Children With Congenital Heart Disease Who Volunteer for Physical Activity Research Tend to Have Higher Activity Adequacy and Participation Aligned With Activity Recommendations

PURPOSE: To assess biases in physical activity beliefs/behaviors between research volunteers and those assessed through clinical care. METHOD: Physical activity behavior (pedometer steps) and adequacy/predilection (Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity scale) were compared among 198 pediatric cardiology patients (5-17 y) with moderate/severe congenital heart disease. Volunteers (n = 142, 59% male, 11.0 (3.4) y) participated in a multicenter activity trial. The clinical subgroup (n = 56, 58% male, 11.1 (4.0) y) completed assessments during a routine clinical encounter. Independent t tests compared outcomes within child/adolescent age groups. RESULTS: Child volunteers tended to report higher activity adequacy (mean difference = 1.9 (1.0), P = .06) than clinic patients, suggesting increased confidence for activity participation. Daily steps did not differ between groups (P > .10). The extra 1600 steps per day among volunteers enabled child volunteers to achieve the recommended 12,000 steps per day. Cardiologist reported activity restrictions were associated with more steps per day (P < .01). CONCLUSION: Research volunteers may be more likely to achieve daily physical activity recommendations. Child volunteers tend to be more confident in their ability to participate successfully. Cardiologist reported activity restrictions may provide confidence regarding appropriate types of activity, leading children and adolescents to take more steps each day. Physical activity research participants and those with cardiologist reported activity restrictions may not reflect those most in need of additional support.