Reliability and Validity of the Multimedia Activity Recall in Children and Adults (MARCA) in People with Chronic Obstructive Pulmonary Disease

Objective: To determine the reliability and validity of the Multimedia Activity Recall for Children and Adults (MARCA) in people with chronic obstructive pulmonary disease (COPD). Design: People with COPD and their carers completed the Multimedia Activity Recall for Children and Adults (MARCA) for four, 24-hour periods (including test-retest of 2 days) while wearing a triaxial accelerometer (Actigraph GT3X+(R)), a multi-sensor armband (Sensewear Pro3 (R)) and a pedometer (New Lifestyles 1000 (R)). Setting: Self reported activity recalls (MARCA) and objective activity monitoring (Accelerometry) were recorded under free-living conditions. Participants: 24 couples were included in the analysis (COPD; age 74.4 +/- 7.9 yrs, FEV1 54 +/- 13% Carer; age 69.6 +/- 10.9 yrs, FEV1 99 +/- 24%). Interventions: Not applicable. Main Outcome Measure(s): Test-retest reliability was compared for MARCA activity domains and different energy expenditure zones. Validity was assessed between MARCA-derived physical activity level (in metabolic equivalent of task (MET) per minute), duration of moderate to vigorous physical activity (min) and related data from the objective measurement devices. Analysis included intra-class correlation coefficients (ICC), Bland-Altman analyses, paired t-tests (p) and Spearman's rank correlation coefficients (r(s)). Results: Reliability between occasions of recall for all activity domains was uniformly high, with test-retest correlations consistently >0.9. Validity correlations were moderate to strong (r(s) = 0.43-0.80) across all comparisons. The MARCA yields comparable PAL estimates and slightly higher moderate to vigorous physical activity (MVPA) estimates. Conclusion: In older adults with chronic illness, the MARCA is a valid and reliable tool for capturing not only the time and energy expenditure associated with physical and sedentary activities but also information on the types of activities.