Enhancing the Content Validity of Self-Reported Physical Activity Self-Efficacy in Adolescents: A Qualitative Study

Abstract

Purpose: This study's primary purpose was to enhance the content validity of a self-reported measure of self-efficacy for physical activity (PA) in adolescents. This was addressed through assessment of younger and older adolescents' understanding of the construct of self-efficacy for PA, coupled with assessment of the content coverage and comprehensibility of items derived from existing measures. Methods: Participants completed individual semistructured and cognitive debriefing interviews as well as 3 PA self-efficacy questionnaires. Results: Thematic analysis identified personal and environmental facilitators and barriers to PA self-efficacy. The major categories were physical; psychological; interaction with surroundings; support and relationships; attitudes; and services, systems, and natural environments. Cognitive interviews resulted in the retention of 52 final items: 24 for self-efficacy with perceived facilitators and 28 for self-efficacy to overcome barriers. Conclusions: This study provides a PA self-efficacy instrument with expanded content coverage that is relevant to adolescents as young as 11 years. With further validation testing in future studies, this instrument will enable pediatric physical therapists and researchers to assess PA self-efficacy and design effective intervention strategies to improve PA.

Convergent Validity of the Patient Reported Outcome Measurement Information System-Pediatric Physical Activity Instrument (PROMIS®-PA) with Wearable Devices in Adolescents

“…Self-reported physical activity (e.g., using YAP or PROMIS) may be better suited for larger clinical trials, natural history, or epidemiological trials for which wearable devices are not feasible or available. Our prior qualitative study [ 24 ] indicated that most interviewed participants (17 out of 18 adolescents) reported a preference to completing the EoD surveys over completing multiple short EMAs throughout the day, as well as over the 7-day recall reporting. The reasons provided were that the EoD reporting would be a more convenient option and easier to adhere to than the EMA; moreover, there was such little variation in their activity across days that one day (EoD reporting) would be a sufficient recall period to summarize their performed PA over the day, and could be more accurate than the 7-day recall.…”

“…These EMA time frames were chosen to be consistent with the 5 specific time periods specified in the YAP to support comparisons across measures. The selection of the time periods was also supported by the participants’ preferences for responding to surveys in our prior qualitative study [ 24 ]. The EMA survey time frames were early morning, 6 to 8 a.m.; mid to late morning, 8 a.m. to 12 p.m.; early afternoon, 12 to 3 p.m.; late afternoon, 3 to 6 p.m.; and evening, 6 p.m. until your bedtime ( Table A1 in Appendix C ).…”