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Rasmus T. Larsen, Christoffer B. Korfitsen, Carsten B. Juhl, Henning Boje Andersen, Henning Langberg and Jan Christensen

for guiding researchers and clinicians in designing studies and interpreting results. Several participant-reported physical activity measurements have been developed, with slightly different purposes. Among these are the International Physical Activity Questionnaire-short form (IPAQ-SF) and the Nordic

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Liane S. Lewis, James Hernon, Allan Clark and John M. Saxton

people is lacking ( Department of Health, 2011 ). However, valid PA measures are needed to assess the effectiveness of interventions targeted at this population. The International Physical Activity Questionnaire long version (IPAQ-L) was developed to measure PA across ages and countries and to enable

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Levi Frehlich, Christine Friedenreich, Alberto Nettel-Aguirre, Jasper Schipperijn and Gavin R. McCormack

( Doma, Speyer, Leicht, & Cordier, 2017 ). Recently, we adapted and tested the measurement properties of the International Physical Activity Questionnaire (IPAQ) to capture neighborhood-based physical activity undertaken in the last week, finding that the self-administered tool had moderate to excellent

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Robin P. Shook, Nicole C. Gribben, Gregory A. Hand, Amanda E. Paluch, Gregory J. Welk, John M. Jakicic, Brent Hutto, Stephanie Burgess and Steven N. Blair

Background:

Subjective measures of moderate and vigorous physical activity (MVPA) rely on relative intensity whereas objective measures capture absolute intensity; thus, fit individuals and unfit individuals may perceive the same activity differently.

Methods:

Adults (N = 211) wore the SenseWear Armband (SWA) for 10 consecutive days to objectively assess sedentary time and MVPA. On day 8, participants completed the International Physical Activity Questionnaire (IPAQ) to subjectively assess sitting time and MVPA. Fitness was assessed via a maximal treadmill test, and participants were classified as unfit if the result was in the bottom tertile of the study population by sex or fit if in the upper 2 tertiles.

Results:

Overall, estimates of MVPA between the IPAQ and SWA were not significantly different (IPAQ minus SWA, 67.4 ± 919.1 MVPA min/wk, P = .29). However, unfit participants overestimated MVPA using the IPAQ by 37.3% (P = .02), but fit participants did not (P = .99). This between-group difference was due to overestimation, using the IPAQ, of moderate activity by 93.8 min/wk among the unfit individuals, but underestimation of moderate activity among the fit participants by 149.4 min/wk.

Conclusion:

Subjective measures of MVPA using the IPAQ varied by fitness category; unfit participants overestimated their MVPA and fit participants accurately estimated their MVPA.

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Marijke Hopman-Rock, Elise Dusseldorp, Astrid Chorus, Gert Jacobusse, Alfred Ruetten and Stef van Buuren

Background:

Many questionnaires for measuring physical activity (PA) exist. This complicates the comparison of outcomes.

Methods:

In 8 European countries, PA was measured in random samples of 600 persons, using the IPAQ as a ‘bridge’ to historical sets of country-specific questions. We assume that a unidimensional scale of PA ability exists on which items and respondents can be placed, irrespective of country, culture, background factors, or measurement instrument. Response Conversion (RC) based on Item Response Theory (IRT) was used to estimate such a common PA scale, to compare PA levels between countries, and to create a conversion key. Comparisons were made with Eurobarometer (IPAQ) data.

Results:

Appropriateness of IRT was supported by the existence of a strong first dimension established by principal component analysis. The IRT analysis resulted in 1 common PA scale with a reasonable fit and face validity. However, evidence for cultural bias (Differential Item Functioning, DIF) was found in all IPAQ items. This result made actual comparison between countries difficult.

Conclusions:

Response Conversion can improve comparability in the field of PA. RC needs common items that are culturally unbiased. Wide-scale use of RC awaits measures that are more culturally invariant (such as international accelerometer data).

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Andreas Wolff Hansen, Inger Dahl-Petersen, Jørn Wulff Helge, Søren Brage, Morten Grønbæk and Trine Flensborg-Madsen

Background:

The International Physical Activity Questionnaire (IPAQ) is commonly used in surveys, but reliability and validity has not been established in the Danish population.

Methods:

Among participants in the Danish Health Examination survey 2007–2008, 142 healthy participants (45% men) wore a unit that combined accelerometry and heart rate monitoring (Acc+HR) for 7 consecutive days and then completed the IPAQ. Background data were obtained from the survey. Physical activity energy expenditure (PAEE) and time in moderate, vigorous, and sedentary intensity levels were derived from the IPAQ and compared with estimates from Acc+HR using Spearman’s correlation coefficients and Bland-Altman plots. Repeatability of the IPAQ was also assessed.

Results:

PAEE from the 2 methods was significantly positively correlated (0.29 and 0.49; P = 0.02 and P < 0.001; for women and men, respectively). Men significantly overestimated PAEE by IPAQ (56.2 vs 45.3 kJ/kg/day, IPAQ: Acc+HR, P < .01), while the difference was nonsignificant for women (40.8 vs 44.4 kJ/kg/day). Bland-Altman plots showed that the IPAQ overestimated PAEE, moderate, and vigorous activity without systematic error. Reliability of the IPAQ was moderate to high for all domains and intensities (total PAEE intraclass correlation coefficient = 0.58).

