Evaluating the Association between Activity and PROMIS Pediatric Measures in

Children with Chronic Conditions

BACKGROUND

We will compare daily step data with patient self-reports on PROMIS Pediatric domains (physical activity, function-mobility, pain interference, fatigue, depression) for 200 children and adolescents, including 50 children 8-12 years of age with cancer, 50 children 8-12 years of age with JIA or SLE, and 50 children 8-12 years of age and 50 adolescents 13 – 17 years of age with not well controlled asthma. Participants will be asked to wear a VivoFit3 activity monitor for 7 days prior to a survey assessment time point on at least two occasions. The VivoFit3 will be worn on Days 1-7 and the surveys will be completed on Day 7 so that the data collected by the monitor corresponds with the recall period of PROMIS surveys.

 

A brief ecological survey regarding participation in organized sports, other circumstances affecting activity, and days/times in which the device was not worn will also be administered on day 7, and aid in interpretation of the data.

Measures and Analyses These PROMIS pediatric measures will be included in this analysis: Physical Activity, Physical Function-Mobility, Pain Interference, Fatigue, and Depression. Cross-sectional analyses of daily step and PROMIS Pediatric measures will be used to test convergent validity of conceptually linked measures.

 

Results from regression models for longitudinal data analyses of PRO measures will be benchmarked against regression results from step data, to ascertain responsiveness. We will use descriptive statistics to understand patterns by condition; we will analyze data in aggregate and test whether disease group (covariate) is associated with outcomes. Analyses will control for demographics, mental health, and ecologic factors such as sports participation and season/weather.

STUDY AIMS

  • Determine the association between activity (steps taken) and PROMIS Pediatric measures in order to explore the use of pedometry data to augment PROs in research and clinical care. 

  • The Duke PEPR Center is currently evaluating the associations between activity trackers and scores on PROMIS pediatric measures in adolescents aged 13 – 17 years who have cancer, juvenile idiopathic arthritis, or lupus. This IOF project extends this project across age and disease groups by:

    • Collecting activity data from younger populations, aged 8 to 12 years of age 

    • Extending the study to pediatric populations with Asthma.

  • This data will be valuable to examine how well activity data is a proxy indicator for a child's overall health status and to what extent activity data may be used to represent health status when it is not possible to directly collect PRO data (poor literacy, severe illness, and non-adherence). 

  • We hypothesize that daily step data will be highly correlated with and responsive when measured against PROMIS Pediatric measures of Physical Activity and Physical Function-Mobility.

  • Exploratory analyses will examine the association of daily steps with pain interference, fatigue, and depression.

GOALS

Manuscript(s) providing findings from evaluation of the association between PROMIS Pediatric measures of health status and activity data.  This information sets a benchmark to both 1) the consideration for use of activity data when the child may not be able to provide self-report data; 2) design of interventions to enhance physical fitness through use of activity trackers and PRO data. 

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