Measuring physical activity among pregnant women using a structured one-week recall questionnaire: evidence for validity and reliability

Fang Wen,Kelly R Evenson

doi:10.1186/1479-5868-7-21

Abstract

BackgroundAccurate measurement of the components of physical activity during pregnancy can aid in our understanding of the dose response relationships between physical activity and corresponding perinatal outcomes. The aim of this study was to develop and evaluate a one-week recall questionnaire to assess moderate to vigorous physical activity during pregnancy.MethodsTo assess concurrent-related validity, 177 pregnant women (median 18 weeks' gestation, interquartile range (IQR) 15 -23) kept a structured diary and wore an accelerometer (Actigraph) for one week. At the conclusion of the week, they completed the Pregnancy Infection and Nutrition 3 (PIN3) physical activity questionnaire over the telephone. To assess evidence for test-retest reliability, 109 pregnant women (median 19 weeks' gestation, IQR 18-27) completed the questionnaire twice over the telephone, within 48 hours apart, recalling the same two time periods. Spearman correlation coefficients (SCC) and intraclass correlation coefficients (ICC) were used to assess evidence for validity and reliability, respectively.ResultsComparison of the questionnaire to the structured diary was moderate to substantial (SCC 0.47 to 0.69) for several measures of moderate or vigorous physical activity using either perceived or absolute intensity. Comparison of moderate to vigorous physical activity from the questionnaire (absolute intensity using MET-hours/week) to the accelerometer ranged from 0.12 to 0.23 using SCC for absolute intensity (MET-hours/week) and 0.28 to 0.34 using relative intensity (hours/week) (n = 177). Test-retest reliability was moderate to almost perfect for moderate to vigorous physical activity, with the ICC ranging from 0.56 to 0.82 for both perceived and absolute intensities.ConclusionsThe PIN3 one-week recall questionnaire assessed moderate to vigorous physical activity in the past week with evidence for reliability and validity.

Highlights

Accurate measurement of the components of physical activity during pregnancy can aid in our understanding of the dose response relationships between physical activity and corresponding perinatal outcomes
We developed a one-week recall questionnaire to assess moderate to vigorous physical activity during pregnancy for use in the third Pregnancy Infection and Nutrition (PIN3) Study
Using recreational activity as an example, the question asked: “In the past week, did you participate in any non-work, recreational activity or exercise, such as walking for exercise, swimming, or dancing, that caused at least some increase in breathing and heart rate?” If the participant responded ‘Yes’, the interviewer asked her to list all types of activities, one by one, with the following question: “What type of recreational activities did you do during the past week?” For each activity, the participant reported the number of sessions per week, duration of each session, and the perceived intensity level using the following options: ‘fairly light,’ ‘somewhat hard,’ and ‘hard or very hard’

Summary

Introduction

Accurate measurement of the components of physical activity during pregnancy can aid in our understanding of the dose response relationships between physical activity and corresponding perinatal outcomes. The aim of this study was to develop and evaluate a one-week recall questionnaire to assess moderate to vigorous physical activity during pregnancy. Several decades of research supports the benefits of physical activity during pregnancy [1,2]. Several physician organizations endorse physical activity during pregnancy with position statements, such as in Canada [3], the United Kingdom [4], and the United States (US) [5]. The US government included a section on pregnancy recommendations in its national “2008 Physical Activity Guidelines for Americans” [1]. To evaluate and provide more specific evidence towards guidelines, accurate assessment of physical activity during pregnancy is needed. In epidemiologic studies of pregnant women, one goal for the questionnaire is to properly rank women within a narrow range of physical activity [6]

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