Is the Risk Perception Attitude Framework Associated with the Accuracy of Self-Reported vs Actual Cardiometabolic Risk and Physical Activity in Young Adults with Overweight/Obesity?

Loretta DiPietro, Department of Exercise & Nutrition Sciences, Milken Institute School of Public Health,The George Washington University, Washington, DC, USA (LD, MN); Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (RR); The Biostatistics Center, Milken Institute School of Public Health, The George Washington University, Rockville, MD, USA (AT); and Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA (RR, CB, MN).
Rajiv Rimal, Department of Exercise & Nutrition Sciences, Milken Institute School of Public Health,The George Washington University, Washington, DC, USA (LD, MN); Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (RR); The Biostatistics Center, Milken Institute School of Public Health, The George Washington University, Rockville, MD, USA (AT); and Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA (RR, CB, MN).
Ashley H. Tjaden, Department of Exercise & Nutrition Sciences, Milken Institute School of Public Health,The George Washington University, Washington, DC, USA (LD, MN); Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (RR); The Biostatistics Center, Milken Institute School of Public Health, The George Washington University, Rockville, MD, USA (AT); and Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA (RR, CB, MN).
Caitlin P. Bailey, Department of Exercise & Nutrition Sciences, Milken Institute School of Public Health,The George Washington University, Washington, DC, USA (LD, MN); Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (RR); The Biostatistics Center, Milken Institute School of Public Health, The George Washington University, Rockville, MD, USA (AT); and Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA (RR, CB, MN).
Melissa A. Napolitano, Department of Exercise & Nutrition Sciences, Milken Institute School of Public Health,The George Washington University, Washington, DC, USA (LD, MN); Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (RR); The Biostatistics Center, Milken Institute School of Public Health, The George Washington University, Rockville, MD, USA (AT); and Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA (RR, CB, MN).

Document Type

Journal Article

Publication Date

7-1-2025

Journal

American journal of lifestyle medicine

Volume

19

Issue

5

DOI

10.1177/15598276221142294

Keywords

cardiometabolic risk; physical activity; risk perception attitude framework; young adults

Abstract

We examined the accuracy of perceived vs actual cardiometabolic risk and physical activity within the Risk Perception Attitude Framework (RPA). We analyzed baseline data from 343 young adults (23.3 ± 4.4 years) participating in a weight management clinical trial. Cardiometabolic risk factors were measured according to standard clinical procedures. A cardiometabolic risk score was created from five biomarkers according to whether or not a standard clinical risk cut point was exceeded. Physical activity was determined by ActiGraph and self-report. Perceived risk and physical activity self-efficacy were assessed by validated measures. The Proactive cluster (low perceived risk/high self-efficacy) was most accurate regarding actual vs perceived risk awareness (54%), while the Responsive cluster (high perceived risk/high self-efficacy) was the least accurate (16%). All RPA clusters underestimated their actual physical activity, self-reporting less than half the moderate-to-vigorous physical activity that was captured via accelerometry. The RPA Framework can identify young adults unlikely to be aware of their cardiometabolic risk. Given the growing prevalence of metabolic syndrome, efforts early in adulthood to increase knowledge and awareness of cardiometabolic risk, and behaviors necessary to reduce that risk, can have substantial impact on future health.

Department

Exercise and Nutrition Sciences

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