Conclusions:

This Danish Internet-based version of the long IPAQ had modest validity and reliability when assessing PAEE at population level.

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Lise Crinière, Claire Lhommet, Agnès Caille, Bruno Giraudeau, Pierre Lecomte, Charles Couet, Jean-Michel Oppert and David Jacobi

Background:

Increasing physical activity and decreasing sedentary time are cornerstones in the management of type 2 diabetes (T2DM). However, there are few instruments available to measure physical activity in this population. We translated the long version of the International Physical Activity Questionnaire (IPAQ-L) into French and studied its reproducibility and validity in patients with T2DM.

Methods:

Reproducibility was studied by 2 telephone administrations, 8 days apart. Concurrent validity was tested against pedometry for 7 days during habitual life.

Results:

One-hundred forty-three patients with T2DM were recruited (59% males; age: 60.9 ± 10.5 years; BMI: 31.2 ± 5.2 kg/m2; HbA1c: 7.4 ± 1.2%). Intraclass correlation coefficients (95% CI) for repeated administration (n = 126) were 0.74 (0.61−0.83) for total physical activity, 0.72 (0.57−0.82) for walking, and 0.65 (0.51−0.78) for sitting time. Total physical activity and walking (MET-min·week-1) correlated with daily steps (Spearman r = .24 and r = .23, respectively, P < .05). Sitting time (min·week-1) correlated negatively with daily steps in women (r = −0.33; P < .05).

Conclusion:

Our French version of the IPAQ-L appears reliable to assess habitual physical activity and sedentary time in patients with T2DM, confirming previous data in nonclinical populations.

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Ann Forsyth, J. Michael Oakes and Kathryn H. Schmitz

Background:

The Twin Cities Walking Study measured the associations of built environment versus socioeconomic and psychosocial variables with total physical activity and walking for 716 adults.

Methods:

This article reports on the test–retest reliability of the survey portion of the study. To test the reliability of the study measures, 158 respondents completed measures twice within 1 to 4 weeks. Agreement between participants’ responses was measured using Pearson r and Spearman rho, and kappa statistics.

Results:

Demographic questions are highly reliable (R > .8). Questions about environmental and social features are typically less reliable (rho range = 0.42– 0.91). Reliability of the International Physical Activity Questionnaire (last 7 days version) was low (rho = 0.15 for total activity).

Conclusions:

Much of the survey has acceptable-to-good reliability. The low test–retest reliability points to potential limitations of using a single administration of the IPAQ to characterize habitual physical activity. Implications for sound inference are accordingly complicated.

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Rute Santos, Maria Paula Santos, José Carlos Ribeiro and Jorge Mota

Background:

The aims of this study were to describe physical activity (PA) prevalence and compare it with other countries and to investigate possible associations between PA and other lifestyle behaviors in Azorean adults.

Methods:

9991 adults (5723 women), aged 37.8 ± 9.5 years, of the 2004 Azorean Physical Activity and Health Study. IPAQ assessed PA. All other lifestyle behaviors (age, gender, education level, income, employment, marital status, number of children, meal frequency, sleep time, sitting time, body mass index and alcohol and tobacco consumptions) were also self-reported.

Results:

57.1% of the participants met current PA recommendations and 32.2% were categorized as Health Enhancing PA (HEPA). Women were less likely to achieve PA recommendations, as well as the HEPA level. In both genders, higher education level, employment status, higher income, and sitting for more than 3h/day were negative predictors of HEPA; and, having at least 5 meals/day was positive predictor for the same PA level.

Conclusions:

There is a significant proportion of Azoreans, particularly women, that does not do enough PA. Targeted programs for Azoreans aimed to increase PA levels should pay special attention on women, and consider a multifactorial approach, once several lifestyle behaviors seem to interact with PA levels, in this population.

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Marita Södergren, Kristina Sundquist, Sven-Erik Johansson, Jan Sundquist and Maria Hagströmer

Background:

The purpose of this study was to examine the association between total self-reported health-enhancing physical activity and country of birth among women living in Sweden.

Methods:

Women (age 18 to 65 years) born in Sweden, Finland, Chile, and Iraq were recruited for this cross-sectional study. Data were collected by means of a postal questionnaire including the International Physical Activity Questionnaire (IPAQ-long version). Self-reported physical activity data were converted to MET-minutes per week and analyzed as continuous or categorical scores. A total of 2649 women were included in the analyses. The association between physical activity and country of birth was explored using ordinal logistic regression assuming proportional odds.

Results:

The total physical activity differed significantly between the countries of birth (P < .001). Women from Finland had significant higher odds and women from Iraq had significantly lower odds for reporting higher levels of physical activity, compared with Swedish-born women.

Conclusions:

The direction of the associations between self-reported total health-enhancing physical activity varied by country of birth, which underlines the need to examine physical activity in each minority group separately.