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Validity and responsiveness of the Global Physical Activity Questionnaire (GPAQ) in assessing physical activity during pregnancy.

ABSTRACT: The physiological and biomechanical changes that occur during pregnancy make accurate measurement of physical activity (PA) a challenge during this unique period. The Global Physical Activity Questionnaire (GPAQ) has been used extensively in low-to-middle income countries, but has never been validated in a pregnant population. In this longitudinal study, 95 pregnant women (mean age: 29.5±5.7 years; BMI: 26.9±5.0 kg/m2) completed the GPAQ and were asked to wear an accelerometer for 7 days at two time points during pregnancy (14-18 and 29-33 weeks gestation). There was a significant difference between accelerometry and GPAQ when measuring moderate-to-vigorous physical activity (MVPA) at 29-33 weeks gestation (16.6 vs 21.4 min/day; p = 0.02) as well as sedentary behaviour (SB) at both 14-18 weeks (457.0 vs 300 min/day; p < 0.01) and 29-33 weeks gestation (431.5 vs 300 min/day; p < 0.01). There was poor agreement between the GPAQ and accelerometry for both PA and SB at both time points (ICC: -0.05-0.08). Bland Altman plots indicated that the GPAQ overestimates PA by 14.8 min/day at 14-18 weeks and by 15.8 min/day at 29-33 weeks gestation. It underestimates SB by 127.5 min/day at 14-18 weeks and by 89.2 min/day at 29-33 weeks gestation. When compared to accelerometry, the GPAQ shows poor agreement and appears to overestimate PA and underestimate SB during pregnancy.

SUBMITTER: Watson ED

PROVIDER: S-EPMC5446115 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Validity and responsiveness of the Global Physical Activity Questionnaire (GPAQ) in assessing physical activity during pregnancy.

Watson Estelle D ED Micklesfield Lisa K LK van Poppel Mireille N M MNM Norris Shane A SA Sattler Matteo C MC Dietz Pavel P

PloS one 20170526 5

The physiological and biomechanical changes that occur during pregnancy make accurate measurement of physical activity (PA) a challenge during this unique period. The Global Physical Activity Questionnaire (GPAQ) has been used extensively in low-to-middle income countries, but has never been validated in a pregnant population. In this longitudinal study, 95 pregnant women (mean age: 29.5±5.7 years; BMI: 26.9±5.0 kg/m2) completed the GPAQ and were asked to wear an accelerometer for 7 days at two ...[more]

PMID: 28552977

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Project description:Feasible and cost-effective as well as population specific instruments for monitoring physical activity (PA) levels are needed for the management and prevention of non-communicable diseases. The WHO-endorsed Global Physical Activity Questionnaire (GPAQ) has been widely used in developing countries, but the evidence base for its validity, particularly for rural populations, is still limited. The aim of the study was to validate GPAQ among rural and urban residents in Bangladesh.A total of 162 healthy participants of both genders aged 18-60 years were recruited from Satia village (n = 97) and Dhaka City (n = 65). Participants were invited to take part in the study and were asked to wear an accelerometer (GT3X) for 7 days, after which they were invited to answer the GPAQ in a face to face interview.Valid accelerometer data (i.e., ≥10 h of wear times over ≥3 days) were received from 155 participants (rural = 94, urban = 61). The mean age was 35 (SD = ±9) years, 55% were females and 19% of the participants had no schooling, which was higher in the rural area (21% vs 17%). The mean ± SD steps/day was 9998 ± 3936 (8658 ± 2788 and 12,063 ± 4534 for rural and urban respectively, p = 0.0001) and the mean ± SD daily moderate-to-vigorous physical activity (MVPA) was 58 ± 30 min (51 ± 26 for rural and 69 ± 34 for the urban, p = 0.001) for accelerometer. In case of GPAQ, rural residents reported significantly higher moderate work related PA (MET-minutes/week: 600 vs. 360 p = 0.02). Spearman correlation coefficients between GPAQ total MVPA MET-min/day and accelerometer MVPA min/day, counts per minute (CPM) or steps counts/day were acceptable for urban residents (rho: 0.46, 0.55 and 0.63, respectively; p < 0.01) but poor for rural residents. The overall correlation between the GPAQ and accelerometer for sitting was low (rho: 0.23; p < 0.001). GPAQ-Accelerometer correlation for MVPA was higher for females (rho: 0.42), ≤35 age group (rho: 0.31) and those with higher education attainment (rho: 0.48). The Bland-Altman plots illustrated bias towards over estimation of GPAQ MVPA with increased activity levels for urban and rural residents.GPAQ is an acceptable measure for physical activity surveillance in Bangladesh particularly for urban residents, women and people with high education. Given waist worn accelerometers do not capture the typical PA in rural context, further study using a physical activity diary and a combination of multiple sensors (e.g., wrist, ankle and waist worn accelerometers) to capture all movement is warranted among rural population with purposive sampling of all education levels.

