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Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Validation of the NPAQ-short – a brief questionnaire to monitor physical activity and compliance with the WHO recommendations

Authors: Ida Høgstedt Danquah, Christina Bjørk Petersen, Sofie Smedegaard Skov, Janne S. Tolstrup

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

Using self-reported surveys to monitor physical activity levels in the population require short items covering both time and intensity. The present study aims to 1) develop the Nordic Physical Activity Questionnaire-short from the original version of the NPAQ, 2) assess test-retest reliability and criterion validity of the NPAQ-short, and 3) test the NPAQ-short’s ability to monitor compliance with the WHO recommendations on physical activity. In addition, we aimed to compare open and closed-ended answering modes for the NPAQ-short.

Methods

A sample of 122 participants were included. The NPAQ-short comprised of two questions on weekly moderate-to-vigorous physical activity (MVPA) and vigorous physical activity (VPA). It was filled in twice, two weeks apart, in open- and closed-ended versions. Physical activity was measured objectively by an Actiheart accelerometer worn 24 h/day seven consecutive days. Spearman’s rank correlation and Cohen’s kappa were used to assess correlations between the test and retest results, and between the objective and the self-reported measures.

Results

Valid data was available for 92 participants. Test-retest reliability showed Spearman’s rho = 0.82 for MVPA and 0.80 for VPA. For the open-ended questions, the correlations between self-reported and objectively measured physical activity levels were Spearman’s rho = 0.33 for MVPA and rho = 0.32 for VPA. For closed-ended questions, the kappa-coefficients were 0.17 for MVPA and 0.21 for VPA. When using objective and self-reported measures to monitor WHO’s physical activity recommendations, the kappa correlations were 0.42 for open-ended and 0.34 for closed-ended answering modes.

