than 18 years and over as in the 2012-13 surveys. Therefore, the population needs to be restricted to 18 years and over when comparing NHS data to NATSIHS data and this population is considered to be directly comparable.
NNPAS is also considered to be directly comparable to NATSINPAS.
Caution must be taken when comparing 2012-13 AATSIHS with 2011-12 AHS data, due to differences in the proportion of respondents in each survey. As the ordering of questions has affected the data, and a different proportion of respondents were asked about vigorous physical activity before moderate physical activity and walking for transport before walking for fitness in the 2012-13 AATSIHS compared with the 2011-12 AHS (26% versus 38%), care should be taken when comparing the physical activity data between the combined Core data files.
Comparability with Active Australia surveys
This topic uses the Active Australia questionnaire, which allows comparisons to be made with other surveys that have used the same questionnaire. It captures the total amount of physical activity for the week prior to interview by number of sessions and duration of each activity domain.
Some modifications have been made to the original questions for use in ABS health surveys:
As a result of these modifications, as well as different collection methodologies that are used by other surveys (such as telephone interviews), some care should be used when comparing AATSIHS survey data with other surveys that use the Active Australia questions