Developing a Valid Physical Activity and Exercise Pyramid

Objective: To develop a valid physical activity and exercise pyramid, which communicates both the Physical Activity Guidelines for Americans and the 2011 American College of Sports Medicine exercise guidelines, using qualitative and quantitative steps.

Methods: To determine consensual content validity for the pyramid text and graphics, a panel of 10 experts in adult fitness and 4 experts in graphic design were asked to judge the selected criteria. The panelists, through two separate reviews, were requested to evaluate 39 items as “useful” or “not useful” and to provide any comments or suggestions on how the items contributed to communicating both sets of guidelines. These panel reviews provided essential quantitative and qualitative for deciding which items and graphics contributed to retain, revise, and eliminate regarding the proposed set of criteria. To quantify the degree of consensual validity, the content-validity ratio method was employed. Finally, 133 college students and community members were asked to help determine whether or not the pyramid illustrated the FITT formula for six different types of physical activity and exercise.

Results: Following the second panel expert review, a data analysis of using the content-validity ratio method, found that 35 items were statistically significant at p<.05 and subsequently retained for inclusion in the final pyramid. Among the lay population, the large majority (91%) were able to accurately identify the FITT formula for the different types of physical activity and exercise.

Conclusions: Health educators are cognizant that the materials they use must have good psychometric qualities and be visually appealing. To date, no one has published a pyramid that has been validated by experts based on the recent physical activity and exercise guidelines. The design of this pyramid has two major strengths. First, the text and graphics were able to accurately convey the different types of activities, each with its own unique benefit, that help adults link activities of daily living with a comprehensive exercise program to improve and maintain physical fitness and health. Second, the pyramid levels were able to further express frequency by proportionality of activity group and progressivity by encouraging individuals to start at the base and increase as their fitness grows. In summary, the use of this validated and graphically pleasing pyramid will markedly assist both professionals and lay people in better understanding the physical activity and exercise guidelines.