Conclusion

The NPAQ-short was found to be sufficiently reliable and valid to monitor physical activity levels in the population when using both open and closed-ended questions. However, using open-ended questions seems to be a better answering mode for self-reported surveys monitoring WHO’s physical activity recommendations.
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Literature
1.
go back to reference Kelly P, Fitzsimons C, Baker G. Should we reframe how we think about physical activity and sedentary behaviour measurement? Validity and reliability reconsidered. Int J Behav Nutr Phys Act. 2016;13:32.CrossRefPubMedPubMedCentral Kelly P, Fitzsimons C, Baker G. Should we reframe how we think about physical activity and sedentary behaviour measurement? Validity and reliability reconsidered. Int J Behav Nutr Phys Act. 2016;13:32.CrossRefPubMedPubMedCentral
2.
go back to reference WHO. Global recommendations on physical Actitvity for health, vol. 1. Switzerland: World Health Organization; 2010. WHO. Global recommendations on physical Actitvity for health, vol. 1. Switzerland: World Health Organization; 2010.
3.
go back to reference Cleland CL, Hunter RF, Kee F, Cupples ME, Sallis JF, Tully MA. Validity of the global physical activity questionnaire (GPAQ) in assessing levels and change in moderate-vigorous physical activity and sedentary behaviour. BMC Public Health. 2014;14:1255.CrossRefPubMedPubMedCentral Cleland CL, Hunter RF, Kee F, Cupples ME, Sallis JF, Tully MA. Validity of the global physical activity questionnaire (GPAQ) in assessing levels and change in moderate-vigorous physical activity and sedentary behaviour. BMC Public Health. 2014;14:1255.CrossRefPubMedPubMedCentral
4.
go back to reference Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.CrossRefPubMed Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.CrossRefPubMed
5.
go back to reference Kim Y, Park I, Kang M. Convergent validity of the international physical activity questionnaire (IPAQ): meta-analysis. Public Health Nutr. 2013;16:440–52.CrossRefPubMed Kim Y, Park I, Kang M. Convergent validity of the international physical activity questionnaire (IPAQ): meta-analysis. Public Health Nutr. 2013;16:440–52.CrossRefPubMed
6.
go back to reference Lee PH, Macfarlane DJ, Lam TH, Stewart SM. Validity of the international physical activity questionnaire short form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act. 2011;8:115.CrossRefPubMedPubMedCentral Lee PH, Macfarlane DJ, Lam TH, Stewart SM. Validity of the international physical activity questionnaire short form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act. 2011;8:115.CrossRefPubMedPubMedCentral
7.
go back to reference Dillman DA, Smyth JD, Christian LM. Internet, phone, mail, and mixed-mode surveys: the tailored design method: John Wiley & Sons; 2014. Dillman DA, Smyth JD, Christian LM. Internet, phone, mail, and mixed-mode surveys: the tailored design method: John Wiley & Sons; 2014.
8.
go back to reference Knudsen VK, Sørensen MR, Matthiessen J, Fagt S, Groth MV: Dokumentationsrapport, pilotundersøgelse 2010. Intern rapport. DTU Fødevareinstitut, Det Nationale Forskningscenter for Velfærd; 2010. Knudsen VK, Sørensen MR, Matthiessen J, Fagt S, Groth MV: Dokumentationsrapport, pilotundersøgelse 2010. Intern rapport. DTU Fødevareinstitut, Det Nationale Forskningscenter for Velfærd; 2010.
9.
go back to reference De Leeuw ED, Dillman DA: International handbook of survey methodology. Taylor & Francis; 2008. De Leeuw ED, Dillman DA: International handbook of survey methodology. Taylor & Francis; 2008.
10.
go back to reference Olsson SJG, Ekblom O, Andersson E, Borjesson M, Kallings LV. Categorical answer modes provide superior validity to open answers when asking for level of physical activity: a cross-sectional study. Scand J Public Health. 2016;44:70–6.CrossRefPubMed Olsson SJG, Ekblom O, Andersson E, Borjesson M, Kallings LV. Categorical answer modes provide superior validity to open answers when asking for level of physical activity: a cross-sectional study. Scand J Public Health. 2016;44:70–6.CrossRefPubMed
11.
go back to reference Walter SD, Eliasziw M, Donner A. Sample size and optimal designs for reliability studies. StatMed. 1998;17:101–10. Walter SD, Eliasziw M, Donner A. Sample size and optimal designs for reliability studies. StatMed. 1998;17:101–10.
12.
go back to reference World Medical Association. World medical association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4.CrossRef World Medical Association. World medical association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4.CrossRef
13.
go back to reference Willis GB. Cognitive interviewing - a “how to” guide: Research Triangle Institute; 1999. Willis GB. Cognitive interviewing - a “how to” guide: Research Triangle Institute; 1999.
14.
