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Fiona C. Bull, Karen Milton and Sonja Kahlmeier

Background:

Physical inactivity is a leading risk factor for noncommunicable disease worldwide. Increasing physical activity requires large scale actions and relevant, supportive national policy across multiple sectors.

Methods:

The policy audit tool (PAT) was developed to provide a standardized instrument to assess national policy approaches to physical activity. A draft tool, based on earlier work, was developed and pilot-tested in 7 countries.

Results:

After several rounds of revisions, the final PAT comprises 27 items and collects information on 1) government structure, 2) development and content of identified key policies across multiple sectors, 3) the experience of policy implementation at both the national and local level, and 4) a summary of the PAT completion process.

Conclusions:

PAT provides a standardized instrument for assessing progress of national policy on physical activity. Engaging a diverse international group of countries in the development helped ensure PAT has applicability across a wide range of countries and contexts. Experiences from the development of the PAT suggests that undertaking an audit of health enhancing physical activity (HEPA) policy can stimulate greater awareness of current policy opportunities and gaps, promote critical debate across sectors, and provide a catalyst for collaboration on policy level actions. The final tool is available online.

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Fiona C. Bull, Tahlia S. Maslin and Timothy Armstrong

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.

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Terry Boyle, Jane Heyworth, Fiona C. Bull and Lin Fritschi

Background:

One of the convenient ways to achieve recommended levels of physical activity is through ‘active transport,’ such as walking or cycling to and from work or school. Although studies have shown that participants can reliably recall information about recent transport-related physical activity, it is not known if the reliability remains high when asking about lifetime behavior. This study tested the reliability of questions that collect information about transport-related physical activity performed over the lifetime.

Methods:

Participants were asked to complete self-administered questions about transport-related physical activity on 2 separate occasions. The questions asked about cycling and walking to and from work and/or school during 3 age periods: 15−24 years, 25−39 years, and 40 years and above. A lifetime average was also calculated for cycling, walking, and total activity.

Results:

There was fair to good test-retest reliability of the age-period specific questions for transport-related cycling (ICCs from 0.65−0.74), walking (ICCs from 0.44−0.58), and total activity (ICCs from 0.57−0.66). The reliability of the lifetime averages were also fair to good (ICCs from 0.58−0.70).

Conclusions:

The questions tested in this study have moderate reliability, and appear to be useful questions for measuring lifetime transport-related physical activity.

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Fiona C. Bull, Lise Gauvin, Adrian Bauman, Trevor Shilton, Harold W. Kohl III and Art Salmon

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Dori E. Rosenberg, Fiona C. Bull, Alison L. Marshall, James F. Sallis and Adrian E. Bauman

Purpose:

This study explored definitions of sedentary behavior and examined the relationship between sitting time and physical inactivity using the sitting items from the International Physical Activity Questionnaire (IPAQ).

Methods:

Participants (N = 289, 44.6% male, mean age = 35.93) from 3 countries completed self-administered long- and short-IPAQ sitting items. Participants wore accelero-meters; were classified as inactive (no leisure-time activity), insufficiently active, or meeting recommendations; and were classified into tertiles of sitting behavior.

Results:

Reliability of sitting time was acceptable for men and women. Correlations between total sitting and accelerometer counts/min <100 were significant for both long (r = .33) and short (r = .34) forms. There was no agreement between tertiles of sitting and the inactivity category (kappa = .02, P = .68).

Conclusion:

Sedentary behavior should be explicitly measured in population surveillance and research instead of being defined by lack of physical activity.

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Sylvia Titze, Billie Giles-Corti, Matthew W. Knuiman, Terri J. Pikora, Anna Timperio, Fiona C. Bull and Kimberly van Niel

Background:

This study investigated the relationship between individual and neighborhood environmental factors and cycling for transport and for recreation among adults living in Perth, Western Australia.

Methods:

Baseline cross-sectional data from 1813 participants (40.5% male; age range 18 to 78 years) in the RESIDential Environment (RESIDE) project were analyzed. The questionnaire included information on cycling behavior and on cycling-specific individual, social environmental, and neighborhood environmental attributes. Cycling for transport and recreation were dichotomized as whether or not individuals cycled in a usual week.

Results:

Among the individual factors, positive attitudes toward cycling and perceived behavioral control increased the odds of cycling for transport and for recreation. Among the neighborhood environmental attributes, leafy and attractive neighborhoods, access to bicycle/walking paths, the presence of traffic slowing devices and having many 4-way street intersections were positively associated with cycling for transport. Many alternative routes in the local area increased the odds of cycling for recreation.

Conclusions:

Effective strategies for increasing cycling (particularly cycling for transport) may include incorporating supportive environments such as creating leafy and attractive neighborhood surroundings, low traffic speed, and increased street connectivity, in addition to campaigns aimed at strengthening positive attitudes and confidence to cycle.

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Areekul Amornsriwatanakul, Kasem Nakornkhet, Piyawat Katewongsa, Chairat Choosakul, Tippawan Kaewmanee, Kurusart Konharn, Atchara Purakom, Anoma Santiworakul, Patraporn Sitilertpisan, Sonthaya Sriramatr, Araya Yankai, Michael Rosenberg and Fiona C. Bull

Background:

Physical activity (PA) is recognized as one of the core modifiable risk factors of noncommunicable diseases. However, little is known about PA in the Thai population, particularly in children. The report card (RC) project provided Thailand with an opportunity to assess PA behaviors in children. This paper summarizes the methodology, grading process, and the final grades of the Thai RC.

Methods:

A school-based survey was conducted to collect data from a nationally representative sample of children aged 6 to 17 years. Survey results provided the primary source for the RC. Nine indicators were graded using the Global Matrix 2.0 framework. Grading was undertaken by a national committee comprising experts from key stakeholders.

Results:

Grades ranged from F to B. Overall PA and Sedentary Behaviors both received the grade D-. Organized Sport Participation scored a C. Active Play scored the grade F. Active Transport and support from Family and Peers were both graded B. School, Community, and Government indicators were scored C.

Conclusions:

In Thai children, participation in PA and active play is very low; conversely, sedentary behaviors are high. These first data on patterns of activity for the Thailand RC will serve to guide national actions and advocacy aimed at increasing PA in children.