Cross-cultural Adaptation of the Activity Questionnaire for Adults and Adolescents into Turkish and Investigation of its Validity and Reliability

Akın Süzer; Özlem Çinar Özdemir

doi:10.58600/eurjther1898

Authors

Akın Süzer Department of Therapy and Rehabilitation, Burdur Vocational School of Health Services, Burdur Mehmet Akif Ersoy University, Burdur, Turkey https://orcid.org/0000-0003-2435-9539
Özlem Çinar Özdemir Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Izmir Democracy University, İzmir, Turkey https://orcid.org/0000-0002-9205-5652

DOI:

https://doi.org/10.58600/eurjther1898

Keywords:

Physical Activity, Surveys and Questionnaires, Adult, Adolescent, Turkish People

Abstract

Objective: The Activity Questionnaire for Adults and Adolescents (AQuAA) is used to evaluate physical activity (PA) levels in different age groups. Its validity and reliability in the Turkish language have not been studied yet. This study aims to adapt the AQuAA into Turkish and to investigate its validity and reliability.

Methods: A total of 124 volunteers were included in the study. After the Turkish adaptation of AQuAA, the AQuAA-Tr version was administered to the volunteers for test-retest reliability twice, with an interval of two weeks, and the International Physical Activity Questionnaire Short Form (IPAQ-SF) for criterion validity. For construct validity, the step counts of the volunteers were followed for two weeks with the Samsung Health^® smartphone pedometer application. The reliability of the AQuAA-Tr was evaluated with intra-class correlation coefficients (ICC). Spearman correlation coefficients (r) were used to analyze the relationships between continuous variables.

Results: A total of 72 adolescents (51 females and 21 males, mean age 14.5 ± 0.1 years) and 52 young adults (32 females and 20 males, mean age 25.8 ± 1.3 years) participated in the test-retest reliability and criterion validity study. Thirty-four adolescents (26 female, 8 male, mean age 14.7 ± 0.2 years) and 39 young adults (27 female, 12 male, mean age 25.6 ± 1.5 years) were included in the construct validity study. The test-retest reliability of the questionnaire was in the range of strong to very strong (ICC = 0.704 to 0.982) in adolescents and moderate to strong (ICC = 0.606 to 0.851) in adults for different levels of PA. In the context of the criterion validity, although there were moderate to strong correlations (r = 0.413 to 0.768) between some PA levels of the IPAQ-SF and AQuAA-Tr in adolescents and moderate correlations (r = 0.422 to 0.525) in adults, the correlations were mostly weak or negligible. In relation to construct validity, although there were moderate correlations (r = 0.435 to 0.504) between the Samsung Health^® data and some PA levels of the AQuAA-Tr in adults, the correlations were mostly weak or negligible. There were no correlations between the Samsung Health^® data and AQuAA-Tr in adolescents.

Conclusion: The reliability of the AQuAA-Tr was confirmed in both adolescents and adults. However, the criterion and construct validity of the AQuAA-Tr were not confirmed for either adolescents or adults. Introducing a PA questionnaire, which can provide detailed information about sedentary, light, moderate, and vigorous PA scores separately and total PA scores and allows the evaluation of PA in different categories, into our language is considered beneficial. Yet, the results of AQuAA-Tr should be interpreted carefully in the clinic.

Metrics

Metrics Loading ...

References

Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, George SM, Olson RD (2018) The physical activity guidelines for Americans. JAMA - J Am Med Assoc 320:2020-2028. https://doi.org/10.1001/jama.2018.14854

Kyu HH, Bachman VF, Alexander LT, Mumford JE, Afshin A, Estep K, Veerman JL, Delwiche K, Iannarone ML, Moyer ML, Cercy K, Vos T, Murray CJL, Forouzanfar MH (2016) Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013. BMJ 354:i3857. https://doi.org/10.1136/bmj.i3857

Westerterp KR (2009) Assessment of physical activity: A critical appraisal. Eur J Appl Physiol 105:823-828. https://doi.org/10.1007/s00421-009-1000-2

Ainsworth B, Cahalin L, Buman M, Ross R (2015) The current state of physical activity assessment tools. Prog Cardiovasc Dis 57:387-395. https://doi.org/10.1016/j.pcad.2014.10.005

Strath SJ, Kaminsky LA, Ainsworth BE, Ekelund U, Freedson PS, Gary RA, Richardson CR, Smith DT, Swartz AM (2013) Guide to the assessment of physical activity: Clinical and research applications: A scientific statement from the American Heart association. Circulation 128:2259-2279. https://doi.org/10.1161/01.cir.0000435708.67487.da

