Comparability of The Netherlands Physical Activity Questionnaire with Accelerometer-Measured Physical Activity in Samoan Children: A Retrospective Analysis of Ola Tuputupua'e Data.

Clara R Warmath,Nicola L Hawley,Courtney C Choy,Muagututia S Reupena,Lauren B Sherar,Rachel L Duckham,Elizabeth A Frame,Christina Soti-Ulberg,Take Naseri

doi:10.3390/ijerph18168438

Abstract

Accurate measurement of physical activity is critical to understand its role in cardiometabolic health and obesity development in children and to monitor trends in behavior and evaluate interventions. An ongoing mixed-longitudinal study of child growth and development in Samoa is collecting physical activity data with both accelerometers and the Netherlands Physical Activity Questionnaire (NPAQ). The aims of our analyses were to (1) describe the response frequency and correlations of individual questions in the NPAQ, (2) develop modified NPAQ scores with selected questions and (3) examine the concordance of modified NPAQ scores with accelerometer outcomes among children aged 2–4 years. We developed two modified NPAQ scores with combinations of questions and assessed concordance of the modified scores with accelerometer data using estimated marginal means adjusted for monitor wear time. Although the evenly distributed tertiles of the modified 15-point NPAQ score showed promising trends of increasing minutes of accelerometer-assessed high-intensity physical activity with increasing tertile, the estimated marginal means were imprecise with high variance, demonstrating that NPAQ score could not accurately assess physical activity levels of preschool-aged children in Samoa. Considering that questionnaires are often considered more cost-effective tools for physical activity measurement than accelerometry, further research is necessary to develop a culturally and age-appropriate physical activity questionnaire in this population.

Highlights

MethodsThe Ola Tuputupua’e (“Growing Up”) study is a mixed-longitudinal study examining determinants of child growth, health and development in Samoa
There is a growing burden of childhood overweight and obesity in low- and middleincome countries, with Pacific Island nations experiencing one of the highest increases in prevalence in the world
The Netherlands Physical Activity Questionnaire (NPAQ) had previously been used in other low- and middle-income country settings such as Brazil [11,12] and is less focused on structured play and organized sports than other questionnaires, which we considered more appropriate for the social and cultural context of Samoa

Summary

Methods

The Ola Tuputupua’e (“Growing Up”) study is a mixed-longitudinal study examining determinants of child growth, health and development in Samoa. Child pairs was recruited from 10 villages on the island of Upolu, the most populated of the Samoan Islands, where >75% of the population are residents [14]. At the time of recruitment, eligible mothers were over 18 years of age, not pregnant and reported no severe physical or cognitive impairments. Eligible children were between 2.00 and 4.99 years of age, of Samoan descent (based on the maternal report of the child having four Samoan grandparents) and had no maternal-reported physical or cognitive impairments

Results

Discussion

Conclusion