Reliability and validity of the Questionnaire on Annual Physical Activity Pattern: A validation study using combined heart rate and accelerometry data as an objective measurement

Introduction Physical activity (PA) is a modifiable lifestyle factor with great public health potential. However, it is still unclear which type, intensity, and temporal pattern of PA is most beneficial. Therefore, a Questionnaire on Annual Physical Activity Pattern (QUAP) for healthy adults was developed; focusing on a detailed assessment of past year PA. The aim was to investigate its test-retest reliability and validity. Materials and Methods: The self-administered 22-item questionnaire was evaluated in a study embedded into the European Prospective Investigation into Cancer and Nutrition (EPIC) project. Participants included men and women aged 47-82. Reliability was examined in 119 participants by comparing two measurements taken 6-8 weeks apart. Criterion validity was examined in 1109 participants by comparing the physical activity level (PAL) derived from an accelerometry device (Actiheart) to those from the questionnaire. Results Reliability was acceptable overall with intraclass correlation coefficients ranging from 0.64 to 0.87, with the exception of the domain sedentary behaviour (r=0.43).Regarding validity, the Spearman correlation coefficient was 0.33. Slightly higher correlations were found for men (rs=0.34), and participants with a lower BMI (rs=0.36). Bland-Altman plots showed a mean difference of -0.00 (SD=0.22) for total PA. Conclusions Our findings suggest that the questionnaire has acceptable reliability and validity comparable to other questionnaires. It enables the identification of domain-specific activity patterns and a differentiation between participants with similar energy expenditure but different behaviour. This additional information about distinct activity patterns may finally enable researchers to analyse PA more specifically in terms of health benefits and to provide more detailed public health recommendations.