Validity of the global physical activity questionnaire (GPAQ) in Bangladesh

Abstract

BackgroundFeasible and cost-effective as well as population specific instruments for monitoring physical activity (PA) levels are needed for the management and prevention of non-communicable diseases. The WHO-endorsed Global Physical Activity Questionnaire (GPAQ) has been widely used in developing countries, but the evidence base for its validity, particularly for rural populations, is still limited. The aim of the study was to validate GPAQ among rural and urban residents in Bangladesh.MethodsA total of 162 healthy participants of both genders aged 18–60 years were recruited from Satia village (n = 97) and Dhaka City (n = 65). Participants were invited to take part in the study and were asked to wear an accelerometer (GT3X) for 7 days, after which they were invited to answer the GPAQ in a face to face interview.ResultsValid accelerometer data (i.e., ≥10 h of wear times over ≥3 days) were received from 155 participants (rural = 94, urban = 61). The mean age was 35 (SD = ±9) years, 55% were females and 19% of the participants had no schooling, which was higher in the rural area (21% vs 17%). The mean ± SD steps/day was 9998 ± 3936 (8658 ± 2788 and 12,063 ± 4534 for rural and urban respectively, p = 0.0001) and the mean ± SD daily moderate-to-vigorous physical activity (MVPA) was 58 ± 30 min (51 ± 26 for rural and 69 ± 34 for the urban, p = 0.001) for accelerometer. In case of GPAQ, rural residents reported significantly higher moderate work related PA (MET-minutes/week: 600 vs. 360 p = 0.02). Spearman correlation coefficients between GPAQ total MVPA MET-min/day and accelerometer MVPA min/day, counts per minute (CPM) or steps counts/day were acceptable for urban residents (rho: 0.46, 0.55 and 0.63, respectively; p < 0.01) but poor for rural residents. The overall correlation between the GPAQ and accelerometer for sitting was low (rho: 0.23; p < 0.001). GPAQ-Accelerometer correlation for MVPA was higher for females (rho: 0.42), ≤35 age group (rho: 0.31) and those with higher education attainment (rho: 0.48). The Bland-Altman plots illustrated bias towards over estimation of GPAQ MVPA with increased activity levels for urban and rural residents.ConclusionGPAQ is an acceptable measure for physical activity surveillance in Bangladesh particularly for urban residents, women and people with high education. Given waist worn accelerometers do not capture the typical PA in rural context, further study using a physical activity diary and a combination of multiple sensors (e.g., wrist, ankle and waist worn accelerometers) to capture all movement is warranted among rural population with purposive sampling of all education levels.

Comparison of Self-Reported Sedentary Time on Weekdays with an Objective Measure (activPAL)

“…More recently, Wanner et al (2017) performed a similar study including Swiss, German, Italian and French populations and reported the moderate correlation (r = 0.47, p < .001) and an underestimation of 88 min/day (ActiGraph produces only 1.2 times higher sitting time than GPAQ). The authors assume that substantially higher correlation that was reported in other studies (Aguilar-Farias & Leppe Zamora, 2017;Cleland et al, 2014;Mumu, Ali, Barnett, & Merom, 2017) might be due to the use of self-administered format of GPAQ. Indeed, this assumption has been supported recently (Chu et al, 2018).…”

Objective measurement of physical activity and sedentary behavior among South Asian adults: A systematic review

“…Within the South Asian sample, mean light physical activity range was 211.7 (67. 3) [ 49 ] to 574.4 (227) min/day [ 36 ]. Curry et al, reported significant differences in mean min/day of light physical activity performed over weekdays vs weekends in women born in UK 316.5 (106.7) vs those born in Pakistan 253.4 (95.1) or Bangladesh 288.9 (113.8), in women under 65 years of age and those belonging to under-weight or normal weight category ( Table 3 ).…”

“…Of the 14 studies, six were conducted in United Kingdom (UK) [37][38][39][40][41][42], two in the United States (USA) [37][38][39][40][41][42][43][44], and one each in Canada [45], Norway [45,46], Netherlands [36], Singapore [47], India [48] and Bangladesh [49] (Table 1). Thirteen out of 14 studies used an Acti-Graph (Pensacola, Florida, USA) with two using a Sensewear Armband (BodyMedia, Inc., Pittsburgh, PA) [41] and a pedometer [42] along with the ActiGraph.…”

A Cross-Sectional Examination of Physical Activity Levels and Their Socio-Demographic Determinants in Southern Tanzania

“…Questions exploring domains of physical activity were based on the WHO Stepwise approach for surveillance tool for NCDs and their risk factors (STEPS) in member countries [ 30 ]. The physical activity questions, which have been validated in different settings [ 31 , 32 , 33 ], assessed MPA and VPA from work, transport (by foot or bicycle) as well as leisure-related activities. The merits of this questionnaire include the assessment of different physical activity domains, provision of activity examples to improve the understanding of interviewees, and the limited need to define leisure time for retirees and older adults [ 34 ].…”