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Development and convergent validity of new self-administered questionnaires of active transportation in three African countries: Kenya, Mozambique and Nigeria.

ABSTRACT: BACKGROUND:There is currently a rapid physical activity transition taking place in developing countries that includes a decrease in active transportation. Building on findings from an earlier systematic review, this paper describes the development and convergent validity of self-administered child and parent questionnaires assessing active transportation of children in three African countries: Kenya, Mozambique and Nigeria. METHODS:A pilot study was conducted to examine the convergent validity of the developed questionnaires by comparing responses between children and their parents (N?=?121; n?=?43 for Mozambique, n?=?24 for Kenya and n?=?54 for Nigeria). After modification, the questionnaires were then administered to a larger convenient sample of both children and parents from Kenya (n?=?1123), Mozambique (n?=?1097) and Nigeria (n?=?831) which defined the main study. The questionnaires assessed active transportation to/from 8 categories of destinations including school, friends' and relatives' home/houses, parks and playgrounds among others. Twenty items were used to assess child - and parent-perceived barriers to active transportation, and the parent questionnaire inquired about parent education and availability of cars, motorcycles, and bicycles. Spearman's rho was used to compare children's mode of travel in the pilot study while the prevalence-adjusted bias-adjusted kappa (PABAK) coefficient was used to compare convergent validity between children's and parents responses on active transportation in the main study. RESULTS:Findings of the main study show that convergent validity for active transportation to and from each destination in the combined sample ranged from 0.472 (from school) to 0.998 (to other places). Convergent validity for challenges/barriers to active transportation to school ranged from fair (0.30 - The route does not have good lighting) to substantial (0.77 - My child has a disability). It varied between countries from fair (n?=?11-items) to moderate (n?=?9-items) agreement in Kenya and from poor (n?=?2-items) to fair (n?=?16-items) agreement in Nigeria. Data from Mozambique was however missing and therefore could be included. CONCLUSIONS:The questionnaires provided valid information on the number of trips to/from various destinations and show acceptable and modest convergent validity for measuring barriers to active transport in a sample of children from three African countries. These questionnaires may be suitable for future research on active transport among school children in Sub-Saharan African countries.

SUBMITTER: Onywera VO

PROVIDER: S-EPMC6097429 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Development and convergent validity of new self-administered questionnaires of active transportation in three African countries: Kenya, Mozambique and Nigeria.

Onywera Vincent O VO Larouche Richard R Oyeyemi Adewale L AL Prista Antonio A Akinroye Kingsley K KK Heyker Sylvester S Owino George E GE Tremblay Mark S MS

BMC public health 20180816 1

<h4>Background</h4>There is currently a rapid physical activity transition taking place in developing countries that includes a decrease in active transportation. Building on findings from an earlier systematic review, this paper describes the development and convergent validity of self-administered child and parent questionnaires assessing active transportation of children in three African countries: Kenya, Mozambique and Nigeria.<h4>Methods</h4>A pilot study was conducted to examine the conver ...[more]

PMID: 30115064

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Project description:BackgroundPhysical activity (PA) is associated with numerous health benefits among children and youth. However, few studies have examined how active transportation (AT) and device-based measures of PA vary within and between countries in sub-Saharan Africa.PurposeThis cross-sectional study sought to investigate the prevalence and correlates of AT and device-measured PA among children living in urban, peri-urban and rural areas in three African countries representing Eastern, Western and Southern regions of Africa.Methods3,205 participants (53.3% girls; 46.7% boys) aged 10-12 years were recruited in Kenya, Nigeria and Mozambique. Data were collected using a child questionnaire, a parent/guardian questionnaire and PiezoRx® pedometers. ANCOVA and binary logistic regression analyses were used to examine the correlates of AT and PA while controlling for gender, age, parent education and vehicle ownership.ResultsParticipants accumulated an average of 45.6±23.5 min/day of moderate-to-vigorous physical activity (MVPA) and 11,215±4,273 steps/day. Kenyan and Mozambican children were significantly more active than their Nigerian counterparts (p<0.001). Only 23% met the MVPA guidelines of 60 min/day. 65.1% of participants engaged in AT to school (and 67.8% for the trip back home) with no gender differences. Living in a rural area, lower parent education, lower vehicle ownership and higher motorcycle ownership were associated with higher odds of AT. Other correlates of AT were country-specific. Girls accumulated less daily MVPA than boys in all countries. MVPA was positively associated with living in less urbanized areas in Nigeria and Mozambique. In Kenya, lower parental education and AT were associated with higher MVPA. Nigerian children's daily MVPA decreased with age and the number of parent-perceived barriers to AT.ConclusionsMajority of children engaged in AT, but still failed to meet MVPA recommendations. Most correlates of AT and PA were country-specific, suggesting that strategies to encourage both behaviours should be informed by local evidence.

