Correlates of Agreement between Accelerometry and Self-reported Physical Activity

Abstract

. Purpose: Understanding factors that influence accurate assessment of physical activity (PA) and sedentary behavior (SB) is important to measurement development, epidemiologic studies, and interventions. This study examined agreement between self-reported (International Physical Activity Questionnaire-Long Form [IPAQ-LF]) and accelerometry-based estimates of PA and SB across six countries and identified correlates of between-method agreement. Methods: Self-report and objective (accelerometry-based) PA and SB data were collected in 2002-2011 from 3865 adult participants in eight cities from six countries (Belgium, Czech Republic, Denmark, Spain, United Kingdom, and United States). Between-method relative agreement (correlation) and absolute disagreement (mean difference between conceptually and intensity-matched IPAQ-LF and accelerometry-based PA and SB variables) were estimated. Also, sociodemographic characteristics and PA patterns were examined as correlates of betweenmethod agreement. Results: Observed relative agreement (relationships of IPAQ-LF with accelerometry-based PA and SB variables) was small to moderate (r = 0.05-0.37) and was moderated by sociodemographic (age, sex, weight status, and education) and behavioral (PAtype) factors. The absolute disagreement was large, with participants self-reporting higher PA intensity and total time in moderate-tovigorous-intensity PA than accelerometry. Also, self-reported sitting time was lower than accelerometry-based sedentary behavior. After adjusting for sociodemographic and behavioral factors, the absolute disagreement between pairs of IPAQ-LF and accelerometry-based PA variables remained significantly different across cities/countries. Conclusions: Present findings suggest systematic cultural and/or linguistic and sociodemographic differences in absolute agreement between the IPAQ-LF and the accelerometry-based PA and SB variables. These results have implications for the interpretation of international PA and SB data and correlate/determinant studies. They call for further efforts to improve such measures. Key Words: INTERNATIONAL PHYSICAL ACTIVITY QUESTIONNAIRE, LONG FORM, INTERNA-TIONAL, SOCIODEMOGRAPHIC FACTORS, MEASUREMENT, EXERCISE, SEDENTARY TIME P revalence data for physical activity (PA) and sedentary behavior (SB) are now available for dozens of countries based on self-report surveys (1,2,18). The validity and the between-country comparability of these data rely on survey items having the same meaning across cultures and languages and capturing relevant behaviors that are prevalent in specific populations (24). The International Physical Activity Questionnaire (IPAQ) was developed for international use and has evidence of reliability and validity (9). Although the IPAQ-Short Form has been most often used for international prevalence studies (1,2), the IPAQ-Long Form (IPAQ-LF) has also been used in international research, especially in research focused on domain-specific PA and studies of the environmental correlates of PA and SB (6,9). The main diff...