apply to physical activity assessment, and it provides a more detailed review of one important potential indicator of activity—television viewing.
As previously discussed, diet and physical activity are both extremely complex behaviors expressed as systematic patterns that are the end result of a complex series of many decisions (Baranowski, 1997b; Campbell and Desjardins, 1989). These decisions are affected by contextual factors that can be considered behavioral indicators, in that these indicators influence or reflect diet or activity but do not attempt to directly measure diet or activity. For example, many contextual factors affect a person’s diet, such as where one eats; who else is present and why; the cost, convenience, or familiarity of certain foods; and the presence of emotional states, such as loneliness or boredom, that can serve as eating cues. Similarly, activity levels can also be affected by contextual factors like the weather, the availability of safe outdoor areas, the support or interest of family and peers, and the presence of competing sedentary activities such as television viewing. Interest in using these behavioral indicators in WIC may also be increased by the untested assumption that, in comparison to conventional tools for assessing diet and activity, these indicators may be easier to recall, less susceptible to various types of reporting bias, and therefore most appropriate targets for behavioral counseling.
A distinction can be drawn between surrogate and target behavioral indicators (See Box 7-1). Surrogate indicators are those that can be used in place of usual dietary or physical activity assessment procedures. For example, the frequency of eating a meal as a family is a possible surrogate indicator because it has been shown that families who eat dinner together tend to eat better diets (Gillman et al., 2000). If the frequency of eating family meals could be assessed more reliably than what foods a person usually eats, and if family meal eating
BOX 7-1 Definitions of Two Behavioral Indicators
Surrogate Behavioral Indicators
Target Behavioral Indicators