Project description:ObjectiveTo examine the validity of the Recent Physical Activity Questionnaire (RPAQ) which assesses physical activity (PA) in 4 domains (leisure, work, commuting, home) during past month.Methods580 men and 1343 women from 10 European countries attended 2 visits at which PA energy expenditure (PAEE), time at moderate-to-vigorous PA (MVPA) and sedentary time were measured using individually-calibrated combined heart-rate and movement sensing. At the second visit, RPAQ was administered electronically. Validity was assessed using agreement analysis.ResultsRPAQ significantly underestimated PAEE in women [median(IQR): 34.9 (22.3, 52.8) vs. 40.6 (32.4, 50.9) kJ/kg/day, 95%LoA: -44.4, 66.1 kJ/kg/day) and overestimated PAEE in men [45.9 (30.6, 71.1) vs. 45.5 (34.1, 57.6) kJ/kg/day, 95%LoA: -44.8, 102.6 kJ/kg/day]. Using individualised definition of 1MET, RPAQ significantly underestimated MVPA in women [median(IQR): 63.7 (30.5, 126.9) vs. 73.6 (47.8, 107.2) min/day, 95%LoA: -127.4, 311.9 min/day] and overestimated MVPA in men [90.0 (42.3, 188.6) vs. 83.3 (55.1, 125.0) min/day, 95%LoA: -134.8, 427.3 min/day]. Correlations (95%CI) between subjective and objective estimates were statistically significant [PAEE: women, rho = 0.20 (0.15-0.26); men, rho = 0.37 (0.30-0.44); MVPA: women, rho = 0.18 (0.13-0.24); men, rho = 0.31 (0.24-0.38)]. When using non-individualised definition of 1MET (3.5 mlO2/kg/min), MVPA was substantially overestimated (16 min/day, and 32 min/day in women and men, respectively). Revisiting occupational intensity assumptions in questionnaire estimation algorithms with occupational group-level empirical distributions reduced median PAEE-bias in manual (38.8 kJ/kg/day vs. 6.8 kJ/kg/day, p<0.001) and heavy manual workers (63.6 vs. -2.8 kJ/kg/day, p<0.001) in an independent hold-out sample [corrected].ConclusionRelative validity of RPAQ-derived PAEE and MVPA is comparable to previous studies but underestimation of PAEE is smaller. Electronic RPAQ may be used in large-scale epidemiological studies including surveys, providing information on all domains of PA.

Project description:ObjectivesTo examine the effect of routinely administered psychiatric questionnaires on the recognition, management, and outcome of psychiatric disorders in non-psychiatric settings.Data sourcesEmbase, Medline, PsycLIT, Cinahl, Cochrane Controlled Trials Register, and hand searches of key journals.MethodsA systematic review of randomised controlled trials of the administration and routine feedback of psychiatric screening and outcome questionnaires to clinicians in non-psychiatric settings. Narrative overview of key design features and end points, together with a random effects quantitative synthesis of comparable studies.Main outcome measuresRecognition of psychiatric disorders after feedback of questionnaire results; interventions for psychiatric disorders; and outcome of psychiatric disorders.ResultsNine randomised studies were identified that examined the use of common psychiatric instruments in primary care and general hospital settings. Studies compared the effect of the administration of these instruments followed by the feedback of the results to clinicians, with administration with no feedback. Meta-analytic pooling was possible for four of these studies (2457 participants), which measured the effect of feedback on the recognition of depressive disorders. Routine administration and feedback of scores for all patients (irrespective of score) did not increase the overall rate of recognition of mental disorders such as anxiety and depression (relative risk of detection of depression by clinician after feedback 0.95, 95% confidence interval 0.83 to 1.09). Two studies showed that routine administration followed by selective feedback for only high scorers increased the rate of recognition of depression (relative risk of detection of depression after feedback 2.64, 1.62 to 4.31). This increased recognition, however, did not translate into an increased rate of intervention. Overall, studies of routine administration of psychiatric measures did not show an effect on patient outcome.ConclusionsThe routine measurement of outcome is a costly exercise. Little evidence shows that it is of benefit in improving psychosocial outcomes of those with psychiatric disorder managed in non-psychiatric settings.

Project description:BACKGROUND:Despite the increasing use of medical records to measure quality of care, studies have shown that their validity is suboptimal. The objective of this study is to assess the concordance of cardiovascular care processes evaluated through medical record review and patient self-administered questionnaires (SAQs) using ten quality indicators (TRANSIT indicators). These indicators were developed as part of a participatory research program (TRANSIT study) dedicated to TRANSforming InTerprofessional clinical practices to improve cardiovascular disease (CVD) prevention in primary care. METHODS:For every patient participating in the TRANSIT study, the compliance to each indicator (individual scores) as well as the mean compliance to all indicators of a category (subscale scores) and to the complete set of ten indicators (overall scale score) were established. Concordance between results obtained using medical records and patient SAQs was assessed by prevalence-adjusted bias-adjusted kappa (PABAK) coefficients as well as intraclass correlation coefficients (ICCs) and 95% confidence intervals (95% CI). Generalized linear mixed models (GLMM) were used to identify patients' sociodemographic and clinical characteristics associated with agreement between the two data sources. RESULTS:The TRANSIT study was conducted in a primary care setting among patients (n?=?759) with multimorbidity, at moderate (16%) and high risk (83%) of cardiovascular diseases. Quality of care, as measured by the TRANSIT indicators, varied substantially between medical records and patient SAQ. Concordance between the two data sources, as measured by ICCs (95% CI), was poor for the subscale (0.18 [0.08-0.27] to 0.46 [0.40-0.52]) and overall (0.46 [0.40-0.53]) compliance scale scores. GLMM showed that agreement was not affected by patients' characteristics. CONCLUSIONS:In quality improvement strategies, researchers must acknowledge that care processes may not be consistently recorded in medical records. They must also be aware that the evaluation of the quality of care may vary depending on the source of information, the clinician responsible of documenting the interventions, and the domain of care.

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Development and convergent validity of new self-administered questionnaires of active transportation in three African countries: Kenya, Mozambique and Nigeria.

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Development and convergent validity of new self-administered questionnaires of active transportation in three African countries: Kenya, Mozambique and Nigeria.

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