Validity, reliability, and calibration of the physical activity unit 7 item screener (PAU-7S) at population scale

Background Validation of self-reported tools, such as physical activity (PA) questionnaires, is crucial. The aim of this study was to determine test-retest reliability, internal consistency, and the concurrent, construct, and predictive validity of the short semi-quantitative Physical Activity Unit...

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Authors: Schroder, Helmut, Subirana, Isaac, Wärnberg, Julia, Medrano, Maria, Gonzalez-Gross, Marcela, Gusi, Narcis, Aznar, Susana, Alcaraz, Pedro E, Gonzalez-Valeiro, Miguel A., Serra-Majem, Lluis, Terrados, Nicolás, Tur, Josep A., Segu, Marta, Homs, Clara, Garcia-Alvarez, Alicia, Benavente-Marín, Juan Carlos, Barón-López, Francisco Javier, Labayen, Idoia, Zapico, Augusto Garcia, Sánchez-Gómez, Jesús, Jimenez-Zazo, Fabio, Marin-Cascales, Elena, Sevilla-Sanchez, Marta, Herrera-Ramos, Estefania, Pulgar, Susana, Bibiloni Esteva, Maria Del Mar, Sistac-Sorigué, Clara, Gomez, Santiago F.
Format: article
Publication Date:2021
Country:España
Institution:Conselleria de Salut i Consum del Govern de les Illes Balears
Repository:Docusalut
Language:English
OAI Identifier:oai:docusalut.com:20.500.13003/19904
Online Access:https://hdl.handle.net/20.500.13003/19904
Access Level:Open access
Keyword:Child
Male
Accelerometry
Calibration
Sedentary Behavior
Female
Humans
Adolescent
Reproducibility of Results
Surveys and Questionnaires
Exercise
Ejercicio Físico
Humanos
Reproducibilidad de los Resultados
Conducta Sedentaria
Calibración
Acelerometría
Femenino
Encuestas y Cuestionarios
Niño
Adolescente
Masculino
Children and adolescents
Self-reported physical activity
Short PAQ
Validation
Description
Summary:Background Validation of self-reported tools, such as physical activity (PA) questionnaires, is crucial. The aim of this study was to determine test-retest reliability, internal consistency, and the concurrent, construct, and predictive validity of the short semi-quantitative Physical Activity Unit 7 item Screener (PAU-7S), using accelerometry as the reference measurement. The effect of linear calibration on PAU-7S validity was tested. Methods A randomized sample of 321 healthy children aged 8-16 years (149 boys, 172 girls) from the nationwide representative PASOS study completed the PAU-7S before and after wearing an accelerometer for at least 7 consecutive days. Weight, height, and waist circumference were measured. Cronbach alpha was calculated for internal consistency. Test-retest reliability was determined by intra-class correlation (ICC). Concurrent validity was assessed by ICC and Spearman correlation coefficient between moderate to vigorous PA (MVPA) derived by the PAU-7S and by accelerometer. Concordance between both methods was analyzed by absolute agreement, weighted kappa, and Bland-Altman statistics. Multiple linear regression models were fitted for construct validity and predictive validity was determined by leave-one-out cross-validation. Results The PAU-7S overestimated MVPA by 18%, compared to accelerometers (106.5 +/- 77.0 vs 95.2 +/- 33.2 min/day, respectively). A Cronbach alpha of 0.76 showed an acceptable internal consistency of the PAU-7S. Test-retest reliability was good (ICC 0.71 p < 0.001). Spearman correlation and ICC coefficients of MVPA derived by the PAU-7S and accelerometers increased from 0.31 to 0.62 and 0.20 to 0.62, respectively, after calibration of the PAU-7S. Between-methods concordance improved from a weighted kappa of 0.24 to 0.50 after calibration. A slight reduction in ICC, from 0.62 to 0.60, yielded good predictive validity. Multiple linear regression models showed an inverse association of MVPA with standardized body mass index (beta - 0.162; p < 0.077) and waist to height ratio (beta - 0.010; p < 0.014). All validity dimensions were somewhat stronger in boys compared to girls. Conclusion The PAU-7S shows a good test-retest reliability and acceptable internal consistency. All dimensions of validity increased from poor/fair to moderate/good after calibration. The PAU-7S is a valid instrument for measuring MVPA in children and adolescents.