Non-response bias in physical activity trend estimates

Background: Increases in reported leisure time physical activity (PA) and obesity have been observed in several countries. One hypothesis for these apparently contradictory trends is differential bias in estimates over time. The purpose of this short report is to examine the potential impact of changes in response rates over time on the prevalence of adequate PA in Canadian adults. Methods: Participants were recruited in representative national telephone surveys of PA from 1995-2007. Differences in PA prevalence estimates between participants and those hard to reach were assessed using Student's t tests adjusted for multiple comparisons. Results: The number of telephone calls required to reach and speak with someone in the household increased over time, as did the percentage of selected participants who initially refused during the first interview attempt. A higher prevalence of adequate PA was observed with 5-9 attempts to reach anyone in the household in 1999-2002, but this was not significant after adjustment for multiple comparisons. Conclusion: No significant impact on PA trend estimates was observed due to differential non response rates. It is important for health policy makers to understand potential biases and how these may affect secular trends in all aspects of the energy balance equation.