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Validity of the global physical activity questionnaire (GPAQ) in Bangladesh.

ABSTRACT: 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.

SUBMITTER: Mumu SJ

PROVIDER: S-EPMC5553893 | biostudies-other | 2017 Aug

REPOSITORIES: biostudies-other

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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: Physical activity patterns of a population remain mostly assessed by the questionnaires. However, few physical activity questionnaires have been validated in Asian populations. We previously utilized a combination of different questionnaires to assess leisure time, transportation, occupational and household physical activity in the Singapore Prospective Study Program (SP2). The International Physical Activity Questionnaire (IPAQ) has been developed for a similar purpose. In this study, we compared estimates from these two questionnaires with an objective measure of physical activity in a multi-ethnic Asian population. METHODS: Physical activity was measured in 152 Chinese, Malay and Asian Indian adults using an accelerometer over five consecutive days, including a weekend. Participants completed both the physical activity questionnaire in SP2 (SP2PAQ) and IPAQ long form. 43 subjects underwent a second set of measurements on average 6 months later to assess reproducibility of the questionnaires and the accelerometer measurements. Spearman correlations were used to evaluate validity and reproducibility and correlations for validity were corrected for within-person variation of accelerometer measurements. Agreement between the questionnaires and the accelerometer measurements was also evaluated using Bland Altman plots. RESULTS: The corrected correlation with accelerometer estimates of energy expenditure from physical activity was better for the SP2PAQ (vigorous activity: r = 0.73; moderate activity: r = 0.27) than for the IPAQ (vigorous activity: r = 0.31; moderate activity: r = 0.15). For moderate activity, the corrected correlation between SP2PAQ and the accelerometer was higher for Chinese (r = 0.38) and Malays (r = 0.57) than for Indians (r = -0.09). Both questionnaires overestimated energy expenditure from physical activity to a greater extent at higher levels of physical activity than at lower levels of physical activity. The reproducibility for moderate activity (accelerometer: r = 0.68; IPAQ: r = 0.58; SP2PAQ: r = 0.55) and vigorous activity (accelerometer: 0.52; IPAQ: r = 0.38; SP2PAQ: r = 0.75) was moderate to high for all instruments. CONCLUSION: The agreement between IPAQ and accelerometer measurements of energy expenditure from physical activity was poor in our Asian study population. The SP2PAQ showed good validity and reproducibility for vigorous activity, but performed less well for moderate activity particularly in Indians. Further effort is needed to develop questionnaires that better capture moderate activity in Asian populations.

Project description:ObjectivesThe use of brief screening tools to identify inactive patients is essential to improve the efficiency of primary care-based physical activity (PA) programs. However, the current employment of short PA questionnaires within the Spanish primary care pathway is unclear. This study evaluated the validity of the Spanish version of a Brief Physical Activity Assessment Tool (SBPAAT).MethodsA validation study was carried out within the EVIDENT project. A convenience sample of patients (n = 1,184; age 58.9±13.7 years; 60.5% female) completed the SBPAAT and the 7-day Physical Activity Recall (7DPAR) and, in addition, wore an accelerometer (ActiGraph GT3X) for seven consecutive days. Validity was evaluated by measuring agreement, Kappa correlation coefficients, sensitivity and specificity in achieving current PA recommendations with the 7DPAR. Pearson correlation coefficients with the number of daily minutes engaged in moderate and vigorous intensity PA according to the accelerometer were also assessed. Comparison with accelerometer counts, daily minutes engaged in sedentary, light, moderate, and vigorous intensity PA, total daily kilocalories, and total PA and leisure time expenditure (METs-hour-week) between the sufficiently and insufficiently active groups identified by SBPAAT were reported.ResultsThe SBPAAT identified 41.3% sufficiently active (n = 489) and 58.7% insufficiently active (n = 695) patients; it showed moderate validity (k = 0.454, 95% CI: 0.402-0.505) and a specificity and sensitivity of 74.3% and 74.6%, respectively. Validity was fair for identifying daily minutes engaged in moderate (r = 0.215, 95% CI:0.156 to 0.272) and vigorous PA (r = 0.282, 95% CI:0.165 to 0.391). Insufficiently active patients according to the SBPAAT significantly reported fewer counts/minute (-22%), fewer minutes/day of moderate (-11.38) and vigorous PA (-2.69), spent fewer total kilocalories/day (-753), and reported a lower energy cost (METs-hour-week) of physical activities globally (-26.82) and during leisure time (-19.62).ConclusionsThe SBPAAT is a valid tool to identify Spanish-speaking patients who are insufficiently active to achieve health benefits.

Project description:Measuring physical activity (PA) and sedentary time (ST) in young children (<5 years) is complex. Objective measures have high validity but require specialist expertise, are expensive, and can be burdensome for participants. A proxy-report instrument for young children that accurately measures PA and ST is needed. The aim of this study was to assess the reliability and validity of the Early Years Physical Activity Questionnaire (EY-PAQ). In a setting where English and Urdu are the predominant languages spoken by parents of young children, a sample of 196 parents and their young children (mean age 3.2 ± 0.8 years) from Bradford, UK took part in the study. A total of 156 (79.6%) questionnaires were completed in English and 40 (20.4%) were completed in transliterated Urdu. A total of 109 parents took part in the reliability aspect of the study, which involved completion of the EY-PAQ on two occasions (7.2 days apart; standard deviation (SD) = 1.1). All 196 participants took part in the validity aspect which involved comparison of EY-PAQ scores against accelerometry. Validty anaylsis used all data and data falling with specific MVPA and ST boundaries. Reliability was assessed using intra-class correlations (ICC) and validity by Bland⁻Altman plots and rank correlation coefficients. The test re-test reliability of the EY-PAQ was moderate for ST (ICC = 0.47) and fair for moderate-to-vigorous physical activity (MVPA)(ICC = 0.35). The EY-PAQ had poor agreement with accelerometer-determined ST (mean difference = -87.5 min·day-1) and good agreement for MVPA (mean difference = 7.1 min·day-1) limits of agreement were wide for all variables. The rank correlation coefficient was non-significant for ST (rho = 0.19) and significant for MVPA (rho = 0.30). The EY-PAQ has comparable validity and reliability to other PA self-report tools and is a promising population-based measure of young children's habitual MVPA but not ST. In situations when objective methods are not possible for measurement of young children's MVPA, the EY-PAQ may be a suitable alternative but only if boundaries are applied.

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.

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Validity of the global physical activity questionnaire (GPAQ) in Bangladesh.

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