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          Abstract

          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.

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          Most cited references27

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          Global physical activity questionnaire (GPAQ): nine country reliability and validity study.

          Instruments to assess physical activity are needed for (inter)national surveillance systems and comparison. Male and female adults were recruited from diverse sociocultural, educational and economic backgrounds in 9 countries (total n = 2657). GPAQ and the International Physical Activity Questionnaire (IPAQ) were administered on at least 2 occasions. Eight countries assessed criterion validity using an objective measure (pedometer or accelerometer) over 7 days. Reliability coefficients were of moderate to substantial strength (Kappa 0.67 to 0.73; Spearman's rho 0.67 to 0.81). Results on concurrent validity between IPAQ and GPAQ also showed a moderate to strong positive relationship (range 0.45 to 0.65). Results on criterion validity were in the poor-fair (range 0.06 to 0.35). There were some observed differences between sex, education, BMI and urban/rural and between countries. Overall GPAQ provides reproducible data and showed a moderate-strong positive correlation with IPAQ, a previously validated and accepted measure of physical activity. Validation of GPAQ produced poor results although the magnitude was similar to the range reported in other studies. Overall, these results indicate that GPAQ is a suitable and acceptable instrument for monitoring physical activity in population health surveillance systems, although further replication of this work in other countries is warranted.
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            Validity of the Global Physical Activity Questionnaire (GPAQ) in assessing levels and change in moderate-vigorous physical activity and sedentary behaviour

            Background Feasible, cost-effective instruments are required for the surveillance of moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB) and to assess the effects of interventions. However, the evidence base for the validity and reliability of the World Health Organisation-endorsed Global Physical Activity Questionnaire (GPAQ) is limited. We aimed to assess the validity of the GPAQ, compared to accelerometer data in measuring and assessing change in MVPA and SB. Methods Participants (n = 101) were selected randomly from an on-going research study, stratified by level of physical activity (low, moderate or highly active, based on the GPAQ) and sex. Participants wore an accelerometer (Actigraph GT3X) for seven days and completed a GPAQ on Day 7. This protocol was repeated for a random sub-sample at a second time point, 3–6 months later. Analysis involved Wilcoxon-signed rank tests for differences in measures, Bland-Altman analysis for the agreement between measures for median MVPA and SB mins/day, and Spearman’s rho coefficient for criterion validity and extent of change. Results 95 participants completed baseline measurements (44 females, 51 males; mean age 44 years, (SD 14); measurements of change were calculated for 41 (21 females, 20 males; mean age 46 years, (SD 14). There was moderate agreement between GPAQ and accelerometer for MVPA mins/day (r = 0.48) and poor agreement for SB (r = 0.19). The absolute mean difference (self-report minus accelerometer) for MVPA was −0.8 mins/day and 348.7 mins/day for SB; and negative bias was found to exist, with those people who were more physically active over-reporting their level of MVPA: those who were more sedentary were less likely to under-report their level of SB. Results for agreement in change over time showed moderate correlation (r = 0.52, p = 0.12) for MVPA and poor correlation for SB (r = −0.024, p = 0.916). Conclusions Levels of agreement with objective measurements indicate the GPAQ is a valid measure of MVPA and change in MVPA but is a less valid measure of current levels and change in SB. Thus, GPAQ appears to be an appropriate measure for assessing the effectiveness of interventions to promote MVPA.
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              Practical guide to measuring physical activity.

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                Author and article information

                Contributors
                k.rudolf@dshs-koeln.de
                florian.lammer@t-online.de
                g.stassen@dshs-koeln.de
                froboese@dshs-koeln.de
                a.schaller@dshs-koeln.de
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                12 February 2020
                12 February 2020
                2020
                : 20
                : 223
                Affiliations
                [1 ]ISNI 0000 0001 2244 5164, GRID grid.27593.3a, Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, , German Sport University Cologne, ; Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
                [2 ]ISNI 0000 0001 2244 5164, GRID grid.27593.3a, Working group physical activity-related prevention research, , German Sport University Cologne, ; Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
                [3 ]ISNI 0000 0001 2244 5164, GRID grid.27593.3a, Center for Health and Physical Activity, , German Sport University Cologne, ; Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
                [4 ]IST-University of Applied Sciences, Erkrather Straße 220 a-c, 40233 Düsseldorf, Germany
                Author information
                http://orcid.org/0000-0001-9815-3475
                Article
                8312
                10.1186/s12889-020-8312-x
                7017628
                32050940
                62b965db-bde4-42ad-9c17-0c2c4ea42ee6
                © The Author(s). 2020

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 16 August 2019
                : 3 February 2020
                Funding
                Funded by: German Federal Ministry of Education and Research
                Award ID: 01EL1425A
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Public health
                physical activity assessment,accelerometry,instrument psychometrics,measurement,methods

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