Validity of electronically administered Recent Physical Activity Questionnaire (RPAQ) in ten European countries

Rajna Golubic, Anne M May, Kristin Benjaminsen Borch, Kim Overvad, Marie-Aline Charles, Maria Jose Tormo Diaz, Pilar Amiano, Domenico Palli, Elisavet Valanou, Matthaeus Vigl, Paul W Franks, Nicholas Wareham, Ulf Ekelund, Soren Brage, Rajna Golubic, Anne M May, Kristin Benjaminsen Borch, Kim Overvad, Marie-Aline Charles, Maria Jose Tormo Diaz, Pilar Amiano, Domenico Palli, Elisavet Valanou, Matthaeus Vigl, Paul W Franks, Nicholas Wareham, Ulf Ekelund, Soren Brage

Abstract

Objective: To examine the validity of the Recent Physical Activity Questionnaire (RPAQ) which assesses physical activity (PA) in 4 domains (leisure, work, commuting, home) during past month.

Methods: 580 men and 1343 women from 10 European countries attended 2 visits at which PA energy expenditure (PAEE), time at moderate-to-vigorous PA (MVPA) and sedentary time were measured using individually-calibrated combined heart-rate and movement sensing. At the second visit, RPAQ was administered electronically. Validity was assessed using agreement analysis.

Results: RPAQ significantly underestimated PAEE in women [median(IQR): 34.9 (22.3, 52.8) vs. 40.6 (32.4, 50.9) kJ/kg/day, 95%LoA: -44.4, 66.1 kJ/kg/day) and overestimated PAEE in men [45.9 (30.6, 71.1) vs. 45.5 (34.1, 57.6) kJ/kg/day, 95%LoA: -44.8, 102.6 kJ/kg/day]. Using individualised definition of 1MET, RPAQ significantly underestimated MVPA in women [median(IQR): 63.7 (30.5, 126.9) vs. 73.6 (47.8, 107.2) min/day, 95%LoA: -127.4, 311.9 min/day] and overestimated MVPA in men [90.0 (42.3, 188.6) vs. 83.3 (55.1, 125.0) min/day, 95%LoA: -134.8, 427.3 min/day]. Correlations (95%CI) between subjective and objective estimates were statistically significant [PAEE: women, rho = 0.20 (0.15-0.26); men, rho = 0.37 (0.30-0.44); MVPA: women, rho = 0.18 (0.13-0.24); men, rho = 0.31 (0.24-0.38)]. When using non-individualised definition of 1MET (3.5 mlO2/kg/min), MVPA was substantially overestimated (16 min/day, and 32 min/day in women and men, respectively). Revisiting occupational intensity assumptions in questionnaire estimation algorithms with occupational group-level empirical distributions reduced median PAEE-bias in manual (38.8 kJ/kg/day vs. 6.8 kJ/kg/day, p<0.001) and heavy manual workers (63.6 vs. -2.8 kJ/kg/day, p<0.001) in an independent hold-out sample [corrected].

Conclusion: Relative validity of RPAQ-derived PAEE and MVPA is comparable to previous studies but underestimation of PAEE is smaller. Electronic RPAQ may be used in large-scale epidemiological studies including surveys, providing information on all domains of PA.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Spearman’s correlation coefficients for the…
Figure 1. Spearman’s correlation coefficients for the associations of PAEE, MVPA and sedentary time assessed by the RPAQ with objectively measured corresponding variables by country and sex in 1343 women and 540 men.
Figure 2. Total PAEE and PAEE at…
Figure 2. Total PAEE and PAEE at work derived from the RPAQ, and bias for total PAEE before and after applying intensity distribution assumption.
Results are based on the“holdout sample”, with the following number of participants in each category: sedentary N = 264, standing N = 147, manual N = 58, heavy manual N = 12, representing 1/3 of participants in each group of the employed participants. Data are median (IQR), and median with 95% limits of agreement for bias.

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