Young DR, Hivert M-F, Alhassan S, Camhi SM, Ferguson JF, Katzmarzyk PT, Lewis CE, Owen N, Perry CK, Siddique J, Yong CM (2016) Sedentary Behavior and Cardiovascular Morbidity and Mortality: A Science Advisory From the American Heart Association. Circulation 134:e262-79. https://doi.org/10.1161/CIR.0000000000000440

Atencio-Osorio MA, Carrillo-Arango HA, Correa-Rodríguez M, Rivera D, Castro-Piñero J, Ramírez-Vélez R (2021) Youth leisure-time sedentary behavior questionnaire (Ylsbq): Reliability and validity in colombian university students. Int J Environ Res Public Health 18:1-10. https://doi.org/10.3390/ijerph18157895

Helmerhorst HJF, Brage S, Warren J, Besson H, Ekelund U (2012) A systematic review of reliability and objective criterion-related validity of physical activity questionnaires. Int J Behav Nutr Phys Act 9:103. https://doi.org/10.1186/1479-5868-9-103

Chinapaw MJM, Slootmaker SM, Schuit AJ, Van Zuidam M, Van Mechelen W (2009) Reliability and validity of the activity questionnaire for adults and adolescents (AQuAA). BMC Med Res Methodol 9:1-8. https://doi.org/10.1186/1471-2288-9-58

Slootmaker SM, Chin A Paw MJM, Schuit AJ, Seidell JC, Van Mechelen W (2005) Promoting physical activity using an activity monitor and a tailored web-based advice: Design of a randomized controlled trial [ISRCTN93896459]. BMC Public Health 5:. https://doi.org/10.1186/1471-2458-5-134

Oostdam N, van Mechelen W, van Poppel M (2013) Validation and responsiveness of the AQuAA for measuring physical activity in overweight and obese pregnant women. J Sci Med Sport 16:412-416. https://doi.org/10.1016/j.jsams.2012.09.001

Liu RDK, Buffart LM, Kersten MJ, Spiering M, Brug J, van Mechelen W, Chinapaw MJM (2011) Psychometric properties of two physical activity questionnaires, the AQuAA and the PASE, in cancer patients. BMC Med Res Methodol 11:30. https://doi.org/10.1186/1471-2288-11-30

Beaton DE, Bombardier C, Guillemin F, Ferraz MB (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976) 25:3186-3191. https://doi.org/10.1097/00007632-200012150-00014

Altman DG (1990) Practical statistics for medical research. CRC press

Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35:1381-1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB

van Poppel MNM, Chinapaw MJM, Mokkink LB, van Mechelen W, Terwee CB (2010) Physical activity questionnaires for adults: a systematic review of measurement properties. Sports Med 40:565-600. https://doi.org/10.2165/11531930-000000000-00000

Lee PH, Macfarlane DJ, Lam TH, Stewart SM (2011) Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act 8:115. https://doi.org/10.1186/1479-5868-8-115

Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, Tokgozoglu L (2010) International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills 111:278-284. https://doi.org/10.2466/06.08.PMS.111.4.278-284

Nolan M, Mitchell JR, Doyle-Baker PK (2014) Validity of the Apple iPhone® /iPod Touch® as an accelerometer-based physical activity monitor: a proof-of-concept study. J Phys Act Health 11:759–769. https://doi.org/10.1123/jpah.2011-0336

Manohar CU, McCrady SK, Fujiki Y, Pavlidis IT, Levine JA (2011) Evaluation of the Accuracy of a Triaxial Accelerometer Embedded into a Cell Phone Platform for Measuring Physical Activity. J Obes Weight Loss Ther 1:. https://doi.org/10.4172/2165-7904.1000106

Johnson M, Turek J, Dornfeld C, Drews J, Hansen N (2016) DIGITAL Validity of the Samsung Phone S Health application for assessing steps and energy expenditure during walking and running : Does phone placement matter ? 2:1-8. https://doi.org/10.1177/2055207616652747

Schober P, Boer C, Schwarte LA (2018) Correlation Coefficients: Appropriate Use and Interpretation. Anesth Analg 126:1763-1768. https://doi.org/10.1213/ANE.0000000000002864

Kemper H, Ooijendijk WTM, Stiggelbout M (2000) Consensus on the Dutch Healthy Physical Activity Guidelines. TSG 78:180-183

Crespo CJ, Smit E, Troiano RP, Bartlett SJ, Macera CA, Andersen RE (2001) Television watching, energy intake, and obesity in US children: results from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med 155:360-365. https://doi.org/10.1001/archpedi.155.3.360

Sallis JF, Saelens BE (2000) Assessment of physical activity by self-report: status, limitations, and future directions. Res Q Exerc Sport 71 Suppl 2:1-14. https://doi.org/10.1080/02701367.2000.11082780