Project description:BACKGROUND:The Global Physical Activity Questionnaire (GPAQ) is applied internationally as a tool to assess the level of physical activity. The GPAQ was designed as an interview, including the use of show cards, which visualise activities of moderate and intensive physical activity and support the distinction between these intensities. The self-administered version of the GPAQ is used in the application-oriented research for reasons of economy and practicality. However, the use of show cards often remains unknown. The aim of the present study was to examine differences in validity between two self-administered versions of the GPAQ with and without show cards. METHODS:In this crossover study, two groups (n?=?54; 57.4% female; 28.3?±?12.2?years) received the GPAQ with or without show cards after 7 days and the respective other version after additional 7 days. For validation, all participants wore an accelerometer (ActiGraph GT3X+) on all 14?days. Differences between GPAQ versions and accelerometer data were compared by Wilcoxon signed rank test. Additionally, Spearman analyses and Bland-Altman plots were calculated. RESULTS:No statistically significant difference between the GPAQ versions could be found in regard to the accuracy of physical activity assessment (p?>?0.05). Both GPAQ versions show similar correlation coefficients for vigorous physical activity (rho?=?0.31-0.42) and sedentary behaviour (rho?=?0.29-0.32). No statistically significant correlation was found for physical activity of moderate intensity. The Bland-Altman plots support these results, as both GPAQ versions have the same trends in terms of overestimation and underestimation of physical activity. CONCLUSION:The use of show cards had no significant impact on questionnaire validity. Therefore, both GPAQ versions can be applied interchangeably. Nevertheless the exact description of application of the GPAQ is desirable in terms of reproducibility and transparent scientific research.

Project description:BACKGROUND:The promotion of a physically active lifestyle might help address the increasing burden of non-communicable diseases in Nepal. However, there is a lack of nationally representative estimates of physical activity (PA) prevalence in Nepal. The aim of this nationwide cross-sectional study was to determine domain-specific PA levels and the association of socio-demographic and lifestyle characteristics with total PA among Nepalese adults aged 15-69 years. METHODS:The data were collected using self-administered questionnaires in a nationally representative sample of 4143 adults (66.5% females), comprised of both rural and urban populations in Nepal. PA levels were assessed using the Global Physical Activity Questionnaire (GPAQ). RESULTS:Based on self-reported estimates, around 97% (95% confidence interval [CI]: 96-98%) of men and 98% (95% CI: 98-99%) of women were found to meet the recommended levels of PA. Both men and women reported high occupational PA, whilst most participants of both sexes did not report engaging in any leisure-time PA. A multiple regression analysis showed that less self-reported total PA was associated with older age, higher level of education, urban place of residence, never been married, being underweight, and smoking in both sexes and with overweight and obesity in males (p < 0.05 for all). CONCLUSION:According to self-reported estimates, majority of Nepalese men and women are meeting the recommended levels of PA. The total self-reported PA in Nepalese adults is high, because many of them have labour intensive jobs. Although older age, higher level of education, urban place of residence, never been married, being underweight, and smoking in both sexes, as well as overweight and obesity in males were inversely associated with self-reported PA, the overall level of PA in all these groups was very high. Given the high overall self-reported PA found in the current study, promoting more PA in Nepal may not be as important as in some other countries; not even in the population groups for which we found a negative association with PA. Nevertheless, future studies should examine whether a more balanced distribution of occupational and leisure-time PA would promote better health among Nepalese adults.

Dataset Information

Validity and responsiveness of the Global Physical Activity Questionnaire (GPAQ) in assessing physical activity during pregnancy.

Publications

Validity and responsiveness of the Global Physical Activity Questionnaire (GPAQ) in assessing physical activity during pregnancy.

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