Accurate assessment is required to assess current and changing physical activity levels, and to evaluate the effectiveness of interventions designed to increase activity levels. This study systematically reviewed the literature to determine the extent of agreement between subjectively (self-report e.g. questionnaire, diary) and objectively (directly measured; e.g. accelerometry, doubly labeled water) assessed physical activity in adults. Eight electronic databases were searched to identify observational and experimental studies of adult populations. Searching identified 4,463 potential articles. Initial screening found that 293 examined the relationship between self-reported and directly measured physical activity and met the eligibility criteria. Data abstraction was completed for 187 articles, which described comparable data and/or comparisons, while 76 articles lacked comparable data or comparisons, and a further 30 did not meet the review's eligibility requirements. A risk of bias assessment was conducted for all articles from which data was abstracted. Correlations between self-report and direct measures were generally low-to-moderate and ranged from -0.71 to 0.96. No clear pattern emerged for the mean differences between self-report and direct measures of physical activity. Trends differed by measure of physical activity employed, level of physical activity measured, and the gender of participants. Results of the risk of bias assessment indicated that 38% of the studies had lower quality scores. The findings suggest that the measurement method may have a significant impact on the observed levels of physical activity. Self-report measures of physical activity were both higher and lower than directly measured levels of physical activity, which poses a problem for both reliance on self-report measures and for attempts to correct for self-report – direct measure differences. This review reveals the need for valid, accurate and reliable measures of physical activity in evaluating current and changing physical activity levels, physical activity interventions, and the relationships between physical activity and health outcomes.

/pdf/a-comparison-of-direct-versus-self-report-measures-for-ebc2zoxerg.pdf

A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review

Purpose: Instruments to assess physical activity are needed for (inter)national surveillance systems and comparison. Methods: 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. Results: 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. Conclusions: 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.

Global Physical Activity Questionnaire (GPAQ) : nine country reliability and validity study

The aim of developing the World Health Organization (WHO) Global Physical Activity Questionnaire (GPAQ) was to have a tool that would produce valid and reliable estimates of physical activity, especially relevant to developing countries where patterns of energy expenditure differ from developed countries because people experience diverse ways of life. The development of a standardized tool to measure physical activity that enables comparisons across culturally diverse populations is a challenging task. Comparable, valid, and reliable information on physical activity enables countries to follow trends over time, understand regional and global comparisons, and better inform physical activity policy decisions. A WHO expert working group on physical activity measurement provided a draft GPAQ for global consultation. The draft instrument was validated in nine countries. Validation studies and qualitative feedback on GPAQ were presented at an Expert Meeting on Global Physical Activity Surveillance held jointly by WHO and the US Centers for Disease Control and Prevention. A second round of global consultation led to minor revisions and preparation of a final GPAQ version 2 instrument (GPAQv2). Around 50 developing countries are now using GPAQ for physical activity data collection. GPAQv2 is a suitable physical activity surveillance instrument for developing countries.

Development of the world health organization global physical activity questionnaire (gpaq)

To develop more efficient programmes for promoting dietary and/or physical activity change (in order to prevent type 2 diabetes) it is critical to ensure that the intervention components and characteristics most strongly associated with effectiveness are included The aim of this systematic review of reviews was to identify intervention components that are associated with increased change in diet and/or physical activity in individuals at risk of type 2 diabetes MEDLINE, EMBASE, CINAHL, PsycInfo, and the Cochrane Library were searched for systematic reviews of interventions targeting diet and/or physical activity in adults at risk of developing type 2 diabetes from 1998 to 2008 Two reviewers independently selected reviews and rated methodological quality Individual analyses from reviews relating effectiveness to intervention components were extracted, graded for evidence quality and summarised Of 3856 identified articles, 30 met the inclusion criteria and 129 analyses related intervention components to effectiveness These included causal analyses (based on randomisation of participants to different intervention conditions) and associative analyses (eg meta-regression) Overall, interventions produced clinically meaningful weight loss (3-5 kg at 12 months; 2-3 kg at 36 months) and increased physical activity (30-60 mins/week of moderate activity at 12-18 months) Based on causal analyses, intervention effectiveness was increased by engaging social support, targeting both diet and physical activity, and using well-defined/established behaviour change techniques Increased effectiveness was also associated with increased contact frequency and using a specific cluster of "self-regulatory" behaviour change techniques (eg goal-setting, self-monitoring) No clear relationships were found between effectiveness and intervention setting, delivery mode, study population or delivery provider Evidence on long-term effectiveness suggested the need for greater consideration of behaviour maintenance strategies This comprehensive review of reviews identifies specific components which are associated with increased effectiveness in interventions to promote change in diet and/or physical activity To maximise the efficiency of programmes for diabetes prevention, practitioners and commissioning organisations should consider including these components

/pdf/systematic-review-of-reviews-of-intervention-components-k0tocs4g1z.pdf

Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions

Physical activity improves health. Different types of activity promote different types of physiologic changes and different health outcomes. A curvilinear reduction in risk occurs for a variety of diseases and conditions across volume of activity, with the steepest gradient at the lowest end of the activity scale. Some activity is better than none, and more is better than some. Even light-intensity activity appears to provide benefit and is preferable to sitting still. When increasing physical activity toward a desired level, small and well-spaced increments will reduce the incidence of adverse events and improve adherence. Prior research on the relationship between activity and health has focused on the value of moderate to vigorous activity on top of an indefinite and shifting baseline. Given emerging evidence that light activities have health benefits and with advances in tools for measuring activities of all intensities, it may be time to shift to zero activity as the conceptual starting point for study.

https://www.annualreviews.org/doi/pdf/10.1146/annurev-publhealth-031210-101151

Physical activity for health: What kind? How much? How intense? On top of what?

Despite extensive use over 40 years, physical activity questionnaires still show limited reliability and validity. Measurements have value in indicating conditions where an increase in physical activity would be beneficial and in monitoring changes in population activity. However, attempts at detailed interpretation in terms of exercise dosage and the extent of resulting health benefits seem premature. Such usage may become possible through the development of standardised instruments that will record the low intensity activities typical of sedentary societies, and will ascribe consistent biological meaning to terms such as light, moderate, and heavy exercise.

https://bjsm.bmj.com/content/bjsports/37/3/197.full.pdf

R J Shephard

Papers

Limits to the measurement of habitual physical activity by questionnaires