Abstract
BackgroundOnly few studies have focused on the cognitive processes of the respondents that are involved when answering physical activity questionnaires (PAQs). This study aimed at examining whether two PAQs work as intended with different segments of the survey population in different cultural settings in Europe.MethodsThe International Physical Activity Questionnaire - Short Form (IPAQ-SF) and the US National Health Interview Survey - Adult Core Physical Activity Questionnaire (NHIS-PAQ) were tested in Belgium, Estonia, Germany and the UK using a standardized cognitive interviewing procedure. IPAQ-SF measures total vigorous physical activity (PA), moderate PA, walking and sitting. NHIS-PAQ measures leisure-time vigorous PA, light and moderate PA and muscle-strengthening PA. In total 62 persons completed cognitive interviews, at least 15 interviews were conducted in each country.ResultsBoth PAQs performed as intended with young and high-skilled persons and those having a regular exercise schedule. For the others, however, the testing revealed that problems occurred with both PAQs relating to understanding the concepts of ‘(light and) moderate’ and ‘vigorous’ PA, classifying activities into the provided answer options of different PA intensities, recalling instances of ‘normal’ activities such as walking and sitting, and calculating the total duration of more than one activity or instance of an activity. The revealed problems with the questionnaires were quite similar in different countries; profound cultural differences were not observed.ConclusionsBoth questionnaires were difficult to answer for many respondents and rather user-unfriendly. They are designed to measure an exactness of PA quantity (frequency and duration) and intensity which would be desirable to obtain from a scientific point of view; however, respondents can hardly provide this information for cognitive reasons. Studies investigating the respondents’ perspective are useful for improving physical activity information based on self-reports.Electronic supplementary materialThe online version of this article (doi:10.1186/s13690-015-0109-5) contains supplementary material, which is available to authorized users.
Highlights
Few studies have focused on the cognitive processes of the respondents that are involved when answering physical activity questionnaires (PAQs)
Physical activity (PA) is foreseen to be assessed via self-reports within the second wave of the European Health Interview Survey (EHIS), a common EU instrument developed by Eurostat [4]
Reported reasons why respondents indicated that the NHIS-PAQ is easier to answer were that they don’t do any LTPA or that it measures exactly what they do, which is LTPA
Summary
Few studies have focused on the cognitive processes of the respondents that are involved when answering physical activity questionnaires (PAQs). Health interview survey (HIS) questionnaires that are used in population health monitoring systems are generally extensive – data on many health topics are obtained – the sub-modules must be concise and easy to answer in different cultural settings. Many studies have investigated the construct validity of PA questionnaires (PAQs) by comparing self-reported and objectively measured PA information. Few studies have focused on the cognitive processes of the respondents that are involved when answering PAQs [11]. Answering quantitative questions requires that respondents understand what the questions refer to and which behavior they are supposed to report. Cognitive interviewing is a qualitative method used to evaluate the respondents’ understanding of the questions and answer mechanisms, to identify problems in the design of survey questions and possible reasons for misclassification bias [15]
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