go back to reference Brage S, Brage N, Franks PW, Ekelund U, Wareham NJ. Reliability and validity of the combined heart rate and movement sensor Actiheart. Eur J Clin Nutr. 2005;59:561–70.CrossRefPubMed Brage S, Brage N, Franks PW, Ekelund U, Wareham NJ. Reliability and validity of the combined heart rate and movement sensor Actiheart. Eur J Clin Nutr. 2005;59:561–70.CrossRefPubMed
16.
go back to reference CamNtech Ltd.: The Actiheart User Manual 4.0.109.2013. CamNtech Ltd.: The Actiheart User Manual 4.0.109.2013.
17.
go back to reference Matthiessen J, Andersen LF, Barbieri HE, Borodulin K, Knudsen VK, Kørup K, Thorgeirsdottir H, Trolle E, Fagt S. The Nordic monitoring system 2011–2014. Status and development of diet, physical activity, smoking, alcohol and overweight. Copenhagen: Nordic Council of Ministers; 2016. Matthiessen J, Andersen LF, Barbieri HE, Borodulin K, Knudsen VK, Kørup K, Thorgeirsdottir H, Trolle E, Fagt S. The Nordic monitoring system 2011–2014. Status and development of diet, physical activity, smoking, alcohol and overweight. Copenhagen: Nordic Council of Ministers; 2016.
18.
go back to reference Brage S, Brage N, Franks PW, Ekelund U, Wong MY, Andersen LB, Froberg K, Wareham NJ. Branched equation modeling of simultaneous accelerometry and heart rate monitoring improves estimate of directly measured physical activity energy expenditure. J Appl Physiol (1985). 2004;96:343–51.CrossRef Brage S, Brage N, Franks PW, Ekelund U, Wong MY, Andersen LB, Froberg K, Wareham NJ. Branched equation modeling of simultaneous accelerometry and heart rate monitoring improves estimate of directly measured physical activity energy expenditure. J Appl Physiol (1985). 2004;96:343–51.CrossRef
19.
go back to reference Wanner M, Probst-Hensch N, Kriemler S, Meier F, Bauman A, Martin BW. What physical activity surveillance needs: validity of a single-item questionnaire. Br J Sports Med. 2014;48:1570–6.CrossRefPubMed Wanner M, Probst-Hensch N, Kriemler S, Meier F, Bauman A, Martin BW. What physical activity surveillance needs: validity of a single-item questionnaire. Br J Sports Med. 2014;48:1570–6.CrossRefPubMed
20.
go back to reference Danquah IH, Kloster S, Holtermann A, Aadahl M, Bauman A, Ersboll AK, Tolstrup JS. Take a stand!-a multi-component intervention aimed at reducing sitting time among office workers-a cluster randomized trial. Int J Epidemiol. 2017;46:128–40.PubMed Danquah IH, Kloster S, Holtermann A, Aadahl M, Bauman A, Ersboll AK, Tolstrup JS. Take a stand!-a multi-component intervention aimed at reducing sitting time among office workers-a cluster randomized trial. Int J Epidemiol. 2017;46:128–40.PubMed
21.
go back to reference Altman DG. Practical statistics for medical research: Chapman & Hall; 1999. p. 455–60. Altman DG. Practical statistics for medical research: Chapman & Hall; 1999. p. 455–60.
22.
go back to reference Milton K, Clemes S, Bull F. Can a single question provide an accurate measure of physical activity? Br J Sports Med. 2013;47:44–8.CrossRefPubMed Milton K, Clemes S, Bull F. Can a single question provide an accurate measure of physical activity? Br J Sports Med. 2013;47:44–8.CrossRefPubMed
23.
go back to reference Ekelund U, Sepp H, Brage S, Becker W, Jakes R, Hennings M, Wareham NJ. Criterion-related validity of the last 7-day, short form of the international physical activity questionnaire in Swedish adults. Public Health Nutr. 2006;9:258–65.CrossRefPubMed Ekelund U, Sepp H, Brage S, Becker W, Jakes R, Hennings M, Wareham NJ. Criterion-related validity of the last 7-day, short form of the international physical activity questionnaire in Swedish adults. Public Health Nutr. 2006;9:258–65.CrossRefPubMed
24.
go back to reference Fagt S, Andersen LF, Anderssen SA, Becker W, Borodulin K, Fogelholm M, Groth MV, Gunnardottis I, Helakorpi S, Kolle E, et al. Nordic monitoring of diet, physical activity and overweight. Part 2. Report on validation studies on diet and physical activity 2009/2010. Copenhagen; 2011. Fagt S, Andersen LF, Anderssen SA, Becker W, Borodulin K, Fogelholm M, Groth MV, Gunnardottis I, Helakorpi S, Kolle E, et al. Nordic monitoring of diet, physical activity and overweight. Part 2. Report on validation studies on diet and physical activity 2009/2010. Copenhagen; 2011.
25.
go back to reference Christensen AL, Ekholm O, Davidsen M, Juel K. Sundhed og Sygelighed i Danmark 2010 - og udviklingen siden 1987. København: Statens Institut for Folkesundhed, Syddansk Universitet; 2012. Christensen AL, Ekholm O, Davidsen M, Juel K. Sundhed og Sygelighed i Danmark 2010 - og udviklingen siden 1987. København: Statens Institut for Folkesundhed, Syddansk Universitet; 2012.
Metadata
Title
Validation of the NPAQ-short – a brief questionnaire to monitor physical activity and compliance with the WHO recommendations
Authors
Ida Høgstedt Danquah
Christina Bjørk Petersen
Sofie Smedegaard Skov
Janne S. Tolstrup
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5538-y

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