Abstract
BackgroundSocio-cultural differences for country-specific activities are rarely addressed in physical activity questionnaires. We examined the reliability and validity of the Indian Migration Study Physical Activity Questionnaire (IMS-PAQ) in urban and rural groups in India.MethodsA sub-sample of IMS participants (n = 479) was used to examine short term (≤1 month [n = 158]) and long term (> 1 month [n = 321]) IMS-PAQ reliability for levels of total, sedentary, light and moderate/vigorous activity (MVPA) intensity using intraclass correlation (ICC) and kappa coefficients (k). Criterion validity (n = 157) was examined by comparing the IMS-PAQ to a uniaxial accelerometer (ACC) worn ≥4 days, via Spearman's rank correlations (ρ) and k, using Bland-Altman plots to check for systematic bias. Construct validity (n = 7,000) was established using linear regression, comparing IMS-PAQ against theoretical constructs associated with physical activity (PA): BMI [kg/m2], percent body fat and pulse rate.ResultsIMS-PAQ reliability ranged from ICC 0.42-0.88 and k = 0.37-0.61 (≤1 month) and ICC 0.26 to 0.62; kappa 0.17 to 0.45 (> 1 month). Criterion validity was ρ = 0.18-0.48; k = 0.08-0.34. Light activity was underestimated and MVPA consistently and substantially overestimated for the IMS-PAQ vs. the accelerometer. Criterion validity was moderate for total activity and MVPA. Reliability and validity were comparable for urban and rural participants but lower in women than men. Increasing time spent in total activity or MVPA, and decreasing time in sedentary activity were associated with decreasing BMI, percent body fat and pulse rate, thereby demonstrating construct validity.ConclusionIMS-PAQ reliability and validity is similar to comparable self-reported instruments. It is an appropriate tool for ranking PA of individuals in India. Some refinements may be required for sedentary populations and women in India.
Highlights
Socio-cultural differences for country-specific activities are rarely addressed in physical activity questionnaires
Within this study the Indian Migration Study Physical Activity Questionnaire (IMS-Physical Activity Questionnaire (PAQ)) consistently overestimated time spent in moderate/vigorous physical activity (MVPA) compared to the Actigraph 7164® uniaxial accelerometer, an issue which has been reported elsewhere [32]
The clustered nature of the sample by sib-pairs, whilst accounted for within construct validity, may have underestimated confidence intervals (CI) presented for the reliability and construct validity substudies. Questionnaires such as the International Physical Activity Questionnaire (IPAQ) and Global Physical Activity Questionnaire (GPAQ) designed to capture physical activity (PA) at a population level are often too prescriptive in style to fully encompass socio-cultural differences, preventing detailed information being gathered on country-specific activities across multipledomains
Summary
Socio-cultural differences for country-specific activities are rarely addressed in physical activity questionnaires. Evidence derived mainly from observational studies undertaken predominantly in High Income Countries (HICs), has established that there are clear health benefits from a physically active lifestyle irrespective of age, The role of low physical activity as an important independent risk factor for many Non-communicable Diseases (NCD) has been well documented in the Western population,[3,5,6] yet there still remains a lack of evidence from population specific studies in Low and Middle Income Countries (LMICs) such as India Whilst international questionnaires such as the International Physical Activity Questionnaire (IPAQ) and Global Physical Activity Questionnaire (GPAQ) have been proven to be valid and reliable,[7,8,9] their structure and design may limit more detailed information being gathered on regional-specific activities within rural and urban areas and across multiple domains (e.g. country-specific sports or household chores such as watering walls and making cow-dung cakes). If shown to be reliable and valid, the IMS could provide an important contribution to PA monitoring and assessment as suggested by the WHO Global Strategy for Diet, Physical Activity and Health [4] within India and more generally across